- Anticholinergics
- Inhaled short-acting beta agonists (SABAs for short)
- Systemic corticosteroids
Let's look at each category individually.
Anticholinergics
An anticholinergic is a type of asthma medicine that, when inhaled, acts as a bronchodilator. Ipratropium bromide (Atrovent) is the only anticholinergic currently approved for use in asthma. It is only approved, however, as an additional medicine to SABAs, to be used in the case of moderate to severe asthma attacks. It appears to be most useful in people with severe obstruction of their airways. Anticholinergics should not be used alone or as long-term treatment. Atrovent can sometimes be used to avoid taking albuterol (an SABA).
Short-Acting Beta Agonists
Short-acting beta agonists are also known as bronchodilators and are used in quick-relief inhalers. In fact, SABAs are the therapy of choice for relief of acute asthma symptoms / asthma attacks and prevention of exercise-induced asthma.Oral Systemic Corticosteroids
Inhaled steroids are the long-term treatment of choice in asthma. But steroids in pill or liquid form are sometimes used as quick-relief asthma medicines too. Oral steroids are sometimes given to help prevent a worsening of a moderate to severe asthma attack. They don't act as quickly as anticholinergics and SABAs, taking as long as 4 hours to reach maximum effectiveness. But they can speed resolution of airflow obstruction and reduce the rate of relapse, which can be quite beneficial in extreme cases.
In Summary
Most people will have a prescription for an inhaled short-acting beta agonist as their main quick-relief medicine. This is the preferred quick-relief medicine according to the national asthma treatment guidelines that guide doctors in prescribing asthma medicine. When to use this quick-relief medicine should depend on your asthma symptoms, possibly peak flow readings, and your Asthma Action Plan. Be sure to check with your doctor if you're not sure when to use your inhaler.
As a rule, though, if your asthma is under control, you should not need quick relief from asthma symptoms more than twice a week or so. If you do, there's a good chance your asthma control is slipping and you should notify your doctor.
You are most likely to have an anticholinergic quick-relief medicine or an oral steroid if your asthma attack becomes so severe you need to seek emergency care.
Source:
"Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma." NHLBI Guidelines for the Diagnosis and Treatment of Asthma. 28 Aug 2007. National Heart Lung and Blood Institute. 18 Dec. 2007 <http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf>
