Zileuton

FRIDAY, May 12, 2023 -- Receiving a diagnosis of asthma may be frightening, but learning what the treatment options are can help alleviate the anxiety that comes with diagnosis. Depending on the severity, certain asthma medications may help you manage your symptoms. Here, experts break down the most common long-term and quick-acting medications for asthma, how they work and potential side effects. Long-term medications These drugs are ones the patient takes daily as a means of controlling asthma and preventing asthma attacks. These can be in pill form or used as inhalers. Bronchodilators: Long-acting beta-2 agonists (LABA) relax the muscle bands around your airway (bronchi), making it easier to get air in and mucus out. These medications for asthma are taken twice a day through an inhaler and last up to 12 hours, according to the Cleveland Clinic . LABA medications should be given with a corticosteroid. (See combination medications below.) The main side effects of LABA medications are nervous or shaky feelings, hyperactivity, overexcitement, increased heart rate, upset stomach and trouble sleeping. Salmeterol (Serevent) Formoterol (Foradil) Long-acting muscarinic antagonists (LAMA) also relax the muscle bands around your airway, the National Heart, Lung, and Blood Institute (NHLBI) says. This asthma medication is used if the steroid/LABA combination doesn’t give enough relief. Do not use this medication if you have glaucoma or are at risk of urinary retention. Tiotropium bromide (Respimat) Theophylline. While not used often, theophylline can be useful in relaxing the airways and preventing reactions to irritants. It is taken as a pill and used for mild asthma symptoms. You may need to have blood tests drawn on a regular basis to make sure the level of medication is correct, the Mayo Clinic says. Side effects are the same as the other bronchodilators, but may also include chest pain or discomfort, dizziness, fainting, increase in urine volume or seizures. Theophylline (Theo-24, Theo-Dur, Slo-Bid, and others) Corticosteroids: Corticosteroids are steroids that reduce inflammation in the airways, according to the NHLBI. They may be taken as a pill, although very few patients are on the pill for long term. It is frequently used in an inhaler, often combined with a LABA. Side effects from the inhaled form are thrush (a mouth infection) and a hoarse voice. Inhaled corticosteroids include: Fluticasone (Flovent HFA, Arnuity Ellipta, others) Budesonide (Pulmicort Flexhaler) Mometasone (Asmanex Twisthaler) Beclomethasone (Qvar RediHaler) Ciclesonide (Alvesco) Combination asthma medications (Corticosteroid and LABA): Fluticasone and salmeterol (Advair) Budesonide and formoterol (Symbicort) Fluticasone and Vilanterol (Breo) Leukotriene modifiers reduce swelling and help keep your airways open for up to 24 hours. According to Mayo Clinic, these medications block the effects of leukotrienes, immune system chemicals that cause asthma symptoms. Side effects are uncommon, but may include nausea, headache, tiredness or diarrhea. Montelukast (Singulair) Zafirlukast (Accolate) Zileuton (Zyflo) Quick-acting asthma medications These are a group of medications that are used when a patient has a flare-up or an asthma attack. Inhaled short-acting beta2-agonists (SABAs) open the airways so air can flow through them during an asthma attack. They start working within 15 to 20 minutes and continue to work for 4 to 6 hours, according to the Cleveland Clinic. Side effects can include tremors, rapid heartbeat, allergic reactions, muscle pain, worsening breathing, dry mouth, headache, sore throat or trouble sleeping. Inhaled forms of SABA medications include: Albuterol (Ventolin) Levalbuterol (Xopenex) Albuterol and ipratropium bromide combination (DuoNeb) Corticosteroids. Oral corticosteroids are usually prescribed for short-term use to help a patient overcome a flare-up. This type of medication quickly reduces swelling and inflammation in the airways. Side effects include: Cataracts, osteoporosis, weight gain, high blood sugar, increased risk of infections, thinning bones and fractures, thin skin, bruising and slower wound healing, mood swings, depression and aggressive behavior. Prednisone (Deltasone, Prednicot, and others ) Methylprednisolone (Medrol, Solu-Medrol, Depo-Medrol) Short-acting anticholinergic bronchodilators help open the airways quickly. This medicine may be less effective than SABAs, but it is an option for people who experience side effects with other medications, the Cleveland Clinic says. Side effects you may experience with these inhalers are dry throat, eyes and nose; unusual taste; nausea and vomiting; or temporary blurred vision if the medicine gets in your eyes. Ipratropium bromide (Atrovent) Tiotropium bromide (Spiriva Respimat) Corticosteroid reliever. In January 2023, the FDA approved Airsupra, which can be used as needed to prevent bronchoconstriction and asthma attacks. In a study conducted before the approval, the risk of severe asthma exacerbation was significantly lower with a fixed-dose combination of albuterol and budesonide than with as-needed use of albuterol alone. Most common side effects are headache, oral yeast infection, cough, and difficulty speaking. Airsupra (albuterol-budesonide) Posted May 2023

THURSDAY, May 11, 2023 -- If you suffer from allergies, you know how bothersome and uncomfortable the sneezing and itchy eyes can be. These symptoms are more than irritating — they impact day-to-day activities like work, school, sports, sleeping and even eating. Not only that, but allergies can also cause more serious health problems such as asthma and even anaphylaxis, a life-threatening allergic reaction. Allergies are a common health condition affecting almost one-third of adults in the United States and just over one-quarter of children under 17, according to the U.S. Centers for Disease Control and Prevention . But there is relief at hand: Here’s what you need to know about the most common allergy medicines, the type of allergies they treat, how they work and common side effects. Antihistamines This type of allergy medicine is very effective in relieving allergy symptoms. Mayo Clinic explains this drug type works by blocking histamine, “a symptom-causing chemical released by your immune system during an allergic reaction.” Antihistamines are available as an over-the-counter medication or as a prescription allergy medicine, and they are sold in oral form, as a nasal spray or as eyedrops. This allergy medicine treats symptoms of indoor and seasonal allergies. Common side effects of antihistamines include drowsiness, dry mouth, dizziness, blurred or double vision, mucous thickening and low blood pressure. Common antihistamines include: Oral Loratadine (Alavert, Claritin) Cetirizine (Zyrtec) Diphenhydramine (Benadryl) Doxylamine (Vicks NyQuil, Tylenol Cold and Cough Nighttime) Fexofenadine (Allegra) Nasal spray Olopatadine (Patanase) Eyedrops Ketotifen (Zaditor) Leukotriene modifiers Leukotriene modifiers prevent or lessen the symptoms of allergic rhinitis (hay fever) and allergic asthma. The Cleveland Clinic explains that leukotrienes are chemicals released in the body when you come in contact with an allergen. This causes symptoms like a runny nose and coughing. Leukotriene inhibitors block the effects leukotrienes have on the body or “stop your body from producing them.” This allergy medicine treats symptoms of indoor and seasonal allergies. Leukotriene inhibitors can cause side effects such as cold or flu symptoms, headache, diarrhea, fatigue and itchy skin or rash. More serious side effects like depression, thoughts of suicide, hives, trouble breathing, vomiting and yellowing of the skin or eyes can occur. You should seek medical treatment in these cases. Common leukotriene inhibitors include: Montelukast (Singulair) Zafirlukast (Accolate) Zileuton (Zyflo) Corticosteroids Corticosteroids treat mild to severe allergy symptoms by reducing inflammation caused by your body’s reaction to an allergen. Corticosteroids are available in several forms including pills and liquids, nasal sprays, inhalers, creams and eyedrops. They treat allergic inflammation caused by indoor and seasonal allergens as well as insect stings. Severe allergic reactions are treated with oral corticosteroids, according to the Mayo Clinic. Side effects vary depending on the medication form, but can include increased blood glucose levels, high blood pressure, nosebleeds, mouth and throat irritation, and skin irritation. Common corticosteroids by form include: Pills and liquids Prednisolone (Prelone) Methylprednisolone (Medrol) Nasal sprays Budesonide (Rhinocort) Mometasone (Nasonex) Inhalers Fluticasone (Flovent) Mometasone (Asmanex Twisthaler) Creams Betamethasone (Dermabet, Diprolene) Desonide (Desonate, DesOwen) Eyedrops Fluorometholone (Flarex, FML) Loteprednol (Alrex, Lotemax) Immunotherapy Immunotherapy works by modifying the immune system and its reaction to allergens. It’s not used for immediate allergy symptom relief but is a long-term allergy treatment. Immunotherapy treatments (or allergy shots) are prescription medicines. "Allergy shots can be helpful for patients with seasonal and year-round allergies," Miranda Curtiss , an assistant professor at the University of Alabama at Birmingham School of Medicine, said in a recent article . "However, these are a long-term investment that require planning to continue therapy for three to five years for maximal benefit. Asthmatics who want to start allergy shots need to have their asthma under good control first before starting shots." With allergy shots, you are exposed to an allergen over and over until your immune system becomes desensitized and no longer reacts to the allergen, the Mayo Clinic says. This type of treatment is commonly given as allergy shots (subcutaneous immunotherapy, or SCIT), but is also available in a form given under the tongue (sublingual immunotherapy, or SLIT). With SCIT, injections are given in your doctor’s office where they can monitor for adverse reactions. Treatment starts with the “build-up phase,” which is once or twice a week, and decreases to a maintenance dose which is once every two to four weeks. Sublingual immunotherapy treatment, like subcutaneous immunotherapy, also exposes you to allergens over a period of time, with the goal of building immunity to the allergen. SLIT tablets are available by prescription and taken daily. Immunotherapy is used to treat seasonal and indoor allergies, as well as insect stings. Side effects include watery eyes, sneezing, mild asthma symptoms, a rash at the injection site, tiredness and headaches. In rare cases, life-threatening reactions such as throat swelling and difficulty breathing can occur. Regardless of the type of allergy or your symptoms, there are options for relief. Reach out to your health care provider to learn more about which remedies are best for you. Posted May 2023