Not All Inhalers are the Same: Long-acting and Short-acting

Welcome back to another post on BioBasics! It’s been a while since my last post, but I have been busy with an exciting internship at New York University researching quantum computing. I recently found a little window to get back to writing, and I’m thrilled to share more about the fascinating field of medicine. Today, I want to talk about a crucial aspect of asthma management: inhalers. Pretty much anyone dealing with asthma has had an inhaler of some sort, but not all inhalers are created equal. There are key differences between long-acting and short-acting inhalers, each designed to serve specific purposes. In this post, I’ll break down what sets them apart, how they work, and why understanding these differences is essential for effective treatment.

Background

When thinking of steroids, most people are often reminded of the anabolic steroids associated with muscle building and hightened athletic performance. In reality, steroids are a diverse class of compounds with a widely spanning range of medical applications. They are a type of chemical compound found in the body that helps regulate various biological processes, including hormone production and cellular function. One of the most important groups within this class is corticosteroids, which play a crucial role in treating various conditions — including asthma, rheumatoid arthritis, and allergies.

Corticosteroids are steroid hormones produced in the adrenal cortex – a part of the adrenal glands situated above the kidneys. These hormones are especially important for physiological functions such as managing inflammation, immune responses, and metabolism. Although our bodies make them, this medicine can be administered to effectively mimic the effects of natural hormones in the body. They are able to inhibit the production of inflammatory substances, such as prostaglandins and histamines, as well as suppress the activity of the immune system, reducing allergic reactions. This makes corticosteroids highly effective in treating conditions characterized by excessive inflammation and immune system activity.

Short-acting beta agonists, a class of asthma medication, are not naturally produced in the body; they are synthetic medications designed to mimic the the body’s natural beta-adrenergic agonists, such as adrenaline (epinephrine). They bind to beta-adrenergic receptors in the body, leading to effects such as bronchodilation (widening of the airways), which is useful in conditions like asthma.

As I discussed in my last post, which can be found here, asthma can be triggered by a variety of allergens, including but not limited to pollen, dust, and pet dander. While respiratory infections and physical activity do not fall under the category of allergens, they are still able to result in the narrowing of the airways and inflammation that asthma is charactarized by. These factions can lead to symptoms like wheezing, coughing, chest tightness, and shortness of breath.

Long-acting vs. Short Acting Inhalers

Inhalers, which are commonly used to manage asthma, deliver medication directly into the lungs, providing rapid relief and long-term control of symptoms. Long-acting beta agonists, or LABAs, are used primarily for long-term relief of asthma symptoms. These inhalers often include corticosteroids such as beclomethasone, budesonide, and flunisolide, which are highly effective at decreasing airway inflammation and immune responses. By targeting inflammation at the source, LABAs help to keep the airways open and reduce the frequency and severity of asthma attacks. Designed for long-term management, their effects can last for several hours, making them a crucial component in the daily regimen of individuals suffering from asthma. Regular use can lead to significant improvements in lung function, a decrease in the need for rescue inhalers, and an increase in overall quality of life for patients.

While corticosteroids provide long term relief, they are not effective in providing the user with instant rescue relief. Short-acting beta agonists, or SABAs, are often used as rescue medications to provide quick relief of asthma symptoms. In the case of an asthma attack, a SABA, such as albuterol or levalbuterol, can ease inflammation and allow for air to flow. These medications are not considered steroids, but rather are bronchodilators that work by stimulating smooth muscles in the airways, leading to muscle relaxation and dilation. In contrast, steroids, particularly corticosteroids, reduce inflammation and suppress immune responses. While both types of medications are used to treat asthma, they do so through different mechanisms of action, leading to their distinguished uses.