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Asthma Medications immune system from overreacting to allergens. By doing this, Asthma treatments have not changed significantly since the asthma symptoms decline as airways become less reactive, which 1950s. For at least 20 years, the only really new medications to has to be a good thing from the asthmatic's point of view. *'* make it into the asthma industry are leukotriene modifiers, which However, because steroids suppress natural immunity,” they can show some improvement in asthma control but less than that seen contribute to infection and the growth of fungi and bacteria, not with a low dose of corticosteroid.” The other "new" drugs that only in the airways but also systemically.“ ** appear from time to time are really only variations on old ones, "The design of the respiratory system means that the lungs are which is clever marketing on the part of the drug companies. For —_ normally sterile, and the deliberate inhalation of any substance is example, in the 2004 report by GlaxoSmithKline it was revealed: usually considered a bad idea," Russell Stark continues. "The "GlaxoSmithKline's respiratory franchise is driven by the wisdom of inhaling something that prevents the body from growth of Seretide/Advair [combination controller-steroid], gain- defending itself against foreign bodies such as bacteria has to be ing patients from competitor products and the cannibalisation of | questioned because chest infections are a common cause of [existing drugs] Serevent and Flixotide/Flovent."** asthma symptoms. People using steroids notice the side effects of In the same report, there are more than 10 "new" asthma prod- oral thrush, husky voice, thinning skin and easy bruising, as well ucts in "the pipeline" and almost all contain long-acting beta-2 as hear about the higher incidence of glaucoma and cataracts, so agonists,’ which have been used they are more likely to stop to treat asthma for several years. EXAMPLES OF ASTHMA MEDICATIONS taking this medication than their Long-acting beta-2 agonists are a bronchodilator, which has no more powerful version of short- = Medications that open up airways: such noticeable side effects. acting bronchodilator medica- Because the medications appear tion, keeping smooth muscle Short-acting Long-acting to create their own dependence, relaxed for up to 12 hours. bronchodilator bronchodilator most people with asthma slowly However, the more medication Airomir * Foradil increase their intake over a you take, the more you need. Albuterol Nuelin number of years. In spite of this, Even taking one puff of a short- Atrovent Ou bronchodilators are dispensed as one P Berotec* Serevent* ot P acting bronchodilator every day Bricanyl* Theophylline if they are harmless, and most causes deterioration in asthma Respolin* Volmax* users are unaware that overuse control, and more medication is Salbutamol* could worsen their condition." required to achieve the same Ventolin* * = Beta-2 agonist Perhaps the worst part about result because a tolerance devel- asthma medication is that it is ops to the drug.’ + Medications that reduce asthma symptoms: not very effective. The person Since the early 1990s, this takes it yet still has symptoms, information has led to current Steroid Non-Steroid and no medication therapy cur- recommendations that these Preventers Preventers rently available significantly drugs should only be taken to Becotide Accolate alters the natural progress of treat acute symptoms, and that if Becloforte Intal . asthma in a positive way.***” they are required more than three Flixotide Singulair Because of this and the per- times a week the person should Biovent qilade ceived danger of asthma medica- also take an inhaled steroid in a Bi uTelis fete tions, many asthmatics become : ulmicort Zyflo ae : : bid to reduce the symptoms.“ QVAR disillusioned with conventional It comes as somewhat of a sur- Respocorte treatments and seek other forms prise, then, that many asthmatics of control, including the are prescribed the twice-daily = Combination Medications Buteyko method. use of powerful, long-acting (combination of bronchodilator and preventer): beta-2 agonist bronchodilators. Buteyko's Discoveries and The main concern with this prac- Flixotide + Serevent = Seretide/Advair Therapeutic Practices tice is that the asthmatic is less Pulmicort + Oxis = Symbicort Konstantin Pavlovich Buteyko aware of how severe the underly- (1923-2003) was a medical ing airway inflammation is,” and one British study reveals that trainee in charge of a Moscow hospital ward when, one night in the risk of dying as a result of asthma is three times higher in asth- 1956, he first made the connection between hyperventilation and matics using long-acting Serevent than short-acting Ventolin.* headache.* He was having a particularly bad headache when he These deaths are likely to be due to airway obstruction—the very __ noticed that his breathing was heavy, so he consciously reduced thing that Serevent is designed to overcome.” the volume of air that he was breathing and found that the pain "Few doctors would tell a patient with a sprained ankle to take a eased. He deliberately increased his breathing and the headache painkiller night and day to mask the problem in order to continue —_ returned. He then commenced waking the patients in his care, walking or running normally, because this would worsen the one after the other, getting them to alternately increase and inflammation and cause more damage to the ankle," says Russell ecrease their breathing. They, too, felt worse when they Stark. "Since the underlying cause of asthma is believed to be breathed heavily, and better when they breathed less air each inflammation in the airways, and long-acting bronchodilators tend = minute. Believing that his teachers would warmly welcome this to cover up the symptoms, it seems possible that they could con- iscovery, he reported his findings—but, to his surprise, not one tribute to worsening airway inflammation, with further airway of them was remotely interested. It seems that this apathy from remodelling in the future." the medical fraternity has largely followed the path of Buteyko for Corticosteroids reduce airway inflammation and stop the the past 50 years. Short-acting bronchodilator Airomir* Albuterol* Atrovent Berotec* Bricanyl* Respolin* Salbutamol* Ventolin* Long-acting bronchodilator Foradil* Nuelin Oxis* Serevent* Theophylline Volmax* * = Beta-2 agonist Steroid Preventers Becotide Becloforte Flixotide Flovent Prednisone Pulmicort QVAR Respocorte Non-Steroid Preventers Accolate Intal Singulair Tilade Vicrom Zyflo = Combination Medications (combination of bronchodilator and preventer): Flixotide + Serevent = Seretide/Advair Pulmicort + Oxis = Symbicort NEXUS * 35 Asthma Medications EXAMPLES OF ASTHMA MEDICATIONS = Medications that open up airways: + Medications that reduce asthma symptoms: DECEMBER 2005 — JANUARY 2006 www.nexusmagazine.com