Asthma Medicines

The use of epinephrine by injection for the treatment of asthma dates to as early as 1903. An aerosol form was developed around 1910. For many decades epinephrine was the only available medication for the treatment of bronchial asthma. Its use in the emergency setting has certainly saved countless numbers of lives.

In view of the fact that epinephrine is a nonselective agent that has potent effects on the heart and circulation, its use for treating bronchial asthma has declined. In elderly patients in particular, administration of epinephrine may result in increases in blood pressure and heart rate. These effects may contribute to the development of stroke and heart attack. For these reasons, emergency room treatment of bronchial asthma usually consists of the administration of a selective B-adrenergic agonist by nebulization.

For Anaphylaxis

Epinephrine is still an important medication for treating severe allergic reactions. It is the treatment of choice for a severe reaction known as anaphylaxis, a total body allergic reaction that may lead to collapse or shock. One example is the severe reaction to a bee sting in a sensitive individual. Injectable preparations of epinephrine that automatically inject a premeasured dose are available by prescription for highly allergic patients.

Over-the-Counter Medication

Over-the-counter nonprescription preparations of aerosol epinephrine should be avoided. These preparations are extremely weak and short acting with effects that may last only a few minutes, and therefore are commonly abused. With the far more effective treatment available for bronchial asthma I feel these agents would best be withdrawn since they may actually deter patients from seeking appropriate and necessary medical attention.

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Gold Salts

Gold salts have been adminitered to asthmatic patients based on the benefit of this drug in patients with rheumatoid arthritis. Small numbers of patients have been treated with gold injections or an oral gold compound called auranofin, and individual patients have been reported to reduce their symptoms and steroid requirements. Studies of large numbers of patients are lacking and this approach is not without adverse effects, since gold may also cause pulmonary fibrosis. For these reasons, the use of gold salts in the treatment of asthma must be regarded as investigational.

Troleandomycin

Troleandomycin (TAO) , an antibiotic, has been administered to asthmatic patients who have been steroid dependent. It appears to simply slow the excretion of one of the oral corticosteroids, methylprednisolone. Selected patients receiving methylprednisolone who are given troleandomycin have been able to reduce their steroid dosage. A similar effect of TAO has been noted on theophylline breakdown. For this reason, blood levels of theophylline are required of patients maintained on this medication during TAO administration. TAO has no anti-inflammatory effect of its own and may cause liver damage. It must be concluded that TAO has little place in the routine treatment of bronchial asthma.

Antihistamines

Antihistamines have long been regarded as contraindicated in asthmatics. This prohibition has stemmed from the drying effect antihistamines have on lung secretions and the greater potential for “plugging”of the bronchial tubes in asthmatic attacks. This adverse effect has clearly been documented in many patients. On the other hand, studies of large dosages of antihistamines in asthmatic patients have occasionally demonstrated a beneficial effect. This is not surprising, since histamine is one of the irritating substances involved in provoking an asthmatic attack.

Azelastine

Azelastine is an antihistamine that has undergone trials in Japan and other countries in patients with bronchial asthma. Despite early positive results no significant benefit has been proven in large numbers of patients. One adverse effect is drowsiness. This drug is not available in the United States.

Ketotifen

Another antihistamine, Ketotifen, has been available for use in Europe for bronchial asthma. Tb date, studies do not demonstrate a significant beneficial effect. This agent may also cause drowsiness. Until further studies of additional agents are made available there can be no basis for the routine use of antihistamines for treatment of bronchial asthma. Antihistamines may be carefully administered for nasal or sinus disease if the patient is closely monitored by a physician.

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Steroids are available online with www.isteroids.com. You can get the complete information on the different steroids on this website. You can book your pack of steroids online and also get information on them. Steroids are used mainly for body building and for exercising. If you are into body building you can easily get the process faster with the use of the steroids. The anabolic steroids that are available on this website are mainly meant for the body builders. Clenbuterol is a steroid that is used for the treatment of asthma. It was later found out that stays in the body for long time and hence its use for the treatment of asthma was discarded later on. You can search the complete list of steroids through this website. Steroids are not easily available, similarly the information on the steroids is also very difficult to get. However you can get all the details of the different steroids with the help of this website. You can buy steroids from www.isteroids.com using your credit card. You must take an experts advice before go for any particular steroid. For more information on the steroids, and to know the advantages and disadvantages of the steroids, simply visit this website.

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These days many new effective treatments are available in the world’s global market which cures asthma completely and involves a simpler process. Medical science and Pharmacology have played a vital and promising role in controlling this problem.

Asthma treatment with ephedrine have made possible to treat asthma more effectively and efficiently. This treatment involves extraction of gland derived from xanthenes and theophylline which are extensively used in treatment of asthma. This is proved to be the most effective, ever lasting and sate technique to cure asthma.

Out of some commonly known methods bronchodilator is also very good solution to asthma. Effective bronchodilator is available now days which rapidly controls this problem. This drug is the most vital and important to control the increasing mortality rate. This drug is also good because it does not create any harmful effect on to the human body and the patient can live a normal life there after.

The main point here is that the patient should use these methods of controlling asthma after consulting to their doctors. Moreover the patient should not only use medicines only but should take adequate rest and control themselves from not to inhale pollutants and wind in to their bodies.

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Inhaled Corticosteroids

With greater emphasis being placed on the inflammatory nature of bronchial asthma, the anti-inflammatory agents have achieved greater importance in treatment. The most effective anti-inflammatory agents are corticosteroids, limited to oral or injectable forms until relatively recently, when an inhalation form became available. The topically active inhaled steroids have radically changed and improved the treatment of bronchial asthma. Patients who would have previously been dependent on oral steroids with serious lifetime consequences have been able to be maintained on the spray with virtually no side effects. Those patients with milder forms of asthma but who overuse bronchodilator drugs have been able to decrease their consumption of these agents, reducing the adverse effects of these drugs and perhaps avoiding fatal attacks.

How They Work

Corticosteroids reduce inflammation in the bronchial tubes. Steroids prevent the late phase response and reduce bronchial hyperresponsiveness. The inhaled corticosteroids (bec1omethasone dipropionate, triamcinolone acetonide, flunisolide, budesonide, fluticasone) are “topically active” and achieve their effect on the surface of the bronchial lining. Many of these same agents are used as creams or ointments for skin conditions. If you visualize the lining of the bronchial tube in asthma to be red and inflamed, then the application of the steroid spray is not unlike applying a steroid cream to a skin rash. The results may be a dramatic reduction in inflammation and irritability.

It must be emphasized that for corticosteroids to be effective they must be administered regularly. Tho often patients may abandon a steroid inhaler before it has a chance to work. Compared to the B-adrenergic agonists, corticosteroids do not have an immediate effect and cannot rapidly reduce symptoms. For this reason patients may stop this important medication before it has had an adequate trial. Remember that the primary purpose of corticosteroid sprays is prevention. If used correctly these agents may provide long-term control over asthma. Another major benefit of the regular use of inhaled corticosteroid sprays is the reduced need for B2-agonists, which is extremely important in view of the detrimental effects noted from overusing B2-adrenergic agents.

Specific Agents

The inhaled corticosteroids, their brand names, and the forms that are available. Beclomethasone dipropionate, triamcinolone acetonide, budesonide, fluticasone propionate, and flunisolide are available in the United States. Budesonide (Pulmicort Thrbuhaler) and fluticasone propionate (Flovent Rotadisk) are now available in multidose DPI dispensers. These two agents have only recently been introduced into the United States.

Dosage and Administration

Inhaled corticosteroids may be given in varying dosages depending on individual patients. A common starting dose would be between 100 and 400 micrograms (l1g) per day. High doses (600-2000 ug) may be necessary for control of severe asthma. Inhaled corticosteroids are best given on a twice-a-day basis.

Current information suggests that the inhaled corticosteroids are not equivalent on a per puff or microgram (u.g) basis. Fluticasone propionate appears to be the most potent agent in laboratory studies. Although these laboratory studies appear to correlate with increased effectiveness in patients, direct comparison of the five agents is lacking. The delivery systems used to administer inhaled corticosteroid may affect the effectiveness of the specific medication. For example, when budesonide is administered as a DPI (Thrbuhaler), twice the amount of medication is delivered when compared to the MDI. Budesonide is only available in the DPI form in this country. Fluticasone propionate is available in three dosages (44, 110, and 220 u.g per puff) which allows increased flexibility in adjusting the appropriate dosage for the individual patient.

“High-Dose” Sprays

In view of the large number of sprays needed on a daily basis, “high-dose” sprays have been made available with up to 250 u.g per puff of corticosteroid. These inhalers allow patients with stable asthma to be maintained on as little as two puffs twice a day.

Adverse Effects and How to Prevent Them

The primary side effect of inhaled corticosteroids is development of a yeast infection known as candidiasis in the mouth or throat. With large numbers of puffs from the “low-dose” inhaler or the use of the “high-dose” preparation, there is a greater risk of this infection. This is a local infection and the rare instances of its spreading outside the mouth have typically occurred in patients with lowered immunity who took no precautionary steps. Several preventive steps can be taken to avoid the infection, including rinsing the mouth and spitting after spraying. If unable to rinse the patient may simply drink, flushing residual medication away from the mouth and throat. Passage through the digestive tract leads to rapid breakdown of the drug but rinsing is still preferred. Another extremely helpful step in administering inhaled steroid aimed at reducing the risk of yeast infection is a spacer. This simple device improves delivery of the steroid to the lung as well as reducing the amount likely to be deposited in the mouth and throat. Triamcinolone acetonide (Azmacort) incorporates a spacer in its MDI.

If candidiasis is discovered, treatment should be given promptly, consisting usually of an antifungal agent (nystatin, clotrimazole) prepared as an oral suspension or as a lozenge. It is rare that development of an oral yeast infection will recur and prompt discontinuation of inhaled steroids. In patients with recurrent yeast infection a switch to another anti-inflammatory agent such as cromolyn sodium or nedocromil is indicated.

Another infrequent side effect of inhaled steroids is an effect on the voice. This uncommon effect is usually noted as hoarseness and may be alleviated with a spacer and by a temporary reduction in dosage. Patients who complain of changes in voice should have a careful examination of the vocal cords to ensure that there is no other explanation for the abnormality.

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