Pharmacology of asthma treatment: an overview

The major advance in the last decade in treating asthma is the realisation that it is primarily an inflammatory process in the airways and not a bronchial smooth-muscle disease. Accordingly, much more emphasis is being placed on the early introduction of regular anti-inflammatory therapy, greatly facilitated by the development of inhaled steroid products. Despite this, inhaled beta 2-agonists remain the other major therapy in modern asthma treatment because of their ability to provide rapid relief from potentially life-threatening bronchoconstriction. At present, there is a tendency to avoid regular daily use of beta 2-agonists alone for persistent symptoms. Theophylline is still used, despite concern about its toxicity. However, it does have pharmacological effects in addition to bronchodilatation that may give it an additional therapeutic role in asthma therapy. It seems unlikely that the search for new single-mediator antagonists or synthesis inhibitors will result in the development of a new, effective asthma treatment.