The preventive medicines are all those that serve to diminish the inflammation eosinófila of the mucous membrane and with it to improve the evolution and the frequency of the crises of asthma.

• The Inhaled Corticoids. They constitute at present the therapy of the first line, providing symptomatic benefits, diminishing the HRB and the need for bronchodilators. The budesonida (Pulmicort ®), the beclometasona (Becotide ®, Becloforte ®, Beclo-Asthma ®) and the fluticasona (Flixotide ®, Flusonal ®, Inalacor ®, Trialona ®) and the innovation the Ciclesonide (Alvesco ®) is the available medicines of this group. To the conventional doses they tolerate well; the adverse effects are usually: candidiasis orofaríngea, disfonía for atrophy of the laryngeal musculature, cough irritativa, etc. These effects are less frequent with low doses, or using cameras espaciadoras. For his absorption they can produce osteoporosis and decrease of the growth. The ciclesonide is the surest medicine of this group diminishing the local and general side effects.
• The Cromonas. The cromoglicato (Unsuch ®, Frenal ®) inhibits the mastocitos degranulación and is capable of controlling the asthma in some patients. The nedocromil sódico (Ildor ®, Brionil ®, Cetimil ®, Tilad ®) has similar effects. The cromonas are innocuous but his effect antinflamatorio is much minor than the inhaled steroids.
• The leucotrienos Inhibiting ones. Anti-inflammatory specially directed against the synthesis or the action of the leucotrienos (mediators lípidos broncoconstrictores and proinflamatorios) in the bronchial tree. They exist the montelukast (Singulair ®) and the zafirlukast (Accolate ®). Both are active for oral route, and they take in tablets. Indicated in the light asthma as the only therapy, and in the asthma moderated –grave associated with the inhaled steroids.

All these medicines are used to support the illness without symptoms. They must take regularly. The absence of fulfillment for the patient is, at present, the biggest cause of defeat in the healing of the bronchial asthma.

These medicines are used of occasional form when the symptoms of the illness increase, with the target to diminish the symptoms at a few hours or days.
There are a group of medicines called ß-2 mimetic selective, for his performance on these recipients, which produce the relaxation of the bronchial muscle. The method of ideal application is the inhalativa, whenever a training adapted for his administration exists. The most usual are the Salbutamol and the Terbutalina, both of immediate effects (minutes) and of approximately 2 at 4 hours of duration. At present hours of duration exist on the market other Betamiméticos of action more prefaced with effects of 8/10. His side effects are the quake and nervousness. The taquifilaxia effects (to stop doing effect) are seen in patients who take exaggerated and continuous doses (bad control of the asthma). The procaterol is similar to the previous ones.

Recently they have gone out to the market them ß-2 mimetic selective of long duration, like the Salmeterol. This one begins his effect to 20-30 minutes of his inhaled administration and remains active between 7 at 9 hours. The medicines beta - agonistas of long action are the salmeterol (Beglan ®, Serevent ®, Inaspir ®, Betamican ®) or the formoterol (Oxis ®, Neblik ®, Foradil ®) with an action duration from 12 until 18 hours.

The betamiméticos of long duration have indicated themselves like association the preventive anti-inflammatory ones (inhaled steroids) like thifty person of dose of the same ones, but nowadays there is discussion if this short-term beneficial effect, it can be a problem in the crises of asthma that he will not answer well to other betamiméticos of short action, with the risk of being refractory crises to the treatment. For it the asthma crises can turn out to be more intense and rebellious. This association of betamiméticos and steroids as base treatment must be indicated personally and not be generalized.
The associations are (Seretide ®, Anasma ®, Inhaladuo ®, Symbicort ®).

The anticolinérgicos (Bromide of Ipratropio) they do not offer advantages on ß-2 mimetic and it takes more side effects (dryness of mucous membranes) as what they are useful limited in the asthma, only they are used associated with other medicines or in the asthma crises in the infancy.

The teofilinas (aminofilina, teofilina) act like bronchodilators with unknown mechanism. They have side effects to high doses (migraines, vomiting, discomfort, even confusion and comma) as what the dose must fit to every individual (by means of analytical of blood). For this reason they are falling down in desuetude.

Steroids. There are hormonal anti-inflammatory medicines. They produce for his habitual capture serious side effects as there are a delay of the growth, osteoporosis, sugar elevation in blood, inflammation of muscles, slimming of skin and blood glasses, etc... By it, in spite of his big efficacy in the asthma, only they are used in rebellious cases to other treatments or in the crises.
They usually use in the crises (Prednisolona, Metil prednisona, etc...) in rules from 1 until 4 days, for what his side effects are only of gastric inconveniences. If they are used more continuously they happen in morning doses and in the alternate days, whenever the situation of the patient allows it.

It is the only treatment of the asthma that modifies the natural evolution of the illness according to the WHO. (Allergy 44, 1998)

There are called the administration an immunotherapy (vaccine) the same products that produce the bronchial asthma in minimal quantities so that the organism gets accustomed to without pushing them back and, consequently the asthma does not appear. His efficacy depends on the content of proteins adapted to every patient (Dermatophagoides pt., Lolium p., Parietaria, etc....) and of his standardization (homologation of the content in proteins alergénicas of every packing).

It is a long-term treatment, by means of the application of subcutaneous injections, with a regularity established and controlled by a trained specialist. It is not necessary to retire without consulting with the responsible doctor producing his effects to him to 2 ó 3 years.