Anti-inflammatory

About anti-inflammatory drugs

Most anti-inflammatory medications are synthetic corticosteroids and are available as inhalers. They are used for regular preventer medication in the long-term management of asthma to prevent asthma worsening by reducing damage to the airways that can happen if chronic inflammation is not treated. Oral corticosteroids are available to treat more severe symptoms of both asthma and allergy but these are not usually a long-term medication. Also available are inhaled non-steroidal anti-inflammatory drugs (NSAID), which can be used for management of asthma.

How do corticosteroids work?

Corticosteroids are produced naturally by the body and are involved in regulation of many functions including inflammatory and allergic reactions. Synthetic corticosteroids mimic natural corticosteroids and work by inhibiting the production of inflammatory chemicals, particularly prostaglandins and leukotrienes. They act at several different stages in the production of these chemicals by inflammatory cells at sites of inflammation, like the bronchioles.
Corticosteroids do not have an immediate effect on symptoms of asthma and cannot relieve an asthma attack, but if taken regularly they reduce inflammation and swelling of the airways, as well as excess mucus production. This helps prevent sensitive airways overreacting to asthma triggers by constricting and narrowing, which is what causes symptoms like wheezing, cough, tightness across the chest and shortness of breath.

Inhaled corticosteroids

Corticosteroids used for treating asthma and other chronic breathing disorders are taken by inhaling through an inhaler device so that they act directly at site of inflammation in the airways and have very little systemic effect. Inhaled corticosteroids include fluticasone, beclomethasone and budesonide.

Oral corticosteroids

If asthma or allergy is severe and cannot be controlled by other medications, oral corticosteroids can be used to treat inflammation, which reduces the swelling and excess mucus production that causes severe breathing problems in uncontrolled asthma; also extreme symptoms of an allergic reaction such as in allergic inflammatory skin conditions. They should be taken only until symptoms are reduced, as long-term use of oral corticosteroids like prednisone and hydrocortisone can have severe side effects.

Inhaled non-steroidal anti-inflammatory (NSAID)

Another inhaled anti-inflammatory medication used for long-term treatment of mild to moderate chronic asthma is the non-steroidal anti-inflammatory (NSAID) nedocromil. It works by inhibiting the release of a range of inflammatory chemicals like prostaglandins from cells lining the airways as well as other cells like macrophages; also histamine release from mast cells that are known to be involved in inflammation of the airways. This medication is not intended for rapid symptom relief but will improve lung function and reduce the frequency and severity of symptoms over time. Nedocromil can be used in addition to other asthma medications.