Medicines and products for asthma

Medicines and Products for Asthma

Asthma medicines divide into two jobs, and confusing them is the commonest - and most dangerous - mistake in asthma care: relievers rescue you during an attack, preventers stop attacks from coming. Most asthma tragedies involve plenty of the first and too little of the second.

Relievers: For the Attack

• Short-acting bronchodilators (salbutamol/levosalbutamol): relax airway muscle within minutes. For symptoms and attacks - not for daily prevention. Needing it more than twice a week means your preventer needs attention.
• How to use during an attack: sit upright, puff through a spacer as your action plan directs (commonly 2-10 puffs in spaced doses), and escalate to emergency care if relief is incomplete or short-lived.

Preventers: The Foundation

• Inhaled corticosteroids (ICS) - beclomethasone, budesonide, fluticasone and others: the single most important asthma medicine. They heal the airway inflammation itself, taken daily even when you feel perfectly well. Low doses are remarkably safe; the doses swallowed in tablet steroids are the harmful ones, not these.
• ICS + long-acting reliever combinations (ICS-LABA): for moderate asthma and beyond; modern guidance also uses a low-dose ICS-formoterol inhaler as both preventer and reliever in many patients.
• Add-ons: leukotriene tablets (montelukast - with a warning to report any mood or behaviour changes), long-acting muscarinic inhalers, and for severe allergic/eosinophilic asthma, biologic injections (anti-IgE, anti-IL5 and others) that have transformed severe disease.

Rules That Keep Medicines Safe

• Inhaler technique beats inhaler choice - most "treatment failure" is technique failure; ask for a check at every visit, and use a spacer
• Never stop the preventer when well - feeling well is the medicine working
• Rinse your mouth after steroid inhalers to prevent oral thrush
• Avoid self-medicating with oral steroid tablets - repeated courses cause osteoporosis, diabetes, cataracts and adrenal damage; they are for short supervised bursts only
• Tell every doctor you have asthma - NSAIDs and beta-blockers can provoke attacks
• Buy inhalers from licensed pharmacies; check expiry; keep a spare reliever

Ayurvedic and OTC Products

Kanakasava (contains Dhatura - toxic if non-standard), Shwasakuthara Rasa (herbo-mineral - mercury/aconite content), Sitopaladi and Vasa-based syrups all circulate widely. None is a substitute for inhalers; some carry real toxicity risks in non-standard manufacturing; and hidden steroid adulteration in "guaranteed asthma cure" powders is a documented menace in India. Any such product is a decision to take with your pulmonologist informed.

Frequently Asked Questions

Are steroid inhalers addictive or harmful long-term? No. Inhaled steroids are not addictive, and low-dose inhaled use has an excellent safety record over decades - the inflammation they control is far more dangerous than the medicine. Uncontrolled asthma stunts children; inhaled steroids let them grow normally.

Why do I still wheeze despite taking my inhaler? Usually technique, adherence, dose or triggers - in that order. Get your technique watched, honestly audit missed doses, and review triggers before assuming the medicine failed.

Is nebulisation better than inhalers? For severe attacks and for those who cannot use inhalers (small children, the very breathless), yes. For routine control, a well-used inhaler with a spacer delivers the same drug more conveniently.

Can I use my relative's inhaler? Only the same reliever in an emergency. Preventer types, doses and combinations are individual - borrow nothing long-term.