ASTHMA MEDICATIONS

Inhaled therapy is the cornerstone of asthma treatment for children of all ages. Almost all children can be taught to effectively use inhaled therapy. Different age groups require different inhalers for effective therapy, so the choice of inhaler must be individualized. A stepwise approach to pharmacological treatment to achieve and maintain control of asthma should take into account the safety of treatment, potential of adverse effects, and cost of treatment required to achieve control. Medications to treat asthma can be classified as controllers or relievers. Controllers are medications taken daily on a long-term basis to keep asthma under clinical control chiefly through their anti-inflammatory effects. Relievers or rescuer are medications used on an as-needed basis that act quickly to reverse bronchoconstriction and relieve its symptoms.

Reliever- e.g. Salbutamol, Salmeterol, formeterol, Ipratropium, Theophylline

Controller- e.g. Inhaled & Betamethsone, flucetasone, Budesonide, ciclisonide

Reliever	Controller
Bronchodilator	Anti-inflammatory
Quickly relieve symptoms	Prevent asthma attacks
Onset of action faster	Takes time to act
Short duration of action	Long acting (12-24 hours)

Choice of Inhaled drug delivery system:

Age Group	Preferred Device	Alternate Device
< 4 years	Pressurized MDI + spacer with face mask	Nebulizer with Face Mask
4 – 6 years	Pressurized MDI + spacer with mouthpiece	Nebulizer with mouthpiece
> 6 years	DPI or breath-actuated pressurized MDI or pressurized MDI with spacer and mouthpiece	Nebulizer with mouthpiece