Are you worried about taking medication every day if you have asthma? Let's talk about these long-term control medicines!

You probably know that some children and adults with asthma have to take their medication every day. You may wonder why they tell you to take your medication every day, even on days when you don't have any symptoms. There's a good reason for that. These long-term control medications, or what we call controller medicines or maintenance medicines, are used to keep your airways open and clear, making it easier to breathe.

What exactly is asthma?

Simply put, asthma is a condition that affects the airways, or airways. What happens in this case is that your airways become a little more sensitive. It's like someone who gets angry easily at even the smallest things. Because of this, sometimes these airways swell from the inside, and the muscles around them tighten and become blocked. Imagine a water pipe that has been inflated from the inside and is being squeezed by someone. Then it's difficult to breathe in and out, right? That's why symptoms like wheezing, chest tightness, and coughing occur when asthma develops. This condition can be different for each person. Some people have it all the time, while others rarely have it.

So what are these long-term control medicines?

If you have asthma, your doctor will likely give you two types of medicine. One is called a reliever medicine . These are used to provide quick relief when your asthma is getting worse, meaning when you have wheezing or difficulty breathing. It's like putting water on a fire.

But the long-term control medicines we're talking about today are something different. These are not medicines that give immediate relief. They are like the foundation of a house. The foundation is strong, and the house is strong. In the same way, these medicines help to gradually reduce the swelling and sensitivity in your airways, and keep your asthma under control. That's why they're called "controller" or "maintenance" medicines.

How does this medicine work? Slowly? Quickly?

This is the most important thing. These long-term control medications work very slowly. Like quick-relief medications, you don't feel much difference after using them. These medications can take a few days, maybe even a few weeks, to do their job properly. Think about it, if you plant a plant in a garden, it takes a while for it to grow, bloom, and bear fruit, right? It only grows well if you water it every day and take care of it. That's how these medications are.

The main function of these is to reduce the chronic swelling (inflammation) in your airways and help keep them open and free from re-clogged airways.

So, do I have to take this medicine every day, even when I feel well?

Yes, absolutely! This is where many people make mistakes. You may think, "I don't have a cold anymore," "I don't even have a cough," "So why do I take this medicine every day?" But, the reason you're doing so well is probably because you're taking your medication correctly.

Imagine, a person with diabetes mellitus uses insulin. Even if he feels well, he still needs to take the medicine as prescribed by the doctor. Otherwise, the disease may worsen again. The same is true of clothing.

If you take these medications daily, exactly as your doctor prescribes, they will have a chance to work inside your body. Only then will your airways stop swelling and becoming blocked, allowing you to continue breathing well. If you stop taking the medication, the problems may start to reappear within a few days.

What are the main types of Long-Term Control Medicines?

There are several types of medications that fall into this category. The medication your doctor has prescribed for you may be one of them.

• Inhaled Corticosteroids (ICS): These are the most commonly used and most important type of controller medication. Don't be alarmed by the name "steroid," but these are not the same as the steroids you usually take in pill form. They are delivered directly to the lungs through an inhaler, so they have very little effect on other parts of the body. They work by reducing inflammation in the airways. It's like putting medicine on a burn to help it heal.

• Long-Acting Beta-Agonists (LABA): These medications help to keep the airways open by relaxing the muscles around them. They are rarely used alone. They are often combined with inhaled corticosteroids in a single inhaler. When these two are combined, they are very effective in controlling asthma.

• Other medications: In addition, there are medications that are taken in pill form, such as leukotriene modifiers. Sometimes, your doctor may recommend using these in combination with other medications.

Most of these medications come in the form of an inhaler . This is a device that allows you to deliver the medication into your lungs as you breathe in. Some young children can also be given this medication through a nebulizer.

What happens if you don't use this medicine properly, every day?

This is something to consider carefully. Imagine that your doctor has told you to use your inhaler twice a day. But what happens if you say, "I'm feeling really good today," and use it only once, or if you don't use it for two or three days?

• Asthma symptoms may reappear: things like coughing, wheezing, and chest tightness may gradually begin to increase.
• Symptoms may worsen at night: You may wake up with a cough and have difficulty breathing.
• The risk of sudden asthma attacks increases: This is the most dangerous thing. If you don't take your medication properly, the protection of your airways decreases. Then even something small (e.g. dust, smoke, cold) can cause a major asthma attack. Then you may have to go to the hospital.
• Long-term damage to the lungs can occur: When asthma flares up frequently, it's not good for the lungs either.

Therefore, it is extremely important to take these control medications exactly as the doctor prescribes, in the amount prescribed, and at the time prescribed.

Should we be afraid of side effects?

Many people are scared when they hear the word "steroids." It's true that some steroids can cause side effects if taken continuously. However, inhaled corticosteroids, which are used for asthma , are given in very low doses. Also, because they go directly to the lungs, very little is absorbed by the body.

However, some minor side effects may occur. For example:

• Minor infections of the mouth and lips (e.g., oral thrush).
• Hoarseness of voice.

There are very easy ways to prevent things like this.

1. Rinse your mouth thoroughly with water after using the inhaler.

2. Using the inhaler with a spacer device (you can ask your doctor about this).

Although other side effects may occur very rarely, the doctor recommends these medications because the benefits far outweigh the possible minor side effects. If you experience any discomfort, don't be afraid to talk to the doctor about it.

The importance of talking to your doctor about this

You and your doctor will decide together how best to control your asthma.

• Your symptoms.
• Your lifestyle.
• The ease with which you can use the medicine.

Your doctor will consider all of these factors to determine the most appropriate controller medication and dosage for you. Therefore, discuss any questions or concerns you may have (e.g., how to use the medication, concerns about side effects) with your doctor. That way, you can rest assured that you are taking your medication correctly and that your asthma is well-controlled.

Take-Home Message

Okay, so, from what we've talked about, these are the most important things to keep in mind:

• Long-Term Control Medicines are medications that must be taken daily, even when symptoms are absent.
• These work slowly, but they are essential for reducing swelling in the airways and preventing asthma attacks.
• Reliever medicines are used only when asthma flares up. But controller medicines should be taken daily.
• If you don't take your medication properly, your asthma can worsen and lead to severe attacks.
• Don't worry too much about side effects. If you use your inhaler correctly and rinse your mouth, you can avoid many side effects.
• Talk to your doctor regularly and make a plan for managing your asthma.

Remember, asthma is a disease that, if properly controlled, does not prevent you from living a normal, active life. Using these long-term control medications correctly is a great help!

` Asthma, Long-Term Control Medicines, Controller Medicines, Maintenance Medicines, Inhaled Corticosteroids, Asthma Sinhala