Asthma and Airway Centre

Medication

Understanding Anti-inflammatory Medication
For Regular Use -- Even When You Are Feeling Well
This group of medication provides long-term control of your asthma and prevents asthma symptoms.

Anti-inflammatory Medication

1. Non Steroidal Anti-Inflammatories

Cromoglycate (Intal®)
Nedocromil Sodium (Tilade®)

Use / Action

Slow action
Prevents swelling and reduces mucus secretions that cause narrowing of the airways
Prevents twitchiness of the airways when taken before exposure to known allergens

Common Side Effects / Preventive Measures

Rare side-effects
May trigger cough when inhaled
Most effective when used regularly over prolonged periods
Do not use for acute attacks

2a. Inhaled Steroids

Beclomethasone dipropionate
Qvar® Vanceril®,
Flunisolide (Bronalide®)
Budesonide (Pulmicort®)
Triamcinolone (Azmacort®)
Fluticasone propionate (Flovent®)

Use / Action

Slow action
Prevent swelling and reduces mucus secretions in the airways
Prevents twitchiness of the airways
More effective than non steroidal anti-inflammatory drugs above

Common Side Effects / Preventive Measures

Hoarseness or oral thrush
Rinsing mouth after use will reduce the risk of side effects
May use with an Aerochamber® to reduce possibility of side effects

Combination Controller Inhaler

Fluticasone+Salmeterol (Advair®)

Use / Action

Reduce airway inflammation and prevent asthma symptoms

Common Side Effects / Preventive Measures

Anti-inflammatory and long acting bronchodilator in one inhaler
Rinse mouth after use
For regular use
Do not increase dose
Report thrush, headache and/or rash

2b. Leukotrienes/Pills

Zafirlukast (Accolate®)

Use / Action

Blocks and prevent airway inflammation

Common Side Effects / Preventive Measures

Take Accolate® on an empty stomach
Caution with wafarin, ASA,antibiotics and theophylline.

Montelukast (Singulair®)

Use / Action

Blocks and prevent airway inflammation and airway narrowing

Common Side Effects / Preventive Measures

Singulair® - no problem when taken with food
Children and adult pills available
Do not use for quick relief
Report rash, diarrhea and/or nausea

3. Tablets

Ketotifen (Zaditen®)

Use / Action

Slow action, takes months to see improvement
Possibly effective in children but rarely used in adults
Has questionable anti-inflammatory effects

Common Side Effects / Preventive Measures

May experience drowsiness or weight gain

4. Steroid Tablets

Prednisone
Prednisolone
Deltasone®
Medrol®

Use / Action

Slow action
Used daily in severe asthma or for a few days only in acute episodes to reduce swelling and mucus secretions in the airways

Common Side Effects / Preventive Measures

May cause mood changes, increased appetite with weight gain. (Eat low calorie diet)
Other symptoms will depend on the dose and length of time taken and include swelling of the face, easy bruising, thinning of the skin and brittle bones
Take with food to prevent upset stomach

5. Intravenous Steroids

Solumedrol®
Hydrocortisone

Use / Action

Used in a hospital to control severe asthma attacks or episodes by reducing swelling and mucus secretions in the airways

6. Injections

Xolair® (omalizumab)

Use / Action

Used for moderate to severe persistent allergic asthma when not controlled with asthma medication
Helps to reduce the number of asthma attacks
May not be effective in all patients
Given once every 2 or 4 weeks
Given based on individual IGE levels and body weight

Common Side Effects / Preventive Measures

Common side effects around the injection site: bruising, redness, warmth, burning, stinging or other discomfort
Other side effects reported: headache, sore throat, viral or upper respiratory tract infection, sinusitis, and rash
You will need to continue with your asthma medications.

Note: If more than one puff is prescribed, follow steps two to six for each puff. Replace cap.

Taking Care of your Turbuhaler®:

How to tell if your Turbuhaler® is empty Image: Red dot

A red dot appears on the Turbuhaler® when it is empty.

Wipe off mouthpiece with a dry tissue after use.
To avoid dampness, do not wash the mouthpiece or breathe into it.
Watch for red indicator in window of inhaler to determine when inhaler is nearly empty. There are approximately 20 puffs left when you first see the red dot.
Replace inhaler after expiratory date.
Keep in a dry place.

Useful Hints:

Medications may not have any taste.
Be careful not to mix up caps if using Bricanyl® and Pulmicort® at the same time.
If inhaler should accidentally fall after loading dose, consider this puff lost and repeat step two.
You may feel little or no sensation of medication being delivered when you inhale from the device. Don't worry, this is normal.
You can't tell if the inhaler is empty by shaking. You can hear the drying agent if you shake it whether it is full or empty.
Rinse mouth after using Pulmicort inhaler to prevent hoarseness or oral thrush.

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