1 Glucocorticoids

Glucocorticoids are currently the most effective anti-inflammatory drugs. Inhaled glucocorticoids are the drug of choice for long-term asthma control. The advantage is that through inhalation, the drug directly acts on the airway mucosa, has strong local anti-inflammatory effects and has few systemic adverse reactions. However, long-term and standardized inhalation is usually required to have a preventive effect. In acute asthma exacerbations, inhaled β2-agonists should be used first, followed by inhaled glucocorticoids. For children with seasonal asthma attacks, continuous and regular inhaled corticosteroids can be started 2 to 4 weeks before the expected attack.

There are three drugs currently on the market: beclomethasone propionate, budesonide and fluticasone propionate. The latter two have fewer systemic adverse reactions and stronger effects. Its dosage forms can be divided into three categories: pressure metered inhalation aerosol, dry powder inhalation and atomized solution. In addition, there are two ways of oral administration and intravenous administration.

2β2 receptor agonists

β2 receptor agonists are currently the most widely used clinical bronchodilators, especially aerosol inhalation, which is widely used in the treatment of acute asthma attacks.

Commonly used short-acting β2-receptor agonists include albuterol and terbutaline. Inhalation administration, including aerosols, dry powders and nebulized solutions, acts directly on bronchial smooth muscle. It has a fast antiasthmatic effect, usually taking effect within a few minutes, and the effect can last for 4 to 6 hours. It is the first choice drug to relieve acute symptoms of asthma, and can also be used as a preventive drug for exercise-induced asthma. Overdose or adverse reactions include palpitations, skeletal muscle tremors, cardiac rhythm disorders, and hypokalemia, and should be used as needed. Salbutamol is 100 to 200 micrograms per inhalation; terbutaline is 250 to 500 micrograms per inhalation, but it is not suitable to be used alone for a long time. If the dosage is more than 4 times a day or the dosage is ≥ 2 cans of aerosol per month, it should be used or adjusted under the guidance of a physician. Oral administration can also be used for cases with mild symptoms. Long-term use of short-acting β2-agonists (including inhaled and oral) can cause a decrease in drug efficacy, which will recover after a period of drug withdrawal.

Long-acting β2 receptor agonists have strong and lasting effects, and can last for 10 to 12 hours each time. Combined with glucocorticoids, they can reduce the dosage of the latter, have a synergistic effect, and are less likely to produce tolerance. Medicinal properties, minimal cardiovascular effects. It is mostly used to prevent nighttime asthma attacks and has the following types:

Salmeterol can be administered via aerosol or disc device. It takes effect 30 minutes after inhalation and lasts for more than 12 hours;

Formoterol can be administered via aerosol or other forms. It takes effect in 3 to 5 minutes after inhalation and lasts for 8 to 12 hours;

Procaterol hydrochloride takes 15 to 15 minutes after oral administration. It takes effect in 30 minutes and lasts for 8 to 10 hours;

Bambuterol has a long-lasting effect after oral administration and can be taken once a day before going to bed.

Currently, it is recommended to combine inhaled corticosteroids and long-acting β2-receptor agonists for the treatment of asthma. The combined use has synergistic anti-inflammatory and anti-asthmatic effects.

3 Theophylline

It has the effects of relaxing airway smooth muscles, stimulating the respiratory center and respiratory muscles. When used for long-term control, it mainly assists inhaled human corticosteroids to fight inflammation, and is mostly used to prevent nighttime asthma attacks and nighttime coughs. Common adverse reactions include nausea, vomiting, arrhythmia, and drop in blood pressure.

4 Anticholinergic drugs

The antiasthmatic effect is weaker than that of β2 receptor agonists, and the onset of action is also slower, but long-term use is not easy to produce drug resistance and has few adverse reactions. It is often used in combination with β2 receptor agonists to enhance and sustain the bronchodilation effect.

5. Leukotriene receptor antagonists

Leukotriene receptor antagonists are a new class of non-glucocorticoid anti-inflammatory drugs. Commonly used drugs are montelukast, Zafirlukast, etc., are often used in combination with inhaled glucocorticoids to treat children with asthma, which can reduce the dose of glucocorticoids and improve the efficacy of inhaled glucocorticoids. The drug is well tolerated, has mild side effects and is easy to take.

6 Mast cell membrane stabilizers

Mat cell membrane stabilizers include cromoglycate sodium, which is a non-corticosteroid anti-inflammatory drug and is suitable for the long-term treatment of mild asthma. It can also be used to prevent exercise-induced asthma and wheezing attacks induced by dry and cold air. It has very few side effects and can be used safely for a long time.

7 Antihistamine drugs

Oral antihistamine drugs include cetirizine, loratadine, ketotifen, etc. These drugs are generally not recommended for children.

8 Specific immunotherapy

Since allergy is the main cause of asthma, when exposure to allergens cannot be avoided or drug treatment is ineffective, allergen-specific treatment can be considered Immunotherapy. People who are allergic to pollen or dust mites can use corresponding allergen extracts for desensitization treatment to relieve asthma attacks.

9 Immune modulators

Those who suffer asthma attacks due to repeated respiratory tract infections can use them as appropriate.

10 Traditional Chinese Medicine

Although the emergency treatment effect of traditional Chinese medicine is not obvious, it can sometimes be used as an auxiliary or preventive treatment.

There are many types of drugs to control and relieve asthma, and the specific application principles should be determined by an experienced doctor. Under the guidance of a doctor, treatment can be maintained at home. If parents cannot control their child's condition based on their own experience, they should take their child to the hospital for formal treatment.