during an acute asthma exacerbation where airway smooth muscle is constricted, inhalation of SABAs provide rapid relief of symptoms—within 5–15 minutes—and are typically called "rescue inhalers". Due to their fast onset of action, they have been selected as first-line therapy for quick relief in persistent and intermittent asthma and bronchospasm. Patients may experience dizziness, heart palpitations, hyperglycemia, diarrhea and muscle cramps when taking these medications. Importantly, medications that antagonize the β2 receptor (β-blockers) may significantly increase the risk of asthma exacerbations, and are generally avoided in asthmatic patients. Corticosteroids: Inhaled corticosteroids (e.g. fluticasone, budesonide) are typically used when bronchoconstrictive disease has advanced to a persistent inflammatory state, more specifically in persistent or severe asthma and chronic obstructive pulmonary disease (COPD). These medications decrease immune system activity which in turn will decrease swelling of the airways, decrease airway resistance, and increase delivery of air to the alveoli during respiration. Unlike the SABAs, these medications do not provide relief of acute symptoms or asthmatic attacks, and their benefits are typically only seen after 3–4 weeks of therapy. Due to this delayed therapeutic response, it is essential that patients who are prescribed corticosteroids for respiratory disease are adherent to their medication regimen. In the ISOLDE trial, fluticasone therapy decreased the frequency of COPD exacerbations and the rate of health decline in patients with moderate-to-severe COPD; however, had little effect in decreasing the rate of FEV1 decline. Patients should be counseled to wash their mouth following use of inhaled corticosteroids to decrease the risk of developing oral thrush, a common side effect of these medications. Muscarinic antagonists (anti-cholinergics): Blocking the muscarinic acetylcholine receptors in pulmonary smooth muscle tissue results in a decrease in smooth muscle tone and bronchodilation. These medications include short-acting muscarinic antagonists (SAMAs) such as ipratropium, and long-acting muscarinic antagonists (LAMA) such as tiotropium. Onset of action for SAMAs is typically between 30 and 60 minutes, making these drugs less efficacious in treating acute asthma attacks and bronchospasm. Most common side effects for these drugs may include dry mouth, headache, urinary tract infection, and bronchitis. Other: Other prescription and over-the-counter medications, such as theophylline, cromolyn, and montelukast are indicated for specific diseases and may only provide bronchoconstriction relief to these studied populations. See also Bronchodilatation Bronchospasm References External links Pharmacotherapy of bronchoconstriction in patients with asthma by antiepileptic drugs Why Do So Many Winter Olympians Have Asthma? Salt Intake, Asthma, and Exercise-Induced