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What medications are best for the treatment of asthma? What are their side effects?

This is one of a series of articles answering questions in this POST: 108 Most Asked Questions For Drugstore Marketing Activities

Albuterol is usually the primary “rescue” or short-term medicine that is used to help acute asthma symptoms, such as coughing or wheezing. When a patient needs to use albuterol to relieve daytime symptoms more than twice per week, however, it usually reflects the need to use daily “controller” or anti-inflammatory medications. Many people are concerned about possible side effects of inhaled steroids, which are the largest group of “controller” medications available. When used in low- to medium-doses, however, inhaled steroids are very safe, even used on a daily basis for years. They are much safer than either multiple courses of oral steroids OR uncontrolled/undertreated asthma symptoms.

—-By Answered by John Carl, MD

Inhalers and nebulizers

Asthma medication comes in various forms, including tablets, liquids, injections, and inhalers. Many medications come as sprays or powders that need to be inhaled deep into your lungs. You can take these using either an inhaler or a nebulizer. Both can deliver fast-acting or long-term medicines. The device you use won’t change the effectiveness of the drug. It’s a matter of personal preference, and there are pros and cons to each method.


These handheld devices are used to pump medicine into your lungs. They require some coordination on the user’s part, because you have to press the apparatus and then inhale the medication. Inhalers are small, light, and portable, but that means they can also be easy to lose. If you or your child uses an inhaler, be sure to have backups. You don’t want to discover you’ve lost the inhaler when you’re having a flare-up.

Inhalers come in two types: metered dose inhaler (MDI) and dry powder inhaler (DPI).

An MDI delivers a measured spritz of medicine when you press the inhaler. Some MDI inhalers count the doses used, so you know when the medicine is about to run out. You can also use a spacer with an MDI inhaler to make it easier to use. A spacer attaches to the inhaler and “holds” the medicine in a small chamber, so you can inhale it when you’re ready. This works well for young kids and babies. You can attach either a mouthpiece or a facemask to the spacer for easy inhalation.

A dry powder inhaler releases medicine in powder form. To use it, you inhale powder forcibly out of the inhaler. This method requires a bit more work on the user’s part, and generally isn’t the best choice for young kids.


Nebulizers are plug-in or battery-powered devices that turn liquid asthma medicines into a mist that’s easy to inhale. They’re especially good for kids, because they’re automatic. To receive the medicine, you wear the nebulizer’s mouthpiece or facemask, and then breathe in the mist slowly. It usually takes between 5 and 10 minutes to breathe in the medicine from the nebulizer. The downside is that the machines need a power source and are less portable than inhalers. They can be bulky and loud.

Bronchodilators and anti-inflammatories

Asthma medications typically fall into two groups: bronchodilators and anti-inflammatories. They work by targeting the two main symptoms of asthma.

Bronchodilators target the tightened muscles in your lungs that are restricting your airways. These drugs help relax the lung muscles. This widens your airways and makes it easier for you to breathe. Bronchodilators are used for quick relief from asthma symptoms.

Anti-inflammatory agents target inflammation in your lungs. They reduce lung swelling and irritation, which helps improve your breathing. Anti-inflammatory drugs are used for daily maintenance to help prevent asthma symptoms.


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