Ashwin Kumar

The drugs used to treat asthma fall into two broad categories: controllers to prevent acute attacks and relievers that check acute symptoms when they occur. Some drugs do both.
Corticosteroids–marketed under numerous brand names, including Aerobid, Azmacort, Vanceril, Flovent and Pulmicovt–as the most effective agents for controlling airway inflammation and thus preventing acute asthma attacks.
Corticosteroids in pill or tablet form (such as Medrol) and in liquid form for children (such as Pediapred and Prelone) are prescribed for some patients with severe asthma.
Other inhaled anti-inflammatory controller drugs include Intal (cromolyn sodium), which is useful in preventing asthma brought on by exercise, and Tilade (nedrocromil sodium).
A new class of oral anti-inflammatory controller drugs acts by blocking a certain part of the inflammation pathway. This class of “anti-leukotriene” drugs include Zyflo (zileuton), Accolate (zafirlukast) and Singulair (montelukast).
Long-acting inhaled bronchodilators, such as Serevent (salmeterol), and long-acting oral bronchodilators, such as Alupent (metaproterenol), Proventil (albuterol sulfate), Theo-24 (theophylline anhydrous), and many others, are often used in conjunction with anti-inflammatory agents to control symptoms. They don’t provide immediate relief of symptoms, but their preventive action persists for many hours, which makes them useful in controlling attacks that might occur during hours of sleep.
Drugs to bring quick relief in acute asthma attacks are chiefly short-acting inhaled bronchodilators that act rapidly but for a relatively brief time to relax bronchial constriction. There are many short-acting bronchodilators to chose from, including Alupent or Metaprel (metaproterenol), Brethaire (terbutaline), and Ventolin or Proventil (albuterol). Although these drugs are effective in treating asthma, there is some controversy about their safety, especially when they are overused.

Scientific debate makes it clear, however, that an increasing need for inhaled bronchodilators, or a decreasing response to each dose, is a signal that the patient’s asthma is not being adequately controlled. Patients who have an increasing need for short-acting inhaled bronchodilators should be reevaluated promptly by their physicians.