Medicinal asthma therapy

The drugs used for asthma therapy can be divided into two groups: This difference is particularly important when it comes to adhering to the drug therapy: While the easing drugs are only used “when needed”, e.g. when breathing difficulties begin or to prevent night-time asthma attacks, the control drugs must be taken regularly and over a longer period of time in order to develop their effect. Which drugs are used for therapy depends on the severity of the disease. There is a step-by-step scheme for long-term drug treatment, which distinguishes four degrees of severity.

How the degrees of severity differ was described under Classification.

The so-called control drugs used for causal therapy (also known as controllers) are directed against the inflammatory reaction and try to bring it under control.
To relieve the symptoms of asthma, so-called relief medications are used (also known as reliever).

Stage 1: mild, intermittent asthma: Here no long-term therapy is necessary, but only the use of relief drugs (short-acting beta 2 – sympatomimetics) as needed. Stage 2: mild, persistent asthma: low-dose glucocorticoids (cortisone) should be used as inhalation sprays.

Additionally short-acting beta 2 – sympatomimetics. Stage 3: moderate persistent asthma: low to medium doses of glucocorticoids (cortisone). Additionally long-acting beta 2 – sympatomimetics Or A monotherapy with a medium-dose glucocorticoid (cortisone) Or The combination of a medium-dose glucocorticoid plus a leukotriene antagonist or theophylline Additionally, always a short-acting beta 2 – sympathomimetic if required.

Stage 4: Severe, persistent asthma: Inhalation of glucocorticoids (cortisone) in high doses plus a long-acting beta 2 sympathomimetic, possibly with an additional leukotriene modifier or theophylline. What to do if an acute asthma attack occurs? You can find more detailed information under: Asthma attack control medication: Glucocorticoids (cortisone) are used to inhibit the inflammatory reaction underlying bronchial asthma.

They cause the swelling and formation of mucus in the bronchi to subside. They are administered as breathing sprays so that they exert their effect as directly as possible at the target lung. Relief drugs: Here, beta 2 -sympatomimetics and parasympatholytics are mainly used.

Beta 2 sympatomimetics lead to a relaxation of the cramped bronchial muscles and thus quickly relieve the shortness of breath during an asthma attack. However, they do not affect the inflammation of the airways. Parasympatholytics also cause the bronchial muscles to relax, and they also reduce the viscosity of the secreted mucus.

Other medicines: theophylline: it has a mild bronchodilator effect and is also anti-inflammatory. Leukotriene modifiers: They suppress the inflammatory reaction. Recently antibody therapy has become available for the treatment of severe allergic asthma.

In this therapy, antibodies against the body’s own IgE are injected under the skin, thus inhibiting the IgE-mediated, allergic inflammatory reaction. In this way, the number of asthma attacks can be reduced or a reduction in the dose of glucocorticoids (cortisone) to be taken can be achieved. Cortisone is a so-called natural glucocorticoid.

It is produced by the body and has an effect on almost all cells of the body. Glucocorticoids are among the substances that, among other things, have an anti-inflammatory effect. Thus, the allergic reaction that occurs in asthma can be inhibited at all levels of the body.

For this purpose, cortisone intervenes in the metabolism of the individual cells. Within the framework of asthma therapy, a five-stage treatment plan has been established. With rather rarely occurring easy to middle asthma attacks one falls back to not-cortisone-containing medicines.

The more frequently and more heavily the attacks express themselves, the more Cortison is used in the therapy. Cortisone is used by asthmatics for various purposes. One is to lower the body’s permanent alarm in the airways.

In acute asthma attacks, the strong reaction of the body is to be reduced. In the long term, cortisone serves to reduce the symptoms and can thus counteract rapid chronification. Due to the different targets of cortisone, a distinction is made between fast-acting cortisone, which is taken during an asthma attack, and long-acting cortisone, which reduces the body’s basic alertness. The fast-acting cortisone is an emergency medicine and should therefore only be used in acute asthma attacks. The long-acting cortisone is a permanent medication which should be given in the early stages of asthma to prevent chronicity.