Medications To Treat The Symptoms of Asthma

Bronchial asthma is a multifactorial disease which is characterized by a chronic inflammatory process in the airways, bronchial hyperreactivity, and transient bronchial obstruction (local or generalized). Clinical symptoms of asthma can be paroxysms of coughing, wheezing and choking. Our pharmacy offers a significant number of drugs for the treatment of asthma symptoms. A rational choice of the optimal scheme of drug therapy is crucial for achieving control over asthma. So before using any medications, you must consult a doctor.

Common drugs used in the treatment of asthma

Antiallergic drugs

• Zyrtec is an antiallergic drug, histamine H1 receptor blocker, competitive histamine antagonist, hydroxyzine metabolite. It prevents development and facilitates the course of allergic reactions, has antipruritic and antiexudative action. It affects the early histamine-dependent stage of allergic reactions, limits the release of inflammatory mediators at the late stage of an allergic reaction, reduces the migration of eosinophils, neutrophils and basophils, stabilizes the membranes of mast cells. It also reduces capillary permeability, prevents the development of tissue edema, relieves spasm of smooth muscles, eliminates the skin reaction to the introduction of histamine, specific allergens, as well as cooling (with the “cold” urticaria), reduces histamine-induced bronchoconstriction in bronchial asthma;
• Cromolyn refers to anti-allergic anti-inflammatory anti-asthma drugs. The active substance of this drug is sodium cromoglycate. When used systematically, it reduces the symptoms of allergic inflammation in the respiratory system. Sodium cromoglycate inhibits both the early and late stages of an allergic reaction, preventing mast cell degranulation and the release of inflammatory mediators from them (histamine, bradykinin, a slow-acting substance, leukotrienes, prostaglandins). Thanks to these properties, Cromolyn prevents bronchospasm caused by contact with an allergen or other provocative factors (cold air, physical stress, stress). In addition, it allows to reduce the use of other anti-asthma drugs (bronchodilators, glucocorticosteroids). The effect of the drug develops gradually. After 4-6 weeks of using Cromolyn, the frequency of asthma attacks decreases. Treatment should be long. With the abolition of the drug, attacks of asthma may resume. The drug is not used for the relief of acute attacks of bronchial asthma;
• Alocril belongs to antiallergic agents. The active ingredient in this drug is nedocromil. When used systematically, it reduces the symptoms of allergic inflammation in the respiratory system. Nedocromil, a mast cell membrane stabilizer, inhibits both the early and late stages of an allergic reaction, preventing mast cell degranulacin and the release of inflammatory mediators from them (histamine, bradicinnin, a slow-acting substance, leukotrienes, prostaglandin D2). Due to these properties, Alocril prevents bronchospasm caused by contact with an allergen or other provocative factors (cold air, physical stress, stress). In patients with bronchial asthma, nedocromil suppresses antigen-induced allergic reactions of the immediate and delayed types, as well as reduces bronchial hyperreactivity. When applied topically, the agent has an anti-inflammatory effect. Prolonged continuous use reduces bronchial hyperreactivity, improves respiratory function, reduces the intensity and frequency of asthma attacks and the severity of coughing. It is more effective in light and moderate forms of asthma. The drug reduces the night symptoms and the need for daily administration of bronchodilator drugs. The therapeutic effect develops by the end of the first week;
• Aller-ease is the blocker of histamine H1 receptors. It practically does not have a sedative effect. The active substance of the drug – fexofenadine – is a pharmacologically active metabolite of terfenadine. The antihistamine effect of the drug occurs after 1 hour, reaching a maximum after 6 hours, and lasts for 24 hours;
• Singular is leukotriene receptor antagonist, a drug for the treatment of bronchial asthma and allergic rhinitis. The active substance – montelukast – selectively inhibits CysLT1 receptors of cysteinyl leukotrienes (LTC4, LTD4, LTE4) of the respiratory tract epithelium, and also prevents bronchospasm in patients with bronchial asthma caused by inhalation of cysteinyl leukotriene LTD4. Montelukast suppresses bronchospasm of the early and late phases by 75% and 57%, respectively, and reduces the number of eosinophils in the peripheral blood by an average of 9-15%. The therapeutic effect of Singular develops during the day;
• Children’s Wal-Fex is an antihistamine (a group of drugs that blocks histamine receptors, which leads to inhibition of their activity and elimination of signs of allergy). The main effect is the suppression of allergens in the circulatory system. The drug blocks the H1 receptors but does not inhibit the state of the central system (the patient can perform work with an increased psychomotor reaction). The drug effectively creates a blockade of biogenic amine receptors in the blood, after which their activity is reduced and the allergic reaction is eliminated. The agent reduces swelling of the mucous membranes, spasm in the bronchi, itching and vesicular rash. In addition to antihistamine drugs, there are other positive effects on the body: it expands the lumen of blood vessels, improves the bowels, improves gastric secretion, decreases vascular permeability, normalizes blood pressure and heart rate. The drug first relieves the symptoms of allergy, then the process of regeneration begins. Maximum suppression of allergens in the body is up to eighty percent;
• Zyrtec is a histamine H1 receptor blocker. The agent does not block cholinergic and serotonin receptors. It has an anti-allergic effect, does not cause any significant sedative effect. Zyrtec affects both the early and late stages of an allergic reaction.

Bronchodilatory drugs (Bronchodilators)

• Atrovent is a bronchodilator drug. It blocks the m-cholinergic receptors of the smooth muscles of the tracheobronchial tree (mainly at the level of the large and medium bronchi) and suppresses reflex bronchoconstriction. It prevents bronchospasm resulting from inhalation of cigarette smoke, cold air, the action of various drugs, and also eliminates bronchospasm associated with the influence of the vagus nerve;
• Theo-24 (theophylline) refers to phosphodiesterase inhibitors. Theophylline increases accumulation in the tissues of c-AMP, which reduces the contractile activity of smooth muscles. Theophylline dilates the bronchi, blood vessels (mainly vessels of the brain, skin and kidneys). It reduces pulmonary vascular resistance, lowers blood pressure in the pulmonary circulation. The agent increases renal blood flow. It has a moderate diuretic effect, inhibits platelet aggregation, has a stimulating effect on the respiratory center, increases the frequency and strength of heart contractions;
• Pentoxifylline is a vasodilating drug that improves microcirculation, angioprotector, xanthine derivative. Pentoxifylline improves blood rheological properties (fluidity) due to the effect on the pathologically changed red blood cell deformability, inhibiting platelet aggregation and reducing the increased blood viscosity. The agent improves microcirculation in the areas of impaired blood circulation. The mechanism of action is associated with the inhibition of phosphodiesterase and accumulation of cAMP in the smooth muscle cells of blood vessels and blood cells. The drug reduces the round focal tract and slightly dilates the coronary vessels;
• Trental (pentoxifylline) improves microcirculation in areas of impaired blood supply, improves the rheological properties of blood (fluidity) due to the impact on the pathologically changed red blood cell deformability, increases the elasticity of erythrocyte membranes, inhibits the aggregation of red blood cells and platelets and reduces the increased blood viscosity. The mechanism of action is associated with the inhibition of phosphodiesterase and accumulation of cAMP in vascular smooth muscle cells and in the blood cells. Pentoxifylline inhibits platelet aggregation and red blood cells, reduces the level of fibrinogen in the blood plasma and increases fibrinolysis, which leads to a decrease in blood viscosity and improves its rheological properties. It improves the supply of oxygen to tissues in areas of impaired blood circulation (including limbs, central nervous system, and to a lesser extent – in the kidneys);
• Spiriva is a bronchodilator drug. Tiotropium bromide (active ingredient of the drug) is a long-acting m-holinoblokator. The drug has the same affinity for the M1-M5 subtypes of muscarinic receptors. The result of the inhibition of M3 receptors in the respiratory tract is the relaxation of smooth muscles. The bronchodilatory effect is dose-dependent and lasts for at least 24 hours. A significant duration of action is probably associated with a very slow dissociation of the drug from the M3 receptors. The half-dissociation period is significantly longer than that of ipratropium bromide;
• Atrovent is a bronchodilator drug – blocker of m-cholinergic receptors. It blocks the m-cholinergic receptors of the smooth muscles of the bronchi (mainly at the level of the large and medium bronchi) and suppresses reflex bronchoconstriction. The agent has a structural similarity with the acetylcholine molecule. The medicine prevents bronchospasm resulting from inhalation of cigarette smoke, cold air, the action of various drugs, and also eliminates bronchospasm associated with the influence of the vagus nerve.

Glucocorticoid hormones

• Seretide. The combined drug contains salmeterol and fluticasone propionate, which have different mechanisms of action. Salmeterol prevents the occurrence of bronchospasm, fluticasone propionate improves pulmonary function and prevents exacerbations. Seretide may be an alternative for patients who simultaneously receive a β2-adrenoreceptor agonist and inhaled corticosteroids (from different inhalers);
• Flixotide (fluticasone propionate ) is a medication for inhalation use. In recommended doses, it has a pronounced anti-inflammatory and antiallergic effect, which leads to a decrease in the severity of symptoms and a decrease in the frequency of exacerbations of diseases accompanied by obstruction of the respiratory tract (bronchial asthma, chronic bronchitis, emphysema). Fluticasone propionate inhibits the proliferation of mast cells, eosinophils, lymphocytes, macrophages, neutrophils, reduces the production and release of inflammatory mediators and other biologically active substances (histamine, prostaglandins, leukotrienes, cytokines);
• Pulmicort (budesonide) is intended for inhalation use. Budesonide in the recommended doses has an anti-inflammatory effect in the bronchi, reducing the severity of symptoms and the frequency of exacerbations of asthma with a lower incidence of side effects than when using systemic corticosteroids. The agent reduces the severity of bronchial mucous edema, mucus production, sputum formation and airway hyperreactivity. The drug is well tolerated with long-term treatment and does not possess mineralocorticoid activity;
• Advair Diskus. The combined drug contains salmeterol and fluticasone propionate, which have different mechanisms of action. Salmeterol prevents the occurrence of bronchospasm, fluticasone propionate improves pulmonary function and prevents exacerbations;
• Symbicort is a combined medication for the treatment of bronchial asthma. The agent contains formoterol and budesonide, which have different mechanisms of action and have an additive effect in reducing the frequency of exacerbations of asthma. After inhalation at the recommended doses, budesonide has an anti-inflammatory effect on the bronchi, reducing the severity of symptoms and the frequency of exacerbations of bronchial asthma;
• Fostair contains beclomethasone dipropionate and formoterol, which have different mechanisms of action and exhibit an additive effect in reducing the frequency of exacerbations of bronchial asthma.

Combined medications

• Carbocisteine is a mucolytic drug. The mucolytic and expectorant action is due to the activation of sialic transferase, an enzyme of the goblet cells of the bronchial mucosa. It normalizes the proportion of acidic and neutral sialomucins of bronchial secretions, restores the viscosity and elasticity of mucus. It promotes the regeneration of the mucous membrane, normalizes its structure, activates the activity of the ciliary epithelium, restores the secretion of immunologically active IgA (specific protection) and the number of sulfhydryl groups of mucus components (non-specific protection), improves mucociliary clearance.

Bronchodilator drugs

• Berodual is a combined bronchodilator drug. It contains two components with bronchodilator activity: ipratropium bromide and fenoterol hydrobromide. Bronchodilation with inhalation ipratropium bromide is mainly due to local rather than systemic anticholinergic effects.
• Dilaterol is a remedy that relieves spasms in the bronchi and belongs to the b2-adrenergic group. Its active substance has the same name – clenbuterol and, acting on the receptors in the bronchi, leads to their relaxation. This effect lasts for twelve hours. At the same time, the puffiness disappears, the liquefaction is diluted and sputum begins to be easily removed, facilitating the condition of the respiratory tract.