What medications should I use with caution in asthma?

  Asthma is an allergic disease, there are many drugs can cause asthma attacks or aggravation, asthma patients should understand which drugs will asthma attacks or aggravation, so as to avoid the use of such drugs. The main drugs that cause asthma attacks or exacerbations are the following: 1. Antipyretic and analgesic drugs: the representative drug is aspirin, and clinically there is a type of asthma called aspirin-like asthma, or aspirin-intolerant asthma. In addition to aspirin intolerance, patients are often accompanied by chronic rhinitis, sinusitis, nasal polyps and abnormal sense of smell. The aspirin class of drugs includes aspirin and aspirin-containing combination preparations such as antipyretic and analgesic tablets, pediatric antipyretic tablets, antipyretic and analgesic powder, APC, etc. Other antipyretic and analgesic drugs acetaminophen, indomethacin, and ibuprofen botrytisone can also induce asthma attacks, but less frequently than the aspirin class of drugs. Patients often experience severe asthma attacks 10 to 120 minutes after taking these drugs, sometimes accompanied by angioneurotic edema, urticaria, and laryngeal edema. Current research suggests that aspirin-like asthma attacks are associated with the inhibition of cyclooxygenase in the body by aspirin, resulting in the release of large amounts of cysteinyl leukotrienes, leading to a strong inflammatory response in the airways and airway constriction. This type of asthma occurs rapidly with severe shortness of breath and hypoxemia within a short period of time, and should be treated aggressively, including oxygenation, nebulized inhalation of β2 agonists, high-dose glucocorticoids and leukotriene receptor antagonists.  2, beta-blockers: this kind of drugs are propranolol (Jinan), oxyenolol (Jinan), pralinol (Jinan), indolol (Jinanjing), thiomorpholol (thiomorphin), atenolol and metoprolol, etc., because this kind of drugs block beta receptors, thus causing bronchial constriction. In addition to conventional treatment for such asthma attacks, larger doses of β2 agonists should be given.  3, iodine-containing contrast agents: any kind of iodine-containing contrast agents can cause allergic reactions and induce asthma attacks, with the highest incidence of contrast agents containing methyl glucosamine.  4, angiotensin-converting enzyme inhibitors: these drugs include captopril, enalapril, benazepril, perindopril, etc., because they can inhibit the degradation of bradykinin, thus inducing airway hyperreactivity and aggravating airway inflammation. It often manifests clinically as chronic cough.  5.Sedatives: Avoid using sedatives during acute asthma attacks because any sedative will inhibit breathing, and when severe asthma attacks occur, the use of sedatives will accelerate the appearance of respiratory failure.  6, other drugs: including antibiotics, proteins and other biological agents, deworming drugs, etc., may induce allergic reactions and asthma attacks.  Asthma patients are allergic and their pathophysiology is characterized by chronic inflammation of the airways, so any drugs that may cause allergic reactions and aggravate airway inflammation may induce or aggravate asthma. If an asthma attack or exacerbation occurs, it is important to clarify whether it is related to the medication used and to stop it in time to prevent re-use from triggering another asthma attack. When an asthma attack occurs, it is important to seek medical attention and take active measures to deal with it.