Medications Used To Treat Asthma and COPD
COPD and asthma are similar diseases. Symptoms felt are similar, such as shortness of breath, chest tightness, and coughing. Even the medicines used are similar. But, they are two different diseases with different treatment strategies. Here is a list of medications used to treat COPD compared with asthma.
The goal of any asthma treatment regimen is to control asthma. Good asthma control means that symptoms are rare and mild and easy to reverse when they do occur. It also means that you are able to maintain your normal activity level between asthma episodes. You should be able to do most of the things you enjoy doing.1
There are three categories of asthma medicine.
These are medicines meant to prevent and control symptoms. These include one of the following types of inhalers.
- Inhaled corticosteroids (ICS). These help to reduce and control underlying airway inflammation. These work to make airways less twitchy or less sensitive to asthma triggers. Common inhaled steroids used are fluticasone (Flovent), budesonide (Pulmicort), beclomethasone (Qvar), fluticasone (Asmanex). ICS inhalers are the most basic asthma controller medicines. One of these is usually the first medicine chosen to control asthma.
- ICS plus Long-Acting Bronchodilator (LABA): These are combination inhalers containing the two medicines. The ICS works to reduce underlying airway inflammation. The LABA works to prevent bronchospasm. Together they work to keep airways open long term to prevent and control symptoms. Usually, one of these medicines is chosen after an ICS alone has failed to control asthma. Examples include salmeterol/flunicasone (Advair), fluticasone and vilanterol (Breo), mometasone and formoterol (Dulera), and busesonide and formoterol (Symbicort).
These are short-acting beta-adrenergics. They dilate airways by binding with b2 receptors on smooth muscles wrapped around airways. They tell these muscles to relax and open airways. So, they open airways rather fast to relieve symptoms when they occur.
With good asthma control, these should rarely be used. However, it is recommended that all asthmatics have access to reliever medicine at all times to relieve symptoms when they do occur.
The most commonly prescribed reliever medicines are inhalers. These include albuterol (Ventolin, ProAir) and levalbuterol (Xopenex). They are also available as nebulizer solutions. These include albuterol (Ventolin) and levalbuterol (Xopenex).
These medicines are used in conjunction with ICS or ICS/ LABA inhalers. They are added on when symptoms persist despite treatment with ICS or ICS/LABA inhalers. Examples here include leukotriene antagonists like Singulair. It may also include one the 5 biologics currently on the market. It may also include any of the following medicines recommended for COPD.
The goal of any COPD treatment regimen is to reduce symptoms and make them less severe when they do occur. It’s to improve tolerance to exercise so a person can maintain a healthy level of activity.2
One or more of the following medicines are options to try.
As noted above, these are medicines that open airways. There are four different kinds of bronchodilators to try.
- SABAs. As for asthma, they are usually prescribed for as needed use. They are handy for treating acute (it’s happening right now) symptoms. Albuterol is the most common one prescribed as an inhaler or nebulizer solution.
- LABAs. These are not recommended as stand-alone asthma treatments. But, with COPD they are sometimes prescribed. They keep airways open long-term. Examples here include salmeterol (Serevent), indacaterol (Arcapta), and olodaterol (Striverdi). These are all inhalers. Another option is aformoterol (Brovana). It’s a nebulizer solution.
- Short-Acting Muscarinic Antagonists SAMA. These are another type of bronchodilators that seem to work well for COPD more so than for asthma. The only one available is ipatropium bromide (Atrovent). It’s available both as an inhaler and as a nebulizer solution.
- Long-Acting Muscarinics Antagonist (LAMA). These are taken daily to keep airways open long-term. Again, they are usually only prescribed for COPD. Examples include tiotropium bromide (Spiriva), umeclidinium (Incruse), glycopyrrolate (Seebri), and aclidinium bromide (Tudorza. These are all inhalers.
- Theophylline. This is a pill taken daily that is also a good bronchodilator. It’s another option sometimes worth consideration. It’s usually reserved as a last resort and mainly due to side effects.
Sometimes, all patients need is one of the above medicines. But, sometimes two or more are indicated. To make this convenient for patients (and less costly), many of these medicines have been combined in the following inhalers.
- SABA plus SAMA. This category includes albuterol/ ipatropium bromide (Duoneb). It’s usually prescribed for use on an as needed basis to open airways.
- LABA plus ICS. As with asthma, these may also be prescribed for COPD. Examples of these types of inhalers are listed above.
- LABA plus SAMA. Combining these two long-acting bronchodilators seems to work well for some people with COPD. Examples include umeclidinium and vilanterol (Anoro). Tiotropium bromide and olodaterol (Stiolto), and glycopyrrolate and indacaterol (utibron). These are all inhalers taken once or twice daily.
- LABA plus muscarinic plus ICS. Some people may benefit from a combination of these three medicines. The only one on the market so far is the Trelegy inhaler. It contains fluticasone furoate, umeclidinium, and vilanterol.
What to make of this?
As you can see, COPD and asthma are treated with similar medicines. But, the goals for treating each disease is unique to that disease. This is why it’s so important to get that proper diagnosis.
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