Asthma Treatment
Asthma cannot be cured, but with the right asthma treatment it can be well managed. Many people with asthma live active, health lives when their condition is controlled properly.
Main Goals of Treatment
- Prevent asthma attacks
- Control asthma symptoms
How to Achieve These Goals
Asthma Plans
People with asthma usually have 2 types of plans:
- Regular Asthma Plan
- includes daily medication details – what to take, how to take it, and how often
- Asthma Action Plan
- provides guidance on what to do when symptoms worsen or during an asthma attack
Medication
Asthma treatment is not the same for everyone. Medication is chosen in a discussion with you and based on:
- Your age
- Type and severity of symptoms
- Known asthma triggers
Medication may be taken every day, only when needed, or both.
2 Types of Asthma Medication
- Quick-relieve medication, used during asthma attack
- Long-term medication, taken regularly to prevent symptoms and to keep your asthma stable
If quick-relief medication is needed often, it may be a sign that the long-term treatment needs adjusting.
Quick-Relief Medication
Quick-relief, or rescue medication, works fast to open the airways during an asthma attack. These medications are usually inhaled and should be carried them with you at all times.
Side effects, while rare, can occur. Any changes, such as rash, swelling, heart palpitations, nervousness, weight gain, or headache should be discussed with your medical team.
Short-acting beta2-agonists (SABAs)
- Quickly open airways and help prevent asthma attacks caused by physical activity.
- Taken as inhalers or through a nebulizer
- Examples: albuterol (ProAir, Ventolin), levabuterol (Xopenex)
Short-acting anticholinergics
- Work as bronchodilatators and quickly open airways
- Often used when SABAs cause side-effects
- Mostly prescribed to adults with other lung conditions (like emphysema or chronic bronchitis)
- Examples: ipratropium (Atrovent), tiotropium (Spiriva)
Systemic corticosteroids
- Reduce inflammation and help ease airway swelling
- Taken as tablets or given through IV
- Used short-term due to potential serious side effects
- Examples: prednisone (Prednisone Intensol, Rayos), methylprednisone (Medrol)
Long-Term Medication
Long-term medication helps reduce airway inflammation and relax the airway muscles. These medications are usually taken daily to help prevent asthma attacks and control asthma symptoms.
Corticosteroids
- Reduce airways swelling
- Can take days to weeks to reach their intended effect
- Available as inhalers (nebulizers, metered dose inhaler, dry powder inhaler)
- Have fewer side effects than oral corticosteroids
- Examples: fluticasone (Flovent, Xhance), budesonide (Pulmicort, Rhinocort), ciclesonide (Alvesco), beclomethasone (Qvar), mometasone (Asmanex), Fluticasone furoate (Arnuity Ellipta)
Leukotriene modifiers
- Block or reduce the effects of leukotrienes, which cause airway narrowing and the mucus production in the airways
- Sometimes used with corticosteroids
- Examples: montelukast (Singulair), zafirlukast (Accolate), zileuton (Zyflo)
Long-acting beta2-agonists (LABAs)
- Relax airway muscles (bronchodilatator) for a longer period
- Often prescribed when inhaled steroids alone don’t control daily symptoms
Combination inhalers
- Contain a long-acting beta agonist (LABA) and an inhaled corticosteroid
- Help reduce inflammation and keep airway muscles relaxed
- Examples: Fluticasone-salmeterol (Advair Diskus, Airduo), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera), fluticasone furoate-vilanterol (Breo Ellipta)
Theophylline (Theo-24)
- Relax airway muscles (bronchodilatator)
- Sometimes used for nighttime asthma symptoms
Immunomodulatory medication (Biologics)
- Change the response of the immune system
- Prescribed when other asthma medication aren’t working sufficiently
- Examples: Mepolizumab (Nucala), dupilumab (Dupixent), benralizumab (Fasenra)
Allergy Medication
If asthma attacks are triggered by an allergy or your asthma symptoms worsen due to allergens, there are specific medical options to help you.
- Allergy shots
- Reduce the immune system’s reaction to specific allergens
- Contain a small amount of an allergen, with the dose slowly increased over time
- Aim to make the reaction to the allergen weaker and help the body build tolerance
- The schedule can be intense (weekly shots for the first few months, then monthly shots for longer)
- Immunotherapy tablets
- Tablets available for some allergens that can be taken instead of allergy shots
- Allergy medications
- Help relieve symptoms and are available a tablets or nasal sprays
- Examples: antihistamine tablets or sprays, decongestants nasal spray, corticosteroid nasal spray and others
How to Handle Asthma Triggers and Allergens
Managing asthma triggers and allergens starts with good hygiene, including regular handwashing with soap, which is more effective than hand sanitizer. Specific recommendations depend on the type of trigger:
- Pollen allergy: Keep windows closed during peak pollen times; shower and wash your hair after having been outdoors
- Ozone: Ozone levels are usually higher in the afternoon and on warm days – limit outdoor activities during those times
- Indoor triggers (e.g., burning candles, dust, and other allergens): Use allergy-proof bedding and wash it in hot water weekly; avoid using wood stoves or open wood fire
- Smoking and vaping: Avoid smoking or vaping and stay away from areas where others are smoking, especially indoors
- Fragrances and chemicals: Use unscented products; make sure rooms are well ventilated after cleaning
- Pet allergy: Avoid contact with the animal that causes the allergy
- Exercise: Consider taking quick-relief medication 20-30mins before physical activity
- Cold weather: Dress warmly and keep clothes dry; cover nose and mouth with a scarf to warm the air before breathing it in; try to breathe through nose instead of the mouth
- Infections: Stay up to date with vaccinations for flu, COVID, and RSV
- Emotions/Stress: Use relaxation techniques to help reduce stress