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Preventer Treatment
The introduction of inhaled corticosteroids greatly improved asthma
control. They control asthma attacks by preventing
the inflammatory reaction in the lung and the associated swelling and discharge of the mucous
membrane lining in the airway. They do not give instant relief, their benefit is acquired over time and they
need to be used continuously. Preventer treatment in the form of tablets or capsules by
mouth is also available.
Patients are encouraged to adjust the dose of their
preventer (brown or maroon) inhaler to achieve the best control - i.e. the lowest need for the
reliever inhaler. There is evidence that excessive use of reliever (blue) inhalers
increases the sensitivity of the airway to allergens, and may tend to cause the asthma to get
worse. In practice adequate use of preventer (brown) inhalers appears to keep the asthma
from getting out of control. All inhaled steroids are absorbed into the bloodstream to
an extent: newer steroids such as fluticasone and mometasone are almost entirely destroyed in
the liver, which means that extremely little circulates in the blood stream. Older
steroids such as beclomethasone diproprionate and budesonide are still regarded as very safe,
although these drugs do enter the blood stream to a greater extent than fluticasone and
mometasone..
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Preventer Inhalers:
Anti-inflammatory: Sodium Cromoglycate (Intal, Cromogen); Nedocromil Sodium (Tilade)
Steroids: Beclomethasone (Becotide, Qvar, Asmabec), Fluticasone (Flixotide) and Budesonide
(Pulmicort)
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Preventer Tablets and Capsules:
Steroid: With proper asthma management, steroid treatment (e.g.
prednisolone) taken by mouth should
rarely be needed, and then for a short time only to resolve an acute breathing
difficulty.
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Leukotriene
Antagonists:
Leukotriene receptor antagonists (LTRAs) are drugs taken by mouth that are
effective in blocking exercise-induced wheeze, and also help in a proportion of people
with asthma of all severities, especially those with sensitivity to aspirin and related
drugs. They are used as adjunct therapy in patients not controlled by inhaled steroids.
More recently, LTRAs have been shown to be active in the treatment of rhinitis. They
include Montelukast (Singulair) and Zafirlukast
(Accolate).
Recommended Websites
National Asthma
Campaign
General information from the UK's main asthma
charity providing articles and information relating to all aspects of asthma management.
Asthma, Allergy and Intolerance
Information
Whatever your allergy or intolerance, this is a really
useful source of information. You can search through articles on allergies, find out about
allergy organisations, as well as the latest publications and products available.
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Allergy Clinic
