Asthma
Asthma Treatment
Even though we cannot cure asthma, we can control it. Each case of asthma is different, so you and your doctor need to create an asthma treatment plan just for you. This plan will have information about your asthma triggers and instructions for taking your medicines.
What Do I Need to Know About Asthma Medicines?
You take most asthma medicines by breathing them in using an inhaler or nebulizer. But some asthma medicines are in pill form. An inhaler or nebulizer allows the medicine to go directly to your lungs.
Inhalers (also called puffers)
There are two types of inhalers: metered dose inhaler (MDI) and dry powder inhaler (DPI).
- Metered dose inhalers: use an aerosol canister inserted into a plastic mouthpiece to deliver a short burst of medicine
- Dry powder inhalers: deliver medicine as a dry powder using a special inhaler
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Different types of inhalers
For inhalers to work well, you must use them correctly. But more than half of all people who use inhalers don’t use them properly. Ask your doctor or nurse to watch you and check your technique. If it is still difficult to use, you have two choices. Ask them to recommend a spacer or holding chamber. This device attaches to the inhaler to make it easier to use and to help more medicine reach the lungs. Everyone can benefit from using a spacer or holding chamber, especially children. Or, ask about using a “breath actuated” inhaler, which automatically releases medicine when you inhale.
Inhaler inserted into a spacer or chamber
Nebulizers
A nebulizer is a machine with tubing that takes liquid medicine and turns it into a mist that you inhale. Nebulizers are an option for anyone who has difficulty using an asthma inhaler.
What Are the Different Types of Asthma Medicine?
There are two types of asthma medicines: long-term controllers and quick-relievers. The difference between these can be confusing. That’s why you need to understand what each type of medicine does and how they help your asthma. It’s also important to learn how to use each medicine correctly. Always take your medicines and follow your health care provider’s instructions.
Long-Term Control Medicines
Long-term control medicines help you prevent and control asthma symptoms. You may need to take this type of medicine every day for best results. There are several kinds of long-term control medicines:
- Inhaled corticosteroids prevent and reduce airway swelling. They also reduce mucus in the lungs. They are the most effective long-term control medicines available. Corticosteroids are not the same as anabolic steroids that are taken by some athletes and banned in many athletic events.
- Inhaled long-acting beta agonists open the airways by relaxing the smooth muscles around the airways. If used, this type of medicine should always be taken in combination with an inhaled corticosteroid.
- Combination inhaled medicines contain both an inhaled corticosteroid and a long-acting beta agonist. If you need both of these medicines, this is a convenient way to take them together.
- Biologics are shots or infusions given every few weeks. They work by targeting a cell or protein in your body to prevent airway inflammation. They can be very expensive treatments and are usually only prescribed if other asthma medicines have not controlled your asthma.
- Leukotriene modifiers are taken in pill or liquid form. This type of medicine reduces swelling inside the airways and relaxes smooth muscles.
- Cromolyn sodium is an inhaled non-steroid medicine. It prevents airways from swelling when they come into contact with an asthma trigger.
- Theophylline comes as a tablet, capsule, solution and syrup to take by mouth. This medicine helps open the airways by relaxing the smooth muscles.
- Oral corticosteroids are taken in pill or liquid form. This medicine may be prescribed for the treatment of asthma attacks that don’t respond to other asthma medicines. They also are used as long-term therapy for some people with severe asthma. Corticosteroids are not the same as anabolic steroids taken by some athletes and banned in many athletic events.
Quick-Relief Medicines
You use quick-relief medicines to help relieve asthma symptoms when they happen. These medicines act fast to relax tight muscles around your airways. This allows the airways to open up so air can flow through them. You should take your quick-relief medicine when you have asthma symptoms. If you use this medicine more than two days a week, talk with your doctor about your asthma control. You may need to make changes to your treatment plan.
- Short-acting beta agonists are inhaled and work quickly to relieve asthma symptoms. These medicines relax the smooth muscles around the airways. These medicines are the first choice for quick relief of asthma symptoms.
- Anticholinergics are inhaled but act slower than the short-acting beta agonist medicines. These medicines open the airways by relaxing the smooth muscles around the airways. They also reduce mucous production.
- Combination quick-relief medicines contain both an anticholinergic and a short-acting beta agonist. This combination comes either as an inhaler or nebulizer for inhalation.
Can Medicine Alone Help My Asthma?
Not usually. Although medicines help a lot, they may not be able to do the job alone. You have to avoid the things that cause or trigger your asthma symptoms as much as you can. Asthma triggers can be found outside or inside your home, school or work place.
Will I Always Have to Take the Same Amount of Medicine?
Not always. You will probably take more medicine when you begin treatment to get control of your asthma. After a while, you and your doctor will learn which medicine(s) control your asthma best and how much you need. Once your asthma is well-controlled, it may be possible to reduce the amount of medicine you take. The goal of this step-down method is to gain control of your asthma as soon as possible and then control it with as little medicine as possible. Once long-term, anti-inflammatory therapy begins, your doctor will want to monitor you every 1 to 6 months.
Will I Have to Take Medicine All the Time?
Maybe not. Asthma is a chronic condition that is controllable, but not curable. For that reason, you will likely have asthma symptoms when exposed to triggers for a long time. This is the case even if you don’t have symptoms very often. Your treatment will depend on the severity and frequency of your symptoms. If your asthma is controlled, your treatment will focus on quick relief from acute symptoms and treatment of episodes when they occur.
If your symptoms occur at certain times and you know what caused them, you and your doctor can use this information to determine the best treatment. If, for example, you have seasonal asthma because of a specific pollen allergy, you may take medicines only when that pollen is in the air. But asthma that specific is not common. Many people with asthma take some form of medicine most or all of the time.
Will Medicine Help Me Sleep Better?
Yes. Asthma symptoms often occur at night. Many people wake up with asthma symptoms such as coughing or wheezing. You can control nighttime symptoms by taking asthma controller medicines on a regular basis.
Many people are allergic to dust mites and mold found in bedding materials. Using mattress or pillow encasements can help contain those allergens. Dehumidifiers can also be helpful reducing the humidity in your home that dust mites and mold need to exist. Using air filters in your bedroom may also help reduce your nighttime symptoms caused by other allergens such as pets.
Will Medicine Help Me Breathe Better When I Exercise?
Yes. Exercising, particularly in cold air, may cause airway inflammation or exercise-induced bronchospasm (EIB). Quick-relief asthma medicines, taken before and during exercise, usually control this. Thanks to these medicines, many Olympic and professional athletes have successful sports careers even with their asthma.
Do Asthma Medicines Have Side Effects?
Yes. All medicines have side effects. You should give your doctor your entire health history, not just your asthma symptoms. Tell your doctor how you are responding to the treatment and whether you have any side effects. Follow-up often with your doctor so you can control your asthma with the least amount of medicines and with the fewest side effects.
What If Medicines Don’t Help My Asthma Symptoms?
Bronchial thermoplasty is a treatment option for people whose asthma symptoms are not controlled with medicines. It is a series of procedures that use a heating device to reduce excess smooth muscle in the airways. This can reduce asthma episodes or attacks for those with severe asthma. AAFA has issued a statement in support of bronchial thermoplasty as a drug-free option for those with severe, uncontrolled asthma. 
Medical Review September 2015.