Know the role of long-term asthma control medications

Seven million American children have asthma

While many people breathe a sigh of relief when spring arrives, the 7 million American children who have asthma may simply find it more difficult to breathe. Spring ushers in the pollen season, which may trigger allergies that lead to asthma.

“Your child’s age, symptoms, the severity of their asthma and possible side effects of medication all play a role in determining the optimal asthma medication for them,” said Tracy Rife, RN, BSN, AE-C, the Asthma and Easy Breathing Program Coordinator at the Akron Children’s Hospital Robert T. Stone, MD, Respiratory Center. “It is important to work closely with your child’s physician to monitor symptoms and adjust asthma medications as needed.”

Many children need to take daily long-term control medications to manage their asthma – even when they are not experiencing symptoms. It is very important that your child be given their controller inhalers every day, as ordered by your doctor. If controller medicine is not given regularly, your child will not get the therapy benefit and will be more likely to have asthma symptoms. These medications have minimal side effects, but if you are concerned, please speak to your doctor.

Inhaled corticosteroids. The most effective long-term control medication for persistent asthma is an inhaled corticosteroid. It takes a few weeks of everyday use for these slow-acting inhalers to decrease swelling and mucus on the inside of the airways. Your child should use the inhaler daily – even when they aren’t having symptoms. Most of these inhalers have a counter window on the back that tracks the number of doses used. These medications usually need to be refilled monthly, and the number ZERO appears in the window when the inhaler needs a refill. To prevent oral yeast infections and throat and mouth irritation, your child should rinse their mouth or brush their teeth after using inhaled corticosteroids.

Leukotriene modifiers. By blocking the effects of leukotrienes (chemicals in the immune system that cause asthma symptoms), these drugs can help prevent symptoms for up to 24 hours. The medication is taken daily in pill form, works best if taken at night, and is sometimes used along with an inhaled corticosteroid.

Combination inhalers: corticosteroids and long-acting beta agonists (LABAs). If your child’s asthma is not controlled with inhaled steroids, they may be prescribed a combination inhaler that reduces swelling and opens up narrowed airways. Combination inhalers control moderate to severe asthma and help prevent nighttime symptoms. LABAs are only taken with inhaled corticosteroids, because taken alone, they have been linked to severe asthma attacks in some cases.

Controller medications have minimal side effects, but if you are concerned, please speak to your doctor. The risk of a severe asthma attack with uncontrolled asthma is much worse than any side effect. When using metered-dose inhalers, it is very important to use a holding chamber or spacer, which helps reduce the effects of residual corticosteroids left in the mouth.

Be sure to read next month’s blog about quick-relief medications. Also known as “rescue medications,” these drugs are used to treat asthma attacks and exercise-induced asthma. Unlike long-term control medications, they should not be used on a daily basis.