Medications & Treatment   Current recommended therapy include a "stepwise" approach to gaining control of asthma. Based on individual patient needs, there are two appropriate approaches: start treatment at the step appropriate to the severity of the asthma at the time of evaluation and gradually step up if control is not achieved. This approach is more traditional. at the onset, administer therapy at a level higher than the patient's step of severity to gain rapid control. Once control is gained, therapy can be stepped down. The aim is to maintain control of asthma with the least amount of medication. The more aggressive approach of gaining prompt control with a higher level of therapy is now preferred. While no direct comparative data is available, studies indicate that the more aggressive approach in initial therapy will more rapidly suppress airway inflammation, restore lung function, and allow for eventual asthma control at lower does of anti-inflammatory therapy. There are two primary types of asthma medications: bronchodilators and anti-inflammatories. Bronchodilators open the airways of the lungs for easier breathing and to relieve symptoms. If you have symptoms less often than once or twice a week, a bronchodilator may be all that's needed to control the asthma. There are two types of bronchodilators: Short acting Beta2-agonists relax smooth muscles in the airways. They come in a variety of forms but most often are taken using a metered dose inhaler. Inhaled short-acting Beta2-agonists are normally used as treatment for asthma episodes or to prevent exercise-induced asthma. This type of medication is usually appropriate to take as soon as early warning signs appear in order to stop an episode. If you're using a short acting Beta2-agonists every day or more than 3 or 4 times a day, talk with your doctor. Such frequent use may indicate that the asthma is worsening and may require different medications. Long acting Salmeterol xinafoate is a long-acting inhaled bronchodilator that helps prevent asthma symptoms before they start. Theophylline is a mild-to-moderate bronchodilator that is usually taken by mouth. It's often used to control nighttime asthma symptoms and works after it reaches a certain level in the blood. It must be taken regularly to be effective. Anit-inflammatory drugs Anti-inflammatory drugs work to prevent the airways from becoming constantly irritated and swollen. They also may decrease the amount of mucus in the lungs and can help to make other drugs work better. They should be used on a regular, scheduled basis. Inhaled and oral corticosteroids are considered the most effective anti-inflammatory agents available. Inhaled corticosteroids are breathed directly into the lungs and generally produce few side effects. Corticosteroids can take as long as 1 to four weeks of use to become fully effective. If you use this medication and a bronchodilator, use the bronchodilator first to help open the airways and increase the effectiveness of the anti-inflammatory medication. Cromolyn (Intal) and nedocromil (Tilade) are nonsteroidal anti-inflammatory agents that prevent the allergic reactions that trigger asthma symptoms. They are usually used in mild-to-moderate cases of asthma to prevent symptoms. These drugs don't work once asthma symptoms have started. To be effective, they must be used daily as directed. Since asthma is very individual, the drugs and treatments your doctor prescribes will be tailored to meet your individual needs. What works for you may not work for someone else. It may take a while for you and your doctor to find the best asthma treatment plan and drugs. Because asthma can get better or worse with time, the treatment and drugs may change. Keep an updated list of medications that have been prescribed for you. Drug therapy should not only reduce or eliminate asthma symptoms; it should also prevent asthma episodes. To get the most out of your asthma medications, follow your treatment plan. Side effects of medications Side effects can tell the doctor that your dosage is not correct. If you experience these side effects, call the doctor immediately: increased heart rate palpitations irregular heart rate nervousness sleeplessness headache nausea vomiting stomach cramps diarrhea tremor shaking restlessness   ABOUT THIS PROGRAM | UNDERSTANDING ASTHMA MANAGING YOUR ASTHMA | CHILDREN WITH ASTHMA | FOR MORE INFORMATION | MAIN PAGE BACK TO HEALTHWORKS © 1998 Prairie Public Broadcasting, Inc.