Short-Acting Beta2-Agonists
These are used for the rapid relief of acute asthma symptoms and to prevent exercise-induced asthma in children. They are first-line treatment of acute asthma symptoms—all patients with asthma need to have available a short-acting beta2-agonist. Children may use them by MDI or nebulizer; either form is effective if used properly. The medication should be available at home, in school, and at the site of sports participation. This class of medication used to be called “rescue” medicine, but this term is no longer used because it implies that a patient must be in terrible shape to use it, which should not be the case. The new preferred term is quick relief. It turns out that almost all patients use albuterol (or a close cous-in called levalbuterol, which acts very similar to albuterol) for their quick-relief medication. Albuterol should be used for any asthma symptom, including wheeze, chest tightness, and cough, and not just reserved for asthma attacks.
Anticholinergics
Ipratropium bromide, a rapid-acting bronchodilator, may be used as an alternative to dilate the airways when inhaled beta2-agonists cannot be used, or given together with an inhaled beta2-agonist in severe asthma.
Systemic Corticosteroids
These are given by mouth or injection to reduce inflammation inside the airways and speed recovery when a youngster is having an asthma flare-up.