What anti-inflammatory drugs are suitable for asthma

Asthma patients should not buy any medicine blindly on their own. They must go to the hospital for a comprehensive examination and use medicine according to the doctor's treatment and treatment recommendations. Medicines such as prednisone, prednisolone or methylprednisolone are treatment drugs.

(1) Inhalation administration: Inhaled hormones have a strong local anti-inflammatory effect. They are administered through the inhalation process, and the drug acts directly on the respiratory tract, so the required dose is smaller. Most of the drugs that enter the blood through the digestive tract and respiratory tract are inactivated by the liver, so there are fewer systemic adverse reactions.

Research results have shown that inhaled hormones can effectively relieve asthma symptoms, improve quality of life, improve lung function, reduce airway hyperresponsiveness, control airway inflammation, reduce the frequency and severity of asthma attacks, and reduce mortality. Most adult asthma patients can better control their asthma by inhaling small doses of hormones.

Local oropharyngeal adverse reactions of inhaled corticosteroids include hoarseness, pharyngeal discomfort, and Candida infection. After inhaling the medicine, rinse the mouth and throat with clean water in time. Using dry powder inhaler or adding a spacer can reduce the above-mentioned adverse reactions. There is currently evidence that adult asthma patients who inhale low to moderate doses of hormones daily do not experience significant systemic adverse reactions. Possible systemic adverse reactions after long-term high-dose inhaled hormones include skin bruises, adrenal suppression, and decreased bone density.

Commonly used inhaled hormones in clinical practice include beclomethasone dipropionate, budesonide, fluticasone propionate, etc.

(2) Solution administration: Budesonide solution is atomized and inhaled through a jet device powered by compressed air. It does not require high cooperation from the patient in breathing and has a rapid onset of effect. It is suitable for the treatment of acute attacks of mild to moderate asthma.

(3) Oral administration: Suitable for patients with moderate asthma attacks and chronic persistent asthma who have not responded to combined therapy with high-dose inhaled hormones, and as a sequential treatment after intravenous hormone therapy. Generally, hormones with a shorter half-life (such as prednisone, prednisolone or methylprednisolone) are used. For hormone-dependent asthma, the drug can be taken once a day or every other morning to reduce the inhibitory effect of exogenous hormones on the hypothalamic-pituitary-adrenal axis. The optimal maintenance dose of prednisone is ≤10 mg per day.

Long-term oral hormone use can cause osteoporosis, hypertension, diabetes, suppression of the hypothalamic-pituitary-adrenal axis, obesity, cataracts, glaucoma, thin skin leading to wrinkles and bruises, and muscle weakness. For asthma patients with tuberculosis, parasitic infection, osteoporosis, glaucoma, diabetes, severe depression or peptic ulcer, systemic hormone therapy should be used with caution and close follow-up should be required. Asthma patients who use systemic hormones for a long time or even a short time may be infected with the fatal herpes virus, which should be taken seriously. It is necessary to avoid exposing these patients to the herpes virus as much as possible.

Although systemic corticosteroids are not a frequently used method for relieving asthma symptoms, they are necessary for severe acute asthma because they can prevent asthma exacerbations, reduce the chances of emergency department visits or hospitalizations due to asthma, prevent early relapses, and reduce mortality. Recommended dose: prednisolone 30-50 mg/day for 5-10 days. The specific use depends on the severity of the disease. When the symptoms are relieved or the lung function has reached the personal best, you can consider stopping the medication or reducing the dosage.

(4) Intravenous administration: In case of severe acute asthma attack, hydrocortisone succinate (400-1000 mg/day) or methylprednisolone (80-160 mg/day) should be given intravenously in a timely manner. Those who are not prone to hormone dependence can stop taking the medication within a short period of time (3 to 5 days); those who are prone to hormone dependence should extend the medication time, switch to oral medication after controlling asthma symptoms, and gradually reduce the dosage of hormones.