Beta-2-agonists (Inhalers):

Asthma Inhaler for a Child

2009 Nucleus Medical Media, Inc.

Children will be more likely to benefit from inhaled medications if a spacer is used with metered-dose asthma inhalers . The University of Arizona offers a table that compares the different brands of spacers. A study, though, found that there was no difference in how medicine was delivered with homemade versus store-bought spacers. Talk to your doctor to find our what is right for you or your child.

Common names of beta-2-agonists (inhalers) include:

• ]]>Albuterol]]> (Proventil, Ventolin)
• ]]>Levalbuterol]]> (Xopenex MDI)
• ]]>Pirbuterol]]> (Maxair)

These drugs are bronchodilators, meaning they open the airways by relaxing the muscles around bronchial tubes. This can provide quick relief of acute symptoms. They can also be used as preventive medications prior to exercise. You must be careful not to overuse these drugs and contact your doctor immediately if your symptoms are not controlled.

Common side effects include:

• Fast heartbeat
• Headache
• Nervousness
• Tremor

Ipratropium Bromide (Atrovent)

]]>Ipratropium]]> is a bronchodilator (medicine that opens up narrowed breathing passages and may decrease mucus secretion). It is taken by inhalation to help control the symptoms of lung diseases, such as asthma, ]]>chronic bronchitis]]> , and ]]>emphysema]]> . Ipratropium helps decrease coughing, wheezing, shortness of breath, and troubled breathing by increasing the flow of air into the lungs.

When ipratropium inhalation is used to treat acute, severe attacks of asthma, bronchitis, or emphysema, it is used only in combination with other bronchodilators.

Common side effects include:

• Cough
• Dryness of mouth
• Unpleasant taste

Corticosteroids (Oral)

Common names include:

• ]]>Methylprednisolone]]> (intravenous)
• ]]>Prednisone]]> (oral)
• ]]>Prednisolone]]> (oral)

These drugs are sometimes used for a short duration to prevent the progression of moderate or severe symptoms, reverse inflammation, speed recovery, and reduce the risk of relapse.

Possible side effects include:

• Indigestion
• Lowered resistance to infections
• Abnormalities in glucose metabolism
• Increased appetite
• Mood alteration
• Fluid retention

Corticosteroids (Inhaler)

Common names include:

• Beclomethasone]]> (Beclovent, Vanceril, Qvar)
• ]]>Budesonide]]> (Pulmicort)
• ]]>Flunisolide]]> (Aerobid)
• ]]>Fluticasone]]> (Flovent)
• ]]>Mometasone]]>
• ]]>Triamcinolone]]>

These drugs suppress, control, and reverse inflammation. They can reduce the need for oral corticosteroids.

Possible side effects include:

• Oral thrush
• Cough

Corticosteroids (Oral)

Common names include:

• Methylprednisolone (Medrol)
• Prednisolone (Pediapred, Orapred)
• Prednisone (Deltasone, Orasone)

These drugs help reduce inflammation and prevent escalation of symptoms. Oral corticosteroids can produce more side effects than inhaled corticosteroids. Long-term use of oral corticosteroids is not generally recommended. However, your doctor may prescribe oral corticosteroids for long durations only when other treatments have failed to restore normal lung function and the risks of uncontrolled asthma are greater than the side effects of the medication.

Possible side effects include:

• Indigestion, nausea, and possibly bleeding in the stomach
• Lowered resistance to infections
• Growth suppression (in children)
• ]]>Obesity]]>
• Diabetes mellitus
• ]]>Hypertension]]> (high blood pressure)
• ]]>Osteoporosis]]> (thinning of the bones)
• ]]>Cataracts]]>
• Adrenal suppression
• Muscle weakness

Nonsteroidal Anti-inflammatory Inhalers

Common names include:

• ]]>Cromolyn sodium]]> (Intal)
• ]]>Nedocromil]]> (Tilade)

These drugs are used for long-term prevention of symptoms. They may modify inflammation and can be used as preventive treatment prior to exercise.

Possible side effects include:

• Unpleasant taste
• Cough

Long-acting Beta-2-agonists

Common names include:

• ]]>Salmeterol]]> (Serevent)
• ]]>Formoterol]]> (Foradil)

These drugs provide long-term prevention of symptoms, especially nighttime symptoms and are often added to anti-inflammatory therapy. They may also be used as preventive treatment prior to exercise or contact with a known allergen. However, they should not be used during an acute attack.

Possible side effects include:

• Rapid heart beat
• Tremor
• Difficulty sleeping, nervousness

Long-acting inhalers, like salmeterol, may increase the risk of asthma-related death, intubation (putting a tube in the windpipe to breathe), and hospitalization. Note: If you have any concerns, talk to your doctor.

Methylxanthines

Common names include:

• ]]>Theophylline]]> (Theo-Dur, Uniphyl, Slo-bid)

This type of drug provides long-term control and prevention of symptoms, especially nighttime symptoms. It works by opening the airways and relaxing the muscles around the bronchial tubes. It also increases the ability to clear mucus out of the airway.

Possible side effects include:

• Headache
• Fast heartbeat
• Difficulty with urination
• Nervousness
• Trouble sleeping
• Upset stomach

Immunomodulators

Common names include:

• ]]>Zafirlukast]]> (Accolate)
• ]]>Montelukast]]> (Singulair)
• ]]>Zileuton]]> —used for long term control and prevention in mild persistent asthma. Blocks the production of leukotrienes. Possible side effects include elevation of liver enzymes and interactions with other medicines
• ]]>Omalizumab]]> —used for long term control and prevention of moderate or persistent allergic asthma. Binds to IgE. This medicine is injected. Pain and bruising at the injection site may occur. ]]>Anaphylaxis]]> has been reported.

These drugs provide long-term control and prevention of symptoms in mild, persistent asthma. They work by blocking the action of leukotrienes—chemicals that play a role in inflammation and allergic reactions.