Asthma 'Drug of Choice' Best in Tandem, Dangerous Alone

It's estimated that 14 million Americans have asthma, and that number is growing. The drug of choice for many sufferers is a bronchial dilator sold under the brand name Serevent. Most doctors recommend it be taken in conjunction with inhaled steroids. But recently, physicians have begun prescribing it alone. That's a bad idea according to two new studies in this week's Journal of the American Medical Association. Serevent may help ease symptoms including wheezing and breathlessness, but it does not alleviate the underlying inflammation that exacerbates the disease. In fact, when given alone, it can make it worse.

The Saturday Early Show talked with Dr. Bernadine Healy, CBS News health contributor, to find out more about these studies and about Serevent for asthma sufferers.

Why are these studies important?

For the first time, we have clear-cut evidence which suggests using a drug like Serevent alone is not a good idea. Although it may ease the symptoms of breathlessness and wheezing, it does not alleviate the underlying inflammation that exacerbates the disease. It is inhaled steroids that are often prescribed in conjunction with a drug like Serevent that reduce the inflammation.

Why might a doctor prescribe the drug alone when it is recommended that it be taken with inhaled steroids?

A doctor may prescribe Serevent alone if a person has a milder case of asthma. It is very important to note here that there are very different degrees of the disease. Some people constantly have trouble breathing. For other people, only certain things set them off, such as playing a sport or being around a pet.

What do you suggest someone taking Serevent alone do?

It depends how often you use it. If you take it perhaps once a week, you're probably okay. But if you are having constant asthma attacks you're going to want to take the steroids. Bottom-line, call your doctor.

Doctors are sometimes hesitant to prescribe steroids because of the side effects. What are some of the side effects?

Prolonged steroid use has been linked to side effects including osteoporosis and cataracts, which is why doctors try and prescribe the lowest dose possible and also try not to keep a patient on them for too long. In fact, many asthmatics will take steroids for say 3 months, then stop taking them, and then go back to taking them. But if you are at risk for say osteoporosis, you can take calcium supplements and exercise to counteract the effects of the steroids.

What about other measures that someone can take to minimize asthma attacks?

You have to stay away from things that may trigger an attack. For some people, that is the dander from a cat or an animal. If you know this bothers you then avoid them. Looking at the environment around you is also important. Many homes are filled with asthma stimulants, including dust mites. If you keep a clean house you are less likely to ave an attack.
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