Medications Used to Treat Asthma
The correct answers are (a) parasympatholytic drugs and (b) corticosteroids—both are established asthma medications, while dactylitis is a symptom (not a drug), amiodarone is an antiarrhythmic, and sulfonylureas are diabetes medications. 1
Corticosteroids (Option B) - CORRECT
Corticosteroids are the most consistently effective long-term control medications at all steps of care for persistent asthma, superior to any other single medication. 1, 2
Mechanism and Role
- Inhaled corticosteroids (ICS) reduce airway hyperresponsiveness, inhibit inflammatory cell migration and activation, and block late-phase allergic reactions to allergens 1, 2
- They are the preferred controller medication for all patients with persistent asthma, more effective than leukotriene receptor antagonists or any other single long-term control medication 1
- Oral systemic corticosteroids (prednisone, prednisolone, methylprednisolone) are used for moderate to severe asthma exacerbations and for patients requiring step 6 care (severe persistent asthma) 1, 2
Available Formulations
- ICS options include: beclomethasone, budesonide, fluticasone, flunisolide, mometasone, ciclesonide, and triamcinolone 1, 3
- Delivered via metered-dose inhalers (MDIs) with spacers or dry powder inhalers (DPIs) 3
Parasympatholytic (Anticholinergic) Drugs (Option A) - CORRECT
Anticholinergic agents, specifically ipratropium bromide, are used in asthma treatment, though they play a more limited role compared to beta-2 agonists and corticosteroids. 4, 5
Clinical Use
- Ipratropium bromide is available in HFA-propelled MDI preparations 1
- It can provide additional benefit when combined with beta-2 agonists in acute severe asthma, though routine use is not recommended for all acute exacerbations 5
- Anticholinergics have slower onset and longer duration of action than inhaled beta-2 agonists, with virtually no side effects 4
- They are more useful for COPD than for chronic asthma management 4
Incorrect Options
Dactylitis (Option C) - INCORRECT
- Dactylitis is a clinical symptom (swelling of fingers or toes), not a medication [@General Medicine Knowledge@]
- This is a distractor answer with no relevance to asthma pharmacotherapy
Amiodarone (Option D) - INCORRECT
- Amiodarone is an antiarrhythmic medication used for cardiac arrhythmias, not asthma [@General Medicine Knowledge@]
- It has no role in asthma management and can actually cause pulmonary toxicity
Sulfonylureas (Option E) - INCORRECT
- Sulfonylureas are oral hypoglycemic agents used to treat type 2 diabetes mellitus, not asthma [@General Medicine Knowledge@]
- They stimulate insulin secretion from pancreatic beta cells and have no bronchodilator or anti-inflammatory properties
Additional Key Asthma Medications (Not Listed in Options)
For completeness, other major asthma medications include:
- Beta-2 agonists (short-acting like albuterol; long-acting like salmeterol and formoterol) - most effective bronchodilators for rapid symptom relief 1, 4
- Leukotriene modifiers (montelukast, zafirlukast, zileuton) - alternative but not preferred therapy for mild persistent asthma 1
- Immunomodulators (omalizumab) - for severe persistent asthma with allergic component 1