9 Ways to Fight Asthma and Allergies
How to beat asthma
If you have asthma, there's a good chance that an underlying allergy—whether it's to dust mites, pollen, cockroaches, or cat dander—is playing a key role in your breathing problems. (About 60% to 90% of people with asthma have allergic asthma.)
The first step is to avoid the allergen, but that's not always possible or sufficient to stop symptoms, like coughing, wheezing, and shortness of breath.
That's where medication comes in. Here are some common drugs used to treat allergic asthma.
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"These are the gold standard and they work by basically blocking the inflammation response in the lungs," says Mitchell H. Grayson, MD, associate professor of pediatrics, medicine, microbiology, and molecular genetics at the Medical College of Wisconsin in Milwaukee.
Known as "controller" medications, they take a few days to workso they aren't for short-term symptom control. (Here are some inhaled corticosteroids drug names and potential side effects.)
Leukotriene receptor antagonists
The pros are that they come in pill form and they have few side effects. The drawback is that the effect is generally mild. "If you have mild persistent or mild intermittent asthma, sometimes they will work quite well," Dr. Mitchell says.
Short-acting beta agonists
"We warn everyone who has asthma to carry one of these," says Dr. Poole.
Albuterol and related medications such as Maxair (pirbuterol) are bronchodilators, meaning they work by rela the airways. These drugs shouldn't be used frequently (1-2 times a week or less). People with exercise-induced asthma can use one 20 minutes before working out to prevent problems, Dr. Mitchell says.
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Long-acting beta agonists
Common products include Advair (a combination of the beta agonist fluticasone and the steroid salmeterol) and Symbicort (a combination of the beta agonist formoterol and the steroid budesonide). A combination formulation (a beta agonist plus a steroid) is important as long-acting beta agonists on their own can worsen asthma.
"If you have an allergy component to your asthma, they can be beneficial," says Dr. Poole. Antihistamines are usually combined with inhaled corticosteroids or Singulair and can reduce inflammation in both the nose and the lungs. They are cheap, available over-the-counter, and have relatively few side effects. They're quick acting so may help if you're allergic to cats and are about to visit a friend with one, says Dr. Grayson. Antihistamines shouldn't be used chronically.
It won't help non-allergic asthma, a type triggered by exercise, cold air, or other non-allergy irritants. (About 10% to 40% of all asthma cases are non-allergic).
Xolair is expensive so it is usually given in more severe cases, says Dr. Mitchell, such as people who have repeat trips to the emergency room. It's an injected drug and has a boxed warning about a risk of anaphylaxis, a potentially life-threatening allergic reaction. (Doctors monitor for such reactions after giving the injections.)
If you still have symptoms and a controller medication isn't doing enough to stop them, your doctor might want to give you oral steroids for four to five days to get you back into good health. Oral steroids, such as prednisone take 4-6 hours to take effect, Dr. Mitchell says.
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It comes in pill form, which is a plus. But there are potential side effects ranging from diarrhea to neurological problems if the dose gets too high.
Patients have to have regular blood tests and the drug is "hardly used any more," says Dr. Poole.