This paper examines two major classes of prophylactic asthma medications—Cromolyn (Intal) and corticosteroids—alongside traditional Chinese herbal formulas used to manage asthma and related allergic conditions. It explains the pharmacological mechanisms by which each drug inhibits inflammation, histamine release, and bronchoconstriction, while also addressing their side effects and administration challenges. The paper then introduces two classical Chinese formulas, Ma Huang Xing Ren Shi Gao Gan Cao Tang and Xiao Qing Long Tang, as potential alternatives or complements to conventional treatment, noting that both approaches require careful patient monitoring to avoid adverse reactions.
In recent years there has been a notable increase in the diagnoses of allergies, asthma, and other diseases that affect people's ability to breathe freely. The reasons for this are still subjects of scientific debate and continued research. However, more effective drugs have been developed to treat the wheezing, shortness of breath, and other symptoms of allergies, asthma, and lung inflammation. One of the most commonly prescribed drugs for asthma is Cromolyn, otherwise known by its more popular brand name, Intal.
Cromolyn is usually inhaled through an atomizer as an aerosolized solution or breathed in as a microfine powder. It inhibits the release of histamine, leukotrienes, and other chemicals in the body that mediate inflammation. These chemicals are secreted from mast cells, macrophages, and other cell types that play a critical role in triggering allergic reactions. Cromolyn is indicated for the prevention of bronchospasms and bronchial asthmatic attacks.
Like all drugs, however, Cromolyn should not be prescribed without careful consideration of its side effects. These side effects include coughing, hoarseness, a dry mouth or throat, throat irritation, and nasal congestion or sneezing. Ironically, Cromolyn can cause side effects similar to the very condition it is intended to treat. This is why it must be used with caution, although it can significantly improve quality of life for someone suffering from allergies if used properly and if the patient does not develop an adverse reaction.
Corticosteroids are another class of prophylactic asthma medications used in asthma treatment. They are used to decrease airway obstruction and constriction. Corticosteroids stabilize the membranes of lysosomes, preventing the release of hydrolytic enzymes that cause the inflammation characteristic of an asthmatic attack. Inhaled glucocorticoids are the most commonly prescribed corticosteroids. These drugs also inhibit leukotriene synthesis and reduce both bronchoconstriction and the secretion of mucus — or, in layperson's terms, coughing and phlegm.
One problem with oral administration of corticosteroids is that a fair percentage of the drug is deposited in the pharynx or mouth, or is swallowed. Precautions must therefore be taken to ensure that the drug is administered effectively. This can be addressed through the use of a spacer attached to a metered-dose inhaler. Rinsing the mouth afterward can also reduce unwanted side effects from drug deposits in the mouth, which is critical in preventing the development of oropharyngeal candidiasis — commonly known as thrush, or the growth of fungus in the mouth.
Severe asthma is sometimes treated with systemic glucocorticoids for a short period of time. These are administered intravenously in the form of methylprednisolone, or taken orally as prednisone. Once the patient has improved, the drug is gradually tapered over a period of one to two weeks.
Both Cromolyn (Intal) and corticosteroids are called prophylactic asthmatic drugs because they inhibit the effects of asthma rather than providing a cure for the illness. However, until a cure exists, they can provide relief and a more normal life for people who suffer from moderate to severe asthma.
"Classical Chinese herbal formulas for asthma management"
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