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Asthma
How is Asthma Treated?
You and your doctor together can decide about your treatment goals and what you need to do to control your asthma. Asthma treatment includes:
Avoiding things that bring on your asthma symptoms or make symptoms worse. Doing so can reduce the amount of medicine you need to control your asthma. Allergy medicine and allergy shots in some cases may help your asthma.
Using asthma medicines.
With proper treatment, you should ideally have these results:
Your asthma should be controlled.
You should be free of asthma symptoms.
You should have fewer attacks.
You should need to use short-acting bronchodilators less often.
You should be able to do normal activities without having symptoms.
Your doctor will fill out an action plan for your asthma. Your action plan will tell you what medications you should take and other things you should do to keep your asthma under control.
Medications for asthma. There are two main types of medicines for asthma:
1. Quick Relief medicines give rapid, short-term treatment and are taken when you have worsening asthma symptoms that can lead to asthma episodes or attacks. You will feel the effects of these medicines within minutes.
2. Long-term Control medicines are taken every day, usually over long periods of time, to control chronic symptoms and to prevent asthma episodes or attacks. You will feel the full effects of these medicines after taking them for a few weeks. People with persistent asthma need long-term control medicines.
Quick relief medicines are used only when needed. A type of quick relief medicine is a short-acting inhaled bronchodilator. Bronchodilators work by relaxing tightened muscles around the airways. They help open up airways quickly and ease breathing. They are sometimes called "rescue" or "relief" medicines because they can stop an asthma attack. These medicines act quickly but their effects only last for a short period of time. You should take quick relief medicines when you first begin to feel asthma symptoms like coughing, wheezing, chest tightness, or shortness of breath. Anyone who has asthma should always have one of these inhalers in case of an attack. For severe attacks, your doctor may use steroids to treat the inflammation.
Long-term control medicines. The most effective, long-term control medication for asthma is an inhaled corticosteroid (kor-ti-ko-STE-roid) because this medicine reduces the swelling of airways that makes asthma attacks more likely.
Inhaled corticosteroids (or steroids for short) are the preferred treatment for controlling mild, moderate, and severe persistent asthma. They are safe when taken as directed by your doctor. Inhaled medicines go directly into your lungs where they are needed. There are many kinds of inhalers that require different techniques, and it is important to know how to use your inhaler correctly. In some cases, steroid tablets or liquid are used for short times to bring asthma under control. The tablet or liquid form may also be used to control severe asthma.
Long-acting beta-agonists are another kind of long-term control medication. They are bronchodilators, not anti-inflammatory drugs. These medicines are used to help control moderate and severe asthma and to prevent nighttime symptoms. Long-acting beta-agonists are taken together with inhaled corticosteroid medicine.
Leukotriene modifiers (montelukast, zafirlukast, and zileuton) are long-term control medicines used either alone to treat mild persistent asthma or together with inhaled corticosteroids to treat moderate persistent asthma or severe persistent asthma.
Cromolyn and nedocromil are also long-term control medicines used to treat mild persistent asthma.
Theophylline is a long-term control medication used either alone to treat mild persistent asthma or together with inhaled corticosteroids to treat moderate persistent asthma. People who take theophylline should have their blood levels checked to be sure the dose is appropriate.
If you stop taking long-term control medicines, your asthma will likely worsen again.
Many people with asthma need both a short-acting bronchodilator to use when symptoms worsen and long-term daily asthma control medication to treat the ongoing inflammation. Over time, your doctor may need to make changes in your asthma medication. You may need to increase your dose, lower your dose, or try a combination of medications. Be sure to work with your doctor to find the best treatment for your asthma. The goal is to use the least amount of medicine necessary to control your asthma.
Use a peak flow meter. As part of your asthma action plan, you may use a hand-held device called a peak flow meter at home to measure lung function. To use it, you take a deep breath and blow hard into a tube to find out how fast you can blow out. This gives you a peak flow number. You will need to find out your "personal best" peak flow number by recording the peak flow number daily for a few weeks until your asthma is under control. The highest number you get during that time is your personal best peak flow. Then you can compare future peak flow measurements to your personal best peak flow, and that will show if your asthma is staying under control or not.
Your doctor will tell you how and when to use your peak flow meter and how to use your medication based on the results. You may be asked to use your peak flow meter each morning to keep track of how well you are breathing. The peak flow meter can help warn of a possible asthma attack even before you notice symptoms. If your peak flow meter shows that your breathing is getting worse, you should follow your action plan. Take your quick relief or other medication as your doctor directed. Then you can use the peak flow meter to see how your airways are responding to the medication.
Ask your doctor about how you can help take care of your own asthma. You should know:
How to take your long-term daily medication correctly
What things tend to make your asthma worse and ways to avoid them
Early signs to watch for that mean your asthma is starting to get worse (like a drop in your peak flow number or an increase in symptoms)
How and when to use your peak flow meter
What medication and how much to take to stop an asthma attack and how to use it correctly
When to call or see your doctor
When you should get emergency treatment
Treating asthma in children. Children with asthma, like adults with asthma, should see a doctor for treatment. Treatment may include allergy testing, finding ways to limit contact with things that cause asthma attacks, and taking medication.
Young children will need help from their parents and other caregivers to keep their asthma under control. Older children can learn to care for themselves and follow their asthma action plan with less supervision.
Medications for asthma in children are like those adults use, but doses are smaller. Children with asthma may need both a quick-relief (or "rescue") inhaler for attacks and daily medication to control their asthma. Children with moderate or severe asthma should learn to use a peak flow meter to help keep their asthma under control. Using a peak flow meter can be very helpful because children often have a hard time describing their symptoms.
Parents should be alert for possible signs of asthma in children, such as coughing at night, frequent colds, wheezing, or other signs of breathing problems. If you suspect asthma or that your child's asthma is not in good control, take your child to a doctor for an exam and testing.
Your doctor will choose medication for your child based on the child's symptoms and test results. If your child has asthma, you will need to go to the doctor for regular followup visits and make sure that your child uses the medication properly.
Treating asthma in older adults. Older adults may need to have adjustments in their asthma treatment because of other diseases or conditions they have. Some medicines (like beta blockers used for treating high blood pressure and glaucoma, aspirin, and nonsteroidal anti-inflammatory drugs) can interfere with asthma medications or even cause asthma attacks. Be sure to tell your doctor about all medications that you take, including over-the-counter ones. Using steroids may affect bone density in adults, so ask your doctor about taking calcium and vitamin D supplements and other ways to help keep your bones strong.
Treating asthma in pregnancy. If you are pregnant, it is very important to both you and your baby to control your asthma. Uncontrolled asthma can lower the oxygen level in your blood, which means that your baby gets less oxygen too. Most asthma medications are safe to take during pregnancy. If you are pregnant or thinking about becoming pregnant, talk to your doctor about your asthma and how to have a healthy pregnancy.
Treating exercise-induced asthma. Regular physical exercise is important for good health. If exercise brings on asthma symptoms, work with your doctor to find the best way to avoid having symptoms when you exercise. Some people with asthma use inhaled quick relief medication before exercising to keep symptoms under control. If you use your asthma medication as directed and learn how to pace yourself, you should be able to take part in any physical activity or sport you choose. Many Olympic athletes have asthma.
Living With Asthma
If you have asthma, it is important to learn how to take care of yourself. Work with your doctor to make an action plan that you are both happy with.
Tell your doctor about all other medications you are taking, in case one of them affects your asthma.
Follow your asthma action plan and have regular checkups.
Learn to use your medication correctly. Ask your doctor to teach you how to use your inhaler. This is very important. If inhalers are not used correctly, less medication gets into the airways.
If you are having problems taking your asthma medicine, let your doctor know right away.
You need to know what things worsen your asthma symptoms. Then do what you can to avoid or limit contact with these things.
If animal dander is a problem for you, keep your pet out of the house and/or at least out of your bedroom and wash your pet often, or find it a new home.
Do not smoke or allow smoking in your home.
If pollen is a problem for you, stay indoors with the air conditioner on when the pollen count is high.
To control dust mites, wash your sheets, blankets, pillows, and stuffed toys once a week in hot water. You can get special dust proof covers for your mattress and pillows.
To prevent colds and flu, wash your hands often and get a flu shot every year. Children with asthma should get flu shots, too.
If cold air bothers you, wear a scarf over your mouth and nose in the winter.
If you get asthma when you exercise or do routine physical activities like climbing stairs, work with your doctor to find ways to be active without having asthma symptoms. Physical activity is important.
If you are allergic to sulfites, avoid foods (like dried fruit) or beverages (like wine) that contain them.
Be alert for warning signs of an asthma attack.
Watch for symptoms (coughing, wheezing, chest tightness, and difficulty breathing) and use your medication as directed by your doctor.
Use your peak flow meter as directed to monitor your asthma.
Adopt a healthy lifestyle. While a healthy lifestyle may not keep you from having problems with allergies and asthma, being healthier in general can't hurt! Eat a healthy diet rich in fruits and vegetables and low in fats and sugars, get enough rest, exercise regularly, try to find ways to manage stress in your life, and don't smoke.
If your asthma is not under control, there will be signs that you should not ignore. The following are some signs that your asthma is getting worse:
Your asthma symptoms happen more often.
Your asthma symptoms are worse than they used to be.
Your asthma symptoms are bothering you a lot at night and making you lose sleep.
You are missing school or work because of your asthma.
Your peak flow number is low or varies a lot from morning to evening.
Your asthma medications do not seem to be working very well anymore.
You have to use your short-acting "quick relief" or "rescue" inhaler more often. (Using quick relief medicine every day, or using more than one inhaler a month is too much)
You have to go to the emergency room or doctor because of an asthma attack.
You end up in the hospital because of your asthma.
If your asthma seems to be getting worse, see your doctor. You may need to change your medication or do other things to get your asthma under control.
Helping Your Child Live with Asthma
Children with asthma need the help of parents, other caregivers, teachers, and health care professionals to keep their asthma under control.
You can help your child with asthma keep it under control. For example, you can:
Take your child to the doctor for regular checkups and treatment.
Schedule your child for a flu shot.
Make sure your child has an asthma action plan and that you know how to follow it.
Help your child learn about asthma and how to control it.
Help your child learn what things cause his or her asthma symptoms and how to avoid them, if possible.
Protect your child from tobacco smoke by not smoking and not allowing people to smoke in your home.
Find ways to reduce your child's exposure to allergens that bring on asthma attacks, like pollen, dust mites, cockroaches, or animal dander.
Make sure your child knows how to take asthma medication correctly (if your child is old enough to use an inhaler without your help).
Make sure that your child uses a peak flow meter to help monitor and control asthma.
Encourage your child to take part in physical activity. Work together to keep his or her asthma under control. Your child can be active.
Talk to your child's other caregivers, teachers, or coaches about his or her asthma; give them copies of your child's asthma action plan.
