Reconsidering Asthma Treatments

Breathe deeply. This simple act sustains life and yet most of the time we don’t even notice it.
Not being able to catch your breath can be terrifying. People with asthma may gasp desperately for air. Sometimes they even die with their inhalers in their hands.
Asthma deaths have been rising for decades, although the drugs to treat it are more powerful than ever before. Researchers now blame some of the most popular asthma drugs for this increased mortality.
A new analysis published in the Annals of Internal Medicine (June 20, 2006) reports that “salmeterol may be responsible for approximately 4000 of the 5000 asthma-related deaths that occur in the United States each year.��?
Salmeterol is one of the most widely prescribed asthma drugs in the world. It is a long-acting bronchodilator found in inhalers such as Advair and Serevent.
The FDA has strengthened the labeling for salmeterol and another long-acting bronchodilator, formoterol (Foradil). Physicians are warned that such medications should not be used as initial treatment since they may increase the risk of serious asthma attacks and asthma-related deaths.
What’s an asthma patient to do? Experts encourage physicians to consider other kinds of asthma medicines. Inhaled corticosteroids can ease the underlying inflammation that triggers breathing problems. When a bronchodilator is needed, shorter-acting beta-agonist medicines may be somewhat safer than long-acting ones. Whatever bronchodilator is used, however, it must not be overused.
Other asthma medications that ease inflammation include montelukast (Singulair), zafirlukast (Accolate) or zileuton (Zyflo). Cell stabilizers such as cromolyn (Intal) or nedocromil (Tilade) are different prescription options. An anticholinergic asthma medicine called ipratroprium (Atrovent) can be helpful for some asthma victims.
In addition, there is interest in breathing exercises to help asthma patients. A study published in the journal Thorax (online June 5, 2006) showed that people with mild asthma may benefit from practicing breathing techniques.
In the study, asthma patients who were using reliever medication four or more times a week were given a video instructing them in one of two breathing techniques. One focused on shallow breathing through the nose, capturing elements of a complementary therapy called Buteyko. A control program coordinated breaths with gentle upper body movements.
Practicing either technique reduced the use of reliever drugs by 86 percent. Patients also needed lower doses of their inhaled corticosteroids. These results suggest that breathing lessons may be worthwhile for asthmatics.
We have spoken with experts about how changing breathing patterns can affect health, especially asthma and blood pressure. Those who would like to learn more about Buteyko and other breathing approaches may want to order a CD of this hour-long interview. This CD is available for $16 from the People’s Pharmacy (CD-489), P. O. Box 52027, Durham, NC 27717-2027. Order online at www.peoplespharmacy.com.
Asthmatics must not change their use of medicine on their own, but check with their doctors about breathing exercises or a safe drug regimen.