The key treatments for asthma are steroids and other anti-inflammatory drugs. These asthma drugs both help to
control asthma and prevent asthma attacks. Steroids and other anti-inflammatory drugs work by reducing inflammation, swelling, and mucus
production in the airways of a person with asthma. As a result, the airways are less inflamed and less likely to react to asthma triggers, allowing people with
symptoms of asthma to have better control over their condition. The main types of anti-inflammatory drugs for better asthma control are steroids or corticosteroids. Other anti-inflammatory treatments include leukotriene modifiers,
anticholinergics, and immunomodulators. Inhaled steroids are the mainstay treatment for controlling asthma. The use of
inhaled steroids leads to: Steroids may help asthma symptoms during an attack but are slow acting and can take several hours to take effect. Dosages of inhaled
steroids in asthma inhalers vary. Inhaled steroids need to be taken daily for best results. Some improvement in asthma symptoms can be seen in 1 to 3 weeks after starting inhaled steroids, with the best results seen after 3 months of daily use. Inhaled steroid medications for better asthma control include:
Inhaled steroids come in three forms: the hydrofluoroalkane inhaler or HFA (formerly called a metered dose inhaler orMDI), dry powder inhaler (DPI), and nebulizer solutions. What Are the Side Effects of Inhaled Steroids?Inhaled steroids have few side effects, especially at lower doses. Thrush (a yeast infection in the mouth) and hoarseness may occur, although this is rare. Rinsing the mouth, gargling after using the asthma inhaler, and using a spacer device with metered dose inhalers can help prevent these side effects. Thrush is easily treated with a prescription antifungal lozenge or rinse. Inhaled steroids (asthma inhalers) are safe for adults and children. Side effects with these
anti-inflammatory asthma inhalers are minimal. Your doctor will prescribe the lowest dose that effectively controls your child's or your asthma. On a side note, many parents are concerned about giving their children "steroids." Inhaled steroids are not the same as anabolic steroids that some athletes take to build muscle. These steroids are anti-inflammatory drugs, the cornerstone
of asthma therapy. There are many benefits of using anti-inflammatory asthma inhalers to manage asthma. To learn more about using inhaled steroids in children, see WebMD's article on Childhood Asthma. What Are the Benefits of Using Inhaled Steroids?The benefits of inhaled steroids for better asthma control far exceed their risks, and include:
How Do Prednisone and Systemic Steroids Work to Increase Asthma Control?Using systemic steroids (steroids taken by mouth or by injection that can affect the entire body) such as methylprednisolone, prednisone, and prednisolone helps to treat severe asthma episodes, allowing people to gain better asthma control. Prednisone and other steroid drugs may be used to help control sudden and severe asthma attacks or in rare cases to treat long-term, hard-to-control asthma. Most often, prednisone or another steroid is taken in high doses for a few days (called a steroid burst) for more a severe asthma attack. Side effects of systemic steroids can include weakness, acne, weight gain, mood or behavior changes, upset stomach, bone loss, eye changes, and slowing of growth. These side effects rarely occur with short-term use, such as for an acute asthma attack. For in-depth information, see WebMD's article on Prednisone and Asthma. How Do the Leukotriene Modifiers Improve Asthma Control?Montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo) are called leukotriene modifiers. Leukotrienes are inflammatory chemicals that occur naturally in our bodies and cause tightening of airway muscles and production of mucus. Leukotriene modifier drugs help control asthma by blocking the actions of leukotrienes in the body. Studies show that these medications are helpful in improving airflow and reducing asthma symptoms. The leukotriene modifiers are taken as pills and have been shown to decrease the need for other asthma medications. These medications have also been shown to be effective in people with allergic rhinitis (nasal allergies) and may be effective in people with both allergic rhinitis and allergic asthma. The most common side effects of leukotriene modifiers are headache, nausea, vomiting, insomnia, and irritability. Leukotriene modifiers may interfere with other medications (for example, theophylline and the blood thinner
warfarin). Make sure you inform your doctor of all the medications you are taking. Mepolizumab
(Nucala) is a biologic therapy that has been found to control the blood cells that often trigger asthma. Nucala targets Interluken-5 (IL-5) which regulates the levels of blood eosinophils (the type of white blood cells that helps trigger asthma). Genetically engineered, Nucala keeps IL-5 from binding to eosinophils and, thereby, lowers the risk of a severe asthma
attack. Nucala is administered by injection once every 4 weeks and is meant to be used in conjunction with other asthma treatments as a maintenance medication. By using Nucala, patients have been found to not only experience fewer asthma incidents, but they are able to reduce the amount of their other asthma medications. Side effects include headache and a hypersensitivity reaction that can cause swelling of the face and tongue, dizziness, hives, and breathing problems. Omalizumab(Xolair), an immunomodulator, works differently from other anti-inflammatory medications for asthma . Xolair blocks the activity of IgE (a protein that is overproduced in people with allergies) before it can lead to asthma attacks. Immunomodulator treatment has been shown to help reduce the number of asthma attacks in people with moderate to severe allergic asthma whose symptoms are not controlled with inhaled steroids. Xolair, a prescription maintenance medication, is given by injection every 2 to 4 weeks. It's recommended for people with moderate to severe allergic asthma. Side effects may include redness, pain, swelling, bruising or itching at the injection site, joint pain, and tiredness. There is a slight increase in risk for problems with the heart and circulation to the brain in people using Xolair. It also carries a boxed warning about a severe, potentially life-threatening allergic reaction (anaphylaxis). Reslizumab (Cinqair) is also maintenance medication. It is used along with regular asthma medicines when those medicines cannot fully control your asthma. This medicine is given every 4 weeks as an intravenous injection over a period of about an hour. This drug works by reducing the number of a specific type of white blood cells called eosinophils that play a role in causing asthma symptoms. It can reduce severe asthma attacks. Side effects include anaphylaxis (a severe allergic reaction), muscle pain, and cancer. Tiotropium bromide (Spiriva Respimat) is a long-acting anticholinergic medication. Anticholinergics relax and enlarge (dilate) the airways in the lungs, making breathing easier
(bronchodilators). Tiotropium bromide is a maintenance medication used once a day along with other maintenance drugs when tighter control is needed for symptom relief . It is not a rescue inhaler. This drug may be used by individuals age 6 and older who have asthma. The most common side effects are pharyngitis, headache, bronchitis, and sinusitis. Other reactions include dizziness,
diarrhea, cough, allergic rhinitis, urinary tract infections and urinary retention, yeast infections in the mouth or throat, and high blood pressure (hypertension). What is the main side effect of inhaled corticosteroids?Inhaled corticosteroids can affect the hypothalamo-pituitary-adrenal axis, bone density and growth, eyes, skin and immunity including an increased risk of pneumonia. Clinicians are recommended to aim for the lowest possible dose to avoid these systemic side effects.
What are the side effects of corticosteroids?Possible side effects. increased appetite – potentially leading to weight gain.. thinned skin that bruises easily.. increased risk of infections.. mood changes, mood swings and depression.. diabetes.. high blood pressure.. osteoporosis (weak and brittle bones). Which of the following is an inhaled corticosteroid?Inhaled corticosteroids are medicines containing corticosteroids such as beclomethasone, budesonide, ciclesonide, flunisolide, fluticasone, or mometasone in a preparation designed to be inhaled through the mouth. Inhaled corticosteroids act directly in the lungs to inhibit the inflammatory process that causes asthma.
Which inhaled corticosteroid has the least side effects?Flunisolide causes fewer side effects but is also relatively less effective. Triamcinolone is generally less effective and causes more side effects than most of the other ICSs. Mometasone may be preferred if once-daily dosing is desired.
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Which of the following side effects is associated with the use of inhaled corticosteroids?
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