Differences between rescue and controller medications?

Asthma medicine comes in two main types: controller medicine and rescue medicine. Rescue medications, also called quick-relief or fast-acting medications, work immediately to relieve asthma symptoms when they occur. These types of medicines are often inhaled directly into the lungs, where they open up the airways and relieve symptoms such as wheezing, coughing, and shortness of breath, often within minutes. But as effective as they are, rescue medications don't have a long-term effect.

Controller medications, also called preventive or maintenance medications, work over a period of time to reduce airway inflammation and help prevent asthma symptoms from occurring. They may be inhaled or swallowed as a pill or liquid.

Rescue Medications

Quick-acting bronchodilators, usually given through an inhaler or a nebulizer, loosen the tightened muscles around inflamed airways and are the most often-prescribed rescue medications. The most common of these are called beta₂-agonists. These medications are related to adrenaline and usually work within minutes to provide temporary relief of symptoms.

If the bronchodilator alone doesn't resolve a severe flare-up, other medications may be given by mouth or injection to help treat it.

If your child has been prescribed rescue medication, it's important to keep these medicines on hand. That means at home, at the mall, at sport practice, and even on vacation.

Rescue medications, although an important part of asthma treatment, can be overused. Talk with your child's doctor about how often your child uses the rescue medication. If it's too much, the doctor also may prescribe a controller medicine, designed to prevent asthma flare-ups from happening.

Controller Medications

Because your child's airways may be inflamed even in between flare-ups, controller medications may be needed to prevent unexpected asthma flare-ups. Slower-acting controller medicines can take days to weeks to start working, but when they do, they prevent airway inflammation and keep the lungs from making too much mucus.

There are a variety of controller medications, but inhaled corticosteroids are most common. They're usually given through an inhaler or nebulizer. Despite their name, corticosteroids are not the same as performance-enhancing steroids used by athletes. They are a safe and proven form of treatment for asthma.

In fact, inhaled corticosteroids are the preferred long-term treatment for children with frequent asthma symptoms. Research shows that they improve asthma control and their risk of causing long-term negative effects is minimal. (But corticosteroids that are swallowed in liquid or pill form may cause side effects if used daily over a long period of time.)

Long-acting bronchodilators can also be used as controller medications. These relax the muscles of the airways for up to 12 hours, but can't be used for quick relief of symptoms because they don't start to work immediately.

Even if your child takes controller medicine regularly, rescue medication will still be needed to handle flare-ups when they occur.

Working With the Doctor

Your child's doctor will determine which type of medicine your child needs, depending on how frequent and how severe the asthma symptoms are. Both the type and dosage of medication that your child needs are likely to change, with the goal being to have your child on the lowest amount of medication necessary for effective asthma management.

Because you spend more time with your child than the doctor will, you're an important player in your child's asthma treatment. For example, you can track how well the medicine is working by using a peak flow meter. You also can record information in an asthma diary and ask your doctor to create an asthma action plan, if you don't already have one. By reporting any concerns or changes in your child's symptoms, you can provide information that will help the doctor select the best course of treatment.