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The Asthma Section

Understanding Asthma Medications

Jolanta Piszczek is a pharmacist and Certified Asthma Educator (CAE).

Asthma medications are commonly divided into two groups: the “relievers” and the “controllers”. Many people will use both –“controllers” to prevent asthma symptoms from occurring and “relievers” to treat occasional asthma symptoms. These drugs can come in a variety of forms. (See Devices section for tips on how to use the different inhalers.)

Relievers

Reliever medications are also called “rescue inhalers” or “bronchodilators”. They are used to quickly alleviate symptoms such as cough, shortness of breath, wheezing and chest tightness. They do so by relaxing the muscle that constricts the airway, allowing it to open and receive more air. They do not, however, reduce inflammation and mucus in the lungs.

Relievers play a crucial role in asthma treatment because exacerbations can occur at any time, even if you take a controller medication to prevent symptoms. Some people will also use a reliever to open the airway right before exercise.

Relievers usually work within 5 to 10 minutes and last anywhere from 4 to 12 hours. Based on their duration of action, relievers are often grouped into two categories: short-acting and long-acting.

Short-Acting Relievers

Short-acting relievers usually last about 4 to 6 hours, and therefore they are often prescribed “every 4 to 6 hours as needed”.

Examples of short-acting relievers (in Canada) are:

Ventolin HFA (Salbutamol)
Apo-Salvent CFC Free (Salbutamol)
Bricanyl (Terbutaline)
Alupent (Orciprenaline)
Atrovent (Ipratropium)

Long-Acting Relievers

Long-acting bronchodilators can only be called “relievers” if they work fast enough to be able to open the airway during an exacerbation. Their action in the body lasts about 12 hours, and they are often prescribed “twice daily as needed.”

Quick and long-acting beta agonists are:

Oxeze (Formoterol)
Foradil (Formoterol)

Serevent (Salmeterol) is a long-acting beta-agonist that is not used as a reliever because it starts to work after about 30 minutes. It can be used to keep the airway open for 12 hours, and although it can be used alone for emphysema or CODP, as an asthma treatment it is combined with a controller medication, fluticasone, in an inhaler called Advair.

Bronchodilators are well tolerated when used within their prescribed doses. They can sometimes cause shakiness or tremor, a fast heart beat, nervousness or headaches.

Next Page: Controllers

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