Asthma is a long-term disease that has no cure. The goal of asthma treatment is to control the disease. Good asthma control will:
- Prevent chronic and troublesome symptoms, such as coughingand shortness of breath
- Reduce your need for quick-relief medicines (see below)
- Help you maintain good lung function
- Let you maintain your normal activity level and sleep through the night
- Prevent asthma attacks that could result in an emergency room visit or hospital stay
To control asthma, partner with your doctor to manage your asthma or your child’s asthma. Children aged 10 or older—and younger children who are able—should take an active role in their asthma care.
Taking an active role to control your asthma involves:
- Working with your doctor to treat other conditions that can interfere with asthma management.
- Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.
- Working with your doctor and other health care providers to create and follow an asthma action plan.
An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking emergency care when needed.
Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or “rescue,” medicines relieve asthma symptoms that may flare up.
Your initial treatment will depend on the severity of your asthma. Followup asthma treatment will depend on how well your asthma action plan is controlling your symptoms and preventing asthma attacks.
Your level of asthma control can vary over time and with changes in your home, school, or work environments. These changes can alter how often you’re exposed to the factors that can worsen your asthma.
Your doctor may need to increase your medicine if your asthma doesn’t stay under control. On the other hand, if your asthma is well controlled for several months, your doctor may decrease your medicine. These adjustments to your medicine will help you maintain the best control possible with the least amount of medicine necessary.
Asthma treatment for certain groups of people—such as children, pregnant women, or those for whom exercise brings on asthma symptoms—will be adjusted to meet their special needs.
Medicines
Your doctor will consider many things when deciding which asthma medicines are best for you. He or she will check to see how well a medicine works for you. Then, he or she will adjust the dose or medicine as needed.
Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler. An inhaler allows the medicine to go directly to your lungs.
Not all inhalers are used the same way. Ask your doctor or another health care provider to show you the right way to use your inhaler. Review the way you use your inhaler at every medical visit.
Long-Term Control Medicines
Most people who have asthma need to take long-term control medicines daily to help prevent symptoms. The most effective long-term medicines reduce airway inflammation, which helps prevent symptoms from starting. These medicines don’t give you quick relief from symptoms.
Quick-Relief Medicines
All people who have asthma need quick-relief medicines to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonists are the first choice for quick relief.
These medicines act quickly to relax tight muscles around your airways when you’re having a flareup. This allows the airways to open up so air can flow through them.
You should take your quick-relief medicine when you first notice asthma symptoms. If you use this medicine more than 2 days a week, talk with your doctor about your asthma control. You may need to make changes to your asthma action plan.
Carry your quick-relief inhaler with you at all times in case you need it. If your child has asthma, make sure that anyone caring for him or her has the child’s quick-relief medicines, including staff at the child’s school. They should understand when and how to use these medicines and when to seek medical care for your child.
Record Your Symptoms
You can record your asthma symptoms in a diary to see how well your treatments are controlling your asthma.
Asthma is well controlled if:
- You have symptoms no more than 2 days a week, and these symptoms don’t wake you from sleep more than 1 or 2 nights a month.
- You can do all your normal activities.
- You take quick-relief medicines no more than 2 days a week.
- You have no more than one asthma attack a year that requires you to take corticosteroids by mouth.
- Your peak flow doesn’t drop below 80 percent of your personal best number.
If your asthma isn’t well controlled, contact your doctor. He or she may need to change your asthma action plan.
Children
It’s hard to diagnose asthma in children younger than 5 years. Thus, it’s hard to know whether young children who wheeze or have other asthma symptoms will benefit from long-term control medicines. (Quick-relief medicines tend to relieve wheezing in young children whether they have asthma or not.)
Doctors will treat infants and young children who have asthma symptoms with long-term control medicines if, after assessing a child, they feel that the symptoms are persistent and likely to continue after 6 years of age. (For more information, go to “How Is Asthma Diagnosed?”)
Inhaled corticosteroids are the preferred treatment for young children. Montelukast and cromolyn are other options. Treatment might be given for a trial period of 1 month to 6 weeks. Treatment usually is stopped if benefits aren’t seen during that time and the doctor and parents are confident the medicine was used properly.
Inhaled corticosteroids can possibly slow the growth of children of all ages. Slowed growth usually is apparent in the first several months of treatment, is generally small, and doesn’t get worse over time. Poorly controlled asthma also may reduce a child’s growth rate.
Many experts think the benefits of inhaled corticosteroids for children who need them to control their asthma far outweigh the risk of slowed growth.
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