by Christobel Rajesh

Created on: March 26, 2008

Asthma is a reversible obstructive airway disease that affects 17% of the American population. Although asthma can be fatal, more often it is just disruptive and affects day to day activities. Asthma can begin at any age, but in most cases it develops in childhood. Children usually develop allergic asthma which they outgrow by adolescence.

The common symptoms of asthma are cough, dyspnea and wheezing. They can either resolve by their own or may require some treatment. However, asthma can be effectively treated or controlled by medication therapy. There are five categories of medications that are used to treat asthma namely beta agonists, methylxanthines, anticholinergics, corticosteroids and mast cell inhibitors.

Beta Agonists: Beta agonists are the initial medications used in the treatment of asthma because they dilate bronchial smooth muscles. They can also increase the ciliary movements and decrease the chemical mediators of anaphylaxis. The most commonly used beta adrenergic agents are epinephrine, albuterol, isoproterenol, metaproterenol and terbutaline. These medications are administered parenterally or by inhalation. Inhalation route is the best route of choice because it directly acts on the bronchioles and has only a few side effects.

Methylxanthines: Methylxanthines, like aminophylline and theophylline are used in the treatment of asthme because of their bronchodilating effects. They relax the bronchial smooth muscles, increase movement of mucus in the airways and increase the contraction of diaphragm. Aminophylline is the IV form of theophylline and is administered intravenously. Theophylline is given orally.

Methylxanthines are not used in acute attacks because they are slow acting compared to beta agonists. There are several factors like tobacco smoking, heart failure, chronic liver disease, oral contraceptives, erythromycin and cimetidine which interfere with the metabolism of methylxanthines, particularly theophylline. Physician should be notified if any of the above mentioned condition exists before taking theophylline. Aminiphylline should be administered very slowly, because giving them rapidly may cause tachycardia or cardiac dysrhythmias.

Anticholinergics: Anticholinergic like atropine is not used in the routine treatment of asthma because of their systemic side effects such as dryness of the mouth, urinary hesitancy, blurred vision, palpitation and flushing. Atropine methylnitrate and ipratropium bromide have shown excellent bronchodilator effects

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