For a parent of a child with asthma or even just the periodic wheeze, the list of medications can be somewhat overwhelming…particularly to the parent who doesn’t wheeze and is already in a bit of shock when hearing an asthma diagnosis for the first time. So what I’d like to do is simplify the thought process behind the different type of asthma-related medications. I’ll do my best not to promote any one specific brand as I believe that is something best to be determined between you, your child, and your child’s physician. But if a brand name appears, it’s only to help identify these medication groups.

The Immediate Relief Medications: think of these meds as the ones that provide quick relief for a wheezing child.

Short-acting bronchodilators: Albuterol and xopenox may be the names you might recognize, although a variety of brand names exist. They work by relaxing the muscle of the airways. For the younger children, this medicine can be delivered via a nebulizer (a machine which delivers the medicine in mist form) but for the older children, the inhaler (or “puffer”) is often used. For those children having problems with the inhaler, we will sometimes add a spacer which makes the inhaler easier to use. Either way, relief should occur within minutes.

Oral or intramuscular (IM) steroids: When the wheezing is significant and/or the movement of air in the lungs is poor, albuterol alone may not be enough. Although there is a bit of lag time (few minutes to an hour pending how the medication is delivered) for the full effect of the steroids, they are very helpful in reducing inflammation of the airways. One caveat about the oral or IM steroids is you only want to use them when you really need to…as side effects after prolonged use can occur.

The Preventive Medications: just as they sound, used to prevent wheezing episodes.

Inhaled corticosteroids: They reduce airway inflammation just like the oral steroids, but don’t have the same risk of side effects like the oral steroids have. Sometimes they will be paired up with a long-acting bronchodilator (e.g. advair and symbicort) to enhance the preventive effects.

Leukotriene modifiers: I’m sure many of you with asthma have heard of Singulair, probably the most well known medication in this group. They help to reduce inflammation of the airways as well.

Any questions…feel free to send my way.


Dr. Jeremy