Asthma is an inflammatory condition of the small airway passages of the lungs. Usually there are trigger factors which result in mucus production and constriction of the involuntary smooth muscle which control the size of the small airway passages. The net result is narrowing (broncho constriction) and plugging of these passages which means less air moves into and out of the lungs resulting in less oxygen getting to the blood stream and a response from the body to breathe harder and attempts to cough up the plugs. While many asthma attacks can be mild people with asthma can get very sick very quickly with some triggers. Untreated asthma can be fatal and appropriate help must be sought fast. Understanding the condition helps enormously

While we have no cure for asthma these days there are excellent treatments which allow good control. There are two main types of treatment acute remedies and preventative treatments. The acute treatments act on relieving the airway narrowing by acting directly on specific receptors in the muscles of the airways causing them to relax. These days these medications are usually relatives of adrenaline and delivered by inhaling them in an aerosol or powder form or delivered via a nebuliser where they are diluted with water and "bubbled" in via a special fan. There are fast short acting commonly used medicatons such as salbutamol ( eg brands such as "Ventolin" or "Respolin") , turbutaline ( eg Bricanyl" ) or ipratropium (eg "atrovent" ). Now there are newer longer acting muscle smooth relaxants like salmeterol (or "serevent").

Then there are also longer slower acting preventative medications which work in different ways – one of the long time mainstays has been the cortico steroid family – these anti inflammatory chemicals block the body’s inflammatory response to the trigger factors. They work very well but have potential side effects especially when taken orally at high dose. Inhaled preparations have helped reduce side effects but there has been a lot of research going on to find better alternatives. One such alternative that had less side effects was Sodium Chromoglycate ( or " Intal ").This drug stabilises mast cells which are the little bombs that release all the inflammatory mediator chemicals which spark of the reactions in the smooth muscle and mucus producing cells. A similar medication is nedocromil ( "tilade") .

However very recently  one of the inflammatory mediators was identified by Australian researchers. This discovery won them a Nobel Prize . The mediators called Leukotrines are responsible for the mucus production that plugs the small airways. A new medication has just been released on the Australian market  – its called montelukast – can be used as a long term prevention medication which has less side effects than steroids.

Most people find their asthma will be best controlled using combinations of the medications and the best approach is to discuss lifestyle and requirements with your doctor to work out the best treatment plan for each individual.