Find An Allergist / Immunologist | Pollen Counts | Journal of Allergy and Clinical Immunology | Annual Meeting   Site Map   Contact   Home    Search
Patients & Consumers Featured Resources Diseases 101 Drug Guide Find an Allergist / Immunologist Pollen Counts En Español Just for Kids Publications for Patients Referral Guidelines Request a Speaker Research for Patients Search by Condition (A-Z) Seniors Useful Links Contact Us Donate Now Request a Speaker Smoke Free Homes Referral Guidelines Other Resources En Español Just for Kids Seniors Allergy & Asthma Issues Educational Brochures Elements of Allergy and Asthma Order Public Education Materials		Allergy & Asthma Advocate: Summer 2007 When a Treatment Becomes an Asthma Trigger: Medications That Can Worsen Asthma By Michael Schatz, MD, FAAAAI Medications are used to treat a variety of medical problems. One important aspect of managing asthma is to identify triggering factors. Sometimes in a patient with asthma, a medical treatment for another condition can actually be a trigger for asthma. It is important to prevent this from occurring, and, if it does occur, to recognize it as soon as possible. Therefore, it is essential that you know which types of medications may actually make your asthma worse. Beta-blockers One important group of drugs that may worsen asthma is betablockers. These drugs may be used for problems such as high blood pressure, heart disease and migraine headache, or in an eye drop form for the eye disease glaucoma. They are classified in one of two groups: “non-specific” (they affect blood vessels and bronchial tissue) or “specific” (they affect blood vessels to a much greater degree than bronchial tissue). Non-specific beta-blockers, such as propanalol (Inderal), are the most important ones to avoid. Ideally, a person with asthma would avoid all beta blockers, including the “specific” ones, such as atenolol (Tenormin) or metoprolol (Lopressor), but these types of drugs may be quite important for certain patients’ health, and may not substantially worsen their asthma. For such patients, physicians may conduct a carefully supervised trial using a “specific” betablocker. Remember that even beta-blockers in eye drops may make asthma worse, so be sure to tell your ophthalmologist that you have asthma. Aspirin and other non-steroidal antiinflammatory drugs (NSAIDs) This group of medications includes some common over-the-counter pain relievers, such drugs as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve). Approximately 10 to 20% of people with asthma may notice that one or more of these drugs trigger their asthma. These asthma attacks may be severe and even fatal, so patients with known aspirin sensitivity must be very careful to avoid these drugs. Since even patients who have not had prior reactions to one of these medications may experience an asthma attack with subsequent use, all people with asthma should use these drugs with caution. Because someone who reacts to any one of these medications may react to other NSAIDS as well, it is recommended that patients who are sensitive to aspirin or other NSAIDS avoid all medications of this class. Medications that usually don’t cause increased asthma in aspirinsensitive patients include acetaminophen (Tylenol), propoxyphene (Darvon) and prescribed narcotics (such as codeine). If you are uncertain about whether or not your asthma is triggered by one of these drugs, check with your doctor before taking a specific medication. In some circumstances, one of these medications may be essential, even in a patient who is sensitive to it. In this case, a desensitization program can be initiated, but this potentially dangerous procedure must be done carefully and under the supervision of a physician experienced in this process. ACE Inhibitors These drugs, which may be used for hypertension or heart disease, include lisinopril (Zestril) and enalopril (Vasotec). Although they usually don’t make asthma worse per se, approximately 10% of patients who receive one of these drugs develop a very troublesome cough. This cough may be confused with asthma in some patients and possibly trigger increased wheezing in others. In addition, any cough has the potential to cause reflux (acid coming up from the stomach into the esophagus) which can cause more cough and worsen asthma. If you develop a cough when using an ACE inhibitor, contact your physician. These are the most common groups of medications that may trigger asthma. The bottom line in avoiding medication-induced asthma is to talk with your physician or specialist about your asthma and then avoid or alter the medications that are worsening your condition. If you develop any of the problems described, contact your physician immediately. It is important not to let your treatments become asthma triggers. <back>
		© 1996-2009 · All Rights Reserved · American Academy of Allergy Asthma & Immunology