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Inhaled short-acting β2-adrenergic agonists, such as terbutaline and salbutamol, are the first-line drugs indicated for asthma exacerbation for all patients to provide rapid bronchodilating effects. [ 1 ] [ 2 ] Short-acting β2-adrenergic agonists can be delivered by different devices, for example, nebulizers and metered-dose inhalers .
[17] [18] It has been shown to, 1) reduce asthma exacerbations that require oral corticosteroids, 2) reduce hospital visits better than maintenance on inhaled corticosteroids alone at a higher dose, or 3) inhaled corticosteroid at the same or higher dose together with a long-acting bronchodilator (LABA), with a short-acting bronchodilator (SABA ...
Fluticasone propionate, sold under the brand names Flovent and Flonase among others, is a glucocorticoid steroid medication. [8] When inhaled it is used for the long term management of asthma and COPD. [8] In the nose it is used for hay fever and nasal polyps. [9] [10] It can also be used for mouth ulcers. [11] It works by decreasing inflammation.
[6] [7] The medications work in different ways: fluticasone furoate is an inhaled corticosteroid (ICS), umeclidinium is a long-acting muscarinic antagonist (LAMA), and vilanterol is a long-acting beta-agonist (LABA). In 2022, it was the 144th most commonly prescribed medication in the United States, with more than 3 million prescriptions. [8] [9]
Budesonide, sold under the brand name Pulmicort, among others, is a steroid medication. [8] It is available as an inhaler, nebulization solution, pill, nasal spray, and rectal forms. [8] [9] The inhaled form is used in the long-term management of asthma and chronic obstructive pulmonary disease (COPD).
Formoterol has a relatively rapid onset of action compared to other LABAs, and is effective within 2-3 minutes. [2] The 2022 Global Initiative for Asthma report [ 3 ] recommends a combination formoterol/inhaled corticosteroid inhaler as both a preventer and reliever treatment for asthma in adults.
Beclometasone or beclomethasone, also known as beclomethasone dipropionate, and sold under the brand name Qvar among others, is a steroid medication. [1] It is available as an inhaler, cream, pills, and nasal spray. [2] The inhaled form is used in the long-term management of asthma. [1] The cream may be used for dermatitis and psoriasis. [3]
While the use of inhaled steroids and long-acting beta2‑adrenergic agonists are recommended for the resulting improvement in control of symptoms of asthma, [10] concerns have been raised that salmeterol may increase the risk of death due to asthma, and this additional risk is not reduced by the addition of inhaled steroids. [11]
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