Asthma Medication- Treatment Overview

Asthma medications are used to provide short-acting relief and long-term management of asthma symptoms. Push Health can help people connect with a medical provider who can prescribe asthma medications, including asthma inhalers (maintenance and refills) and pills, when appropriate to do so.

What Is Asthma?

Asthma is a chronic inflammatory condition of the airways characterized by episodic narrowing of the bronchial passages, causing the characteristic symptoms of wheezing, shortness of breath, chest tightness, and cough. In people with asthma, the airways are persistently inflamed and hypersensitive. Said another way, the airways of people with asthma react strongly to triggers that would not affect non-asthmatic individuals.

Asthma affects millions of people in the United States and is one of the most common chronic respiratory conditions, accounting for approximately 4.9 million medical office visits per year. While asthma cannot be cured, it can be effectively managed with appropriate medication. When properly managed, most people with asthma live active, normal lives. Asthma can begin at any age and its severity can change over time.

Asthma Symptoms

Common asthma symptoms include:

• Wheezing - a whistling or high-pitched sound when breathing, particularly when exhaling
• Shortness of breath or difficulty breathing, especially during physical activity
• Chest tightness or pressure
• A persistent cough, particularly at night or early morning
• Increased mucus production

Symptoms can range from mild and intermittent to severe and persistent. An acute worsening of symptoms - sometimes called an asthma attack or asthma exacerbation - can develop rapidly and may require immediate medical attention. People experiencing symptoms including, but not limited to, severe shortness of breath, inability to speak full sentences, cyanosis, peak flow in red zone, and / or no response to rescue inhaler, should seek emergency care immediately.

Asthma Triggers

Asthma symptoms are often worsened or triggered by specific environmental or physiological factors. Common asthma triggers include:

• Allergens such as pollen, dust mites, pet dander, and mold
• Respiratory infections including colds and the flu
• Exercise or physical activity (exercise-induced bronchoconstriction)
• Cold or dry air
• Air pollution, smoke, and chemical irritants
• Strong odors or fragrances
• Stress and strong emotions
• Certain medications including aspirin, NSAIDs, and beta blockers

Identifying and avoiding personal triggers is an important part of asthma management alongside medication.

Asthma Medication Prescriptions - Online

One cannot simply buy most types of asthma medications online. Asthma medications need to be prescribed by a licensed medical provider after which they can be dispensed by a pharmacy. Push Health can connect people with asthma with medical providers who can provide asthma medications prescriptions when appropriate to do so.

Asthma Prescription Medication Options

Asthma medications can be divided into several categories. Some asthma medications are available in an inhaler form and provide relief during an acute asthma exacerbation. Examples of quick-relief asthma inhalers are medications based on albuterol sulfate such as ProAir, Proventil and Ventolin. Other medications used in the treatment of asthma include long-acting beta-agonists (LABAs), inhaled and oral corticosteroids such as prednisone (Rayos), anticholinergic agents such as ipratropium and tiotropium (Spiriva), leukotriene modifier medications such as montelukast (Singulair), and combination medications such as Symbicort. Mast cell blockers such as cromolyn sodium are also used preventatively. Combination medications such as Combivent and DuoNeb are also used to administer multiple medications at the same time.

Long-Acting Beta Agonists (LABAs) for Asthma

In addition to rescue medications used during acute asthma exacerbations, other medications are also often prescribed to help with the long-term management of someone with asthma. While albuterol and levalbuterol (Xopenex) are both short-acting beta-agonists, long-acting beta-agonists (LABAs) such as salmeterol (Serevent) and formoterol are available and have a longer duration of action that short-acting beta agonists like albuterol. LABAs are usually taken at the same time as inhaled corticosteroids.

Inhaled Corticosteroids for Asthma

Inhaled corticosteroid medications are commonly used to reduce inflammation in the airways of an asthmatic person. Examples of an inhaled steroid medication for asthma include fluticasone (Arnuity Ellipta and Flonase), budesonide (Pulmicort Flexhaler), mometasone (Asmanex Twisthaler), beclomethasone (Qvar RediHaler), and ciclesonide (Alvesco) inhalation aerosol. Another class of medications are the leukotriene modifiers which can help reduce symptoms for a period of time. Leukotriene modifier medications include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo), all of which are oral medications.

Combination Beta-Agonist / Corticosteroid Asthma Inhalers

For added convenience, LABAs and inhaled corticosteroid medications are often combined into one form. Common combination beta₂-agonist / inhaled corticosteroid medications include Symbicort, Dulera, Advair and Wixela. Breo Ellipta also contains an inhaled steroid combined with a LABA medication.

Interleukin Blocker Medications

In some cases, medications that block interleukins and other inflammatory mediators are used for preventative therapy of asthma. An example of these types of medications includes Dupixent.

Asthma Medications - Antibodies

Asthma prescription medications also consist of a class of drugs based around antibodies, including Fasenra, Nucala and Xolair.

Asthma Medications - Effectiveness

When used correctly and consistently, asthma medications are effective for the majority of people with asthma. Rescue inhalers such as albuterol provide rapid bronchodilation within minutes of use and typically last 3-6 hours. Maintenance medications including inhaled corticosteroids and LABAs, when taken consistently as prescribed, reduce airway inflammation and the frequency of asthma attacks over time.

Proper inhaler technique is critical to achieving the full benefit of asthma medications. Studies have shown that incorrect technique is a common reason patients experience suboptimal symptom control. Patients who feel that their medication is not working as expected should discuss inhaler technique and their current treatment plan with a medical provider prior to assuming that the medication is ineffective. Using asthma medications consistently is important as symptoms can return when medication is stopped.

Asthma Medications - Side Effects

All asthma inhalers and medications can cause side effects. Side effects that can occur when one is being treated for asthma include a rapid heart rate, nervousness, high blood pressure, and stomach pain. While safe in many people, asthma medications can, rarely, also cause an allergic reaction. Many side effects will go away once the asthma inhaler or medication is discontinued. Questions about asthma medications and inhalers are best discussed with one's pharmacist and licensed medical provider.

How to Get Asthma Treatment with Push Health

• Complete a brief health intake. Answer a few questions about your asthma symptoms, current medications, and your inhaler use history.
• Connect with a licensed medical provider. A medical provider will review your information and evaluate which asthma medication or combination of medications is most appropriate for your situation. Same-day consultations are available.
• Receive your prescription electronically. Your provider can send prescriptions for rescue inhalers, maintenance inhalers, or other asthma medications to a pharmacy of your choice. No office visit required.
• Pick up your medication or have it delivered. Generic albuterol rescue inhalers are available at most pharmacies for $25-$60. Maintenance inhalers vary in cost but savings cards and insurance may help reduce out-of-pocket expenses.

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