- Body system
- Respiratory
- Name stem
- -lukast, -sonide
- Drug cards
- 2 in this guide
Drugs in this class
- Fluticasone (inhaled)Arnuity Ellipta, Advair (with salmeterol), Flovent (now sold as generic fluticasone propionate inhalers)
- MontelukastSingulair
Other examples: Budesonide, Mometasone, Beclomethasone, Zafirlukast, Omalizumab, Dupilumab.
How asthma controller drugs work
Inhaled corticosteroids reduce airway inflammation. Leukotriene receptor antagonists block leukotrienes. Biologics target specific inflammatory pathways (IgE, interleukins).
Uses
- Persistent asthma
- COPD with frequent exacerbations (inhaled corticosteroid combinations)
- Allergic rhinitis (montelukast, nasal steroids)
Adverse effects
- Oral thrush and hoarseness (inhaled corticosteroids)
- Neuropsychiatric effects (montelukast)
- Injection reactions and rare anaphylaxis (biologics)
Nursing considerations
- Teach mouth rinsing after inhaled corticosteroids.
- Ask about mood and sleep changes with montelukast.
- Assess adherence and inhaler technique when asthma is not controlled.
Patient teaching
- Use your controller every day as prescribed.
- Rinse and spit after inhaled steroids.
- Carry your rescue inhaler.
Asthma controller drugs NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
-
What should a patient do after using an inhaled corticosteroid?
Show answer
Answer C: Rinse the mouth with water and spit Rinsing removes drug left in the mouth and throat and prevents oral candidiasis (thrush).
-
Which adverse effect is the subject of a boxed warning for montelukast?
Show answer
Answer D: Neuropsychiatric events such as depression and suicidal thoughts Montelukast carries a boxed warning for serious neuropsychiatric events in children and adults.
-
A patient says, 'I only use my fluticasone inhaler when I'm wheezing.' What is the best response?
Show answer
Answer B: Fluticasone works only if used every day; use albuterol for wheezing Inhaled corticosteroids take days to weeks to reduce inflammation and do not relieve acute symptoms.
Frequently asked questions
What are asthma controller drugs?
Controller drugs reduce airway inflammation and prevent asthma attacks. They are taken every day, even when symptoms are absent, and are never used to treat an attack.
How do asthma controller drugs work?
Inhaled corticosteroids reduce airway inflammation. Leukotriene receptor antagonists block leukotrienes. Biologics target specific inflammatory pathways (IgE, interleukins).
What are examples of asthma controller drugs?
Fluticasone (inhaled), Montelukast, Budesonide, Mometasone, Beclomethasone, Zafirlukast, Omalizumab and Dupilumab.
What are the nursing considerations for asthma controller drugs?
Teach mouth rinsing after inhaled corticosteroids. Ask about mood and sleep changes with montelukast.