Asthma medication

Unfortunately, this is basically just a long list for asthma. However, I have tried to put it into vaguely sensible divisions. The first big group is inhalers and then you have other oral medicines.

Inhalers

There are broadly speaking 5 categories of inhaler: short-acting bronchodilators, long-acting bronchodilators, inhaled steroids, inhalers with two different drugs in them and ipratropium. The smart ones among you will have figured out that the colour of the text below is related to the colour of the inhaler.

Short-Acting Bronchodilators

These drugs are short-acting Beta-2 agonists which are drugs that act on beta-2 receptors. If you read about the pathophysiology of asthma you will see they have opposite effect of IgE. The two important drugs to know about are:

• Salbutamol - trade names: Ventolin, Salamol
• Terbutaline - trade name: Bricanyl

These drugs are relievers. They are used to resolve acute exacerbations of asthma and the inhalers are blue.

Long-Acting Bronchodilators

These drugs are long-acting Beta-2 agonists which work in exactly the same way as short-acting bronchodilators but stay in the airway for up to twelve hours. The important ones are:

• Salmeterol - trade name: Serevent
• Formoterol - trade name: Oxis

These ones are preventers. They are used at regular intervals depending on symptoms - essentially, they aren't for acute exacerbations. The inhalers tend to be green.

Inhaled Steroids

These drugs have an anti-inflammatory effect. The important ones are:

• Beclometasone - trade name: Clenil
• Budesonide - trade name: Pulmicort
• Fluticasone - trade name: Flixotide

These are, like long-acting bronchodilators, preventers and not relievers. They are used at regular intervals and the dosage and frequency depends on the symptoms. Again they are NOT for acute exacerbations. The inhalers are usually brown though fluticasone is orange, apparently because they ran out of shades of brown.

Combination Inhalers

Does exactly what it says on the tin. It's a combination of a long-acting bronchodilators and an inhaled steroid. The two combinations currently available are:

• Fluticasone + Salmeterol (purple) - trade name: Seretide
• Budesonide + Formoterol (red) - trade name: Symbicort

The clever ones amongst you (i.e. none of you) will have noticed that these are combinations of long-acting or preventer therapy. That's because these are preventers, NOT relievers, used at regular intervals.

Anticholinergics

The only inhaled anticholinergic is:

• Ipratropium bromide - trade name: Atrovent

It is a preventer, NOT a reliever and used at regular intervals and the inhaler is grey. Ipratopium acts specifically on muscarinic receptors (a type of cholinergic receptor) to inhibit bronchoconstriction and mucus secretion.