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Types of Anti-Inflammatory Drugs

There are steroidal and non-steroidal anti-inflammatory drugs.

The most common ones include:

A-Steroids

  • beclomethasone (Beclovent®, Vanceril®, Becloforte®)
  • budesonide (Pulmicort®)
  • flunisolide (Bronalide®)
  • fluticasone (Flovent®)

B-Non-Steroidal

  • sodium cromoglycate (Intal®)
  • nedocromil (Tilade®)


Corticosteroid Inhalers
Corticosteroid drugs are the most effective Preventers. They work by reducing and preventing airway inflammation, swelling and mucus.

They must be used regularly and do not have an instant effect. This means they have no value whatsoever if an effect is needed straight away.


The Side effects of Corticosteroid Inhalers
There are few side effects at low doses

  • High doses might cause growth suppression; studies have shown children whose asthma is not controlled don't grow as quickly as other children.
  • side effects, in general, are usually restricted to the throat:
    • hoarseness and sore throat
    • Thrush or yeast contamination which can be prevented by rinsing the mouth and gargling, Using a holding chamber can also help prevent side effects.

Corticosteroid Tablets
Corticosteroid tablets or Prednisone®:

  • These are used when inflammation becomes severe
  • They reduce inflammation, swelling & mucus, and help bronchodilators work better
  • They start to work within a few hours, but may take several days to have a full effect
  • They are often used for short periods of time just to get the inflammation under control

There are lots of side effects if used on a long-term basis such as water retention, bruising, puffy face, increased appetite, weight gain and stomach irritation.

Other Preventers
Other preventers are Intal® and Tilade®. They are non-steroidal and again used to reduce inflammation.

  • sodium cromoglycate (Intal®)
    - for mild asthma
    - this can protect against the effects of cold air and exercise
    - it requires 4-6 weeks to be effective
    - it has few side effects.
  • nedocromil (Tilade®)
    - is similar to Intal®
    - is requires 3-4 weeks to be effective
    - it has a bad taste
    - it has fewer doses/canister; therefore, you will probably need more than one canister per month.
  • ketotifen (Zaditen®)
    - is used for mild asthma
    - it can be useful for asthmatics who also suffer from hay fever
    - it helps to reverse inflammation of the airways
    - it can be used orally and comes in tablets or syrup
    - it requires regular use of 8-12 weeks to become effective
    - it's side effects include drowsiness and weight gain

Bronchodilator Medications (Relievers)
Bronchodilators are the most extensively used medications for controlling unexpected asthma attacks and for preventing attacks brought on by physical activity or exercise. Theophylline is a bronchodilator that works by relaxing the muscles surrounding the airways.

These:-

  • Are rescue medications, therefore are used only when needed, and rarely on a regular basis (unless the asthma is under inadequate control)
  • Provide quick relief of symptoms shown
  • Relax the muscles of the airways
  • Are useful with exercise induced broncho-spasm
  • Are usually in blue devices


Types of Bronchodilator Drugs

The most common bronchodilators are:

  • B 2-Agonists
  • Anticholinergic Inhaler
  • Theophylline
  • B 2-Agonists
  • - salbutamol (Ventolin®, Apo-Salvent®, Novo Salmol®)
  • - fenoterol (Berotec®)
  • - terbutaline (Bricanyl®)
  • - pirbuterol (Maxair®)

B 2-Agonists are rescue medications which:

    • Relax the muscles around the airways which allows the breathing to become much easier within minutes.
    • Are used only when needed and rarely on a regular basis, unless the asthma is under inadequate control.
    • Make the airway muscle less likely to contract.
    • Are usually in blue devices.

When to use B<SUB2< sub>-Agonists

    • to relieve symptoms of cough, chest tightness, wheezing and shortness of breath
    • a few minutes before exercising or before exposure to any trigger known that might worsen asthma

Side effects of B 2-Agonists include:

    • trembling
    • nervousness
    • flushing
    • increased heart rate
  • Anticholinergic Inhaler

- Atrovent®

Atrovent opens the airways by blocking signals from the nervous system which cause the airways to become contracted. It takes one to two hours to reach its maximum effect; therefore, it shouldn't be used as an immediate emergency medication.

Side effects
 There are few side effects, a bad taste is probably the only one.

  • Theophylline
  • - TheoDur®
  • - Uniphyll®
  • - Phyllocontin®
  • -TheoLair®
  • Theophylline is an oral bronchodilator which works directly to relax the airway muscle.

It can be used at night-time if shortness of breath disturbs sleep or more frequently if the asthma condition is very severe. Theophylline levels can be affected by other medications – so it's important the physician is aware of all medications asthmatics are taking, including over-the-counter drugs.

Side effects include:

  • - Diarrhoea
  • - Nausea
  • - Heartburn
  • - Loss of appetite
  • - Headaches
  • - Nervousness
  • - Rapid heart beat
  • - Upset stomach
  • - Theophylline is not now commonly used in the treatment of asthma


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