Asthma

  • Alternative Names

    Bronchial asthma; Exercise-induced asthma


    Treatment

    The goal of treatment is to avoid the substances that trigger your symptoms and control airway inflammation. You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.

    For information on treating asthma in children, see: Pediatric asthma

    There are two basic kinds of medication for treating asthma:

    • Control drugs to prevent attacks
    • Quick-relief drugs for use during attacks

    Control drugs for asthma control your symptoms if you don't have mild asthma. You must take them every day for them to work. Take them even when you feel okay.

    The most common control drugs are:

    • Inhaled corticosteroids (such as Asmanex, Alvesco, Qvar AeroBid, Flovent, Pulmicort) prevent symptoms by helping to keep your airways from swelling up.
    • Long-acting beta-agonist inhalers also help prevent asthma symptoms. Do not take long-acting beta-agonist inhaler drugs alone. These drugs are almost always used together with an inhaled steroid drug. It may be easier to use an inhaler that contains both drugs.

    Other control drugs that may be used are:

    • Leukotriene inhibitors (such as Singulair and Accolate)
    • Omalizumab (Xolair)
    • Cromolyn sodium (Intal) or nedocromil sodium (Tilade)
    • Aminophylline or theophylline (rarely used anymore)

    Quick-relief drugs work fast to control asthma symptoms:

    • You take them when you are coughing, wheezing, having trouble breathing, or having an asthma attack. They are also called "rescue" drugs.
    • They also can be used just before exercising to help prevent asthma symptoms that are caused by exercise.
    • Tell your doctor if you are using quick-relief medicines twice a week or more to control your asthma symptoms. Your asthma may not be under control, and your doctor may need to change your dose of daily control drugs.

    Quick-relief drugs include:

    • Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, and Xopenex
    • Your doctor might prescribe oral steroids (corticosteroids) when you have an asthma attack that is not going away. These are medicines that you take by mouth as pills, capsules, or liquid. Plan ahead. Make sure you do not run out of these medications.

    A severe asthma attack requires a check-up by a doctor. You may also need a hospital stay, oxygen, breathing assistance, and medications given through a vein (IV).

    ASTHMA CARE AT HOME

    • Self-care skills that are important in taking care of your asthma are
    • Know the asthma symptoms to watch out for
    • Know how to take your peak flow reading and what it means
    • Keep the phone number of your child's doctor or nurse with you.
    • Know which triggers make your asthma worse and what to do when this happens.
    • Children with asthma need a lot of support at school. They may need help from school staff to keep their asthma under control and to be able to do school activities.

    Asthma action plans are written documents for anyone with asthma. An asthma action plan should include:

    • A plan for taking asthma medications when your condition is stable
    • A list of asthma triggers and how to avoid them
    • How to recognize when your asthma is getting worse, and when to call your doctor or nurse

    A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.

    • It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken.
    • Peak flow values of 50% - 80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.

    Support Groups

    You can often ease the stress caused by illness by joining a support group, where members share common experiences and problems.

    See: Asthma and allergy - support group


    Expectations (prognosis)

    There is no cure for asthma, although symptoms sometimes improve over time. With proper self management and medical treatment, most people with asthma can lead normal lives.


    Complications

    The complications of asthma can be severe. Some include:

    • Death
    • Decreased ability to exercise and take part in other activities
    • Lack of sleep due to nighttime symptoms
    • Permanent changes in the function of the lungs
    • Persistent cough
    • Trouble breathing that requires breathing assistance (ventilator)

    Calling your health care provider

    Call for an appointment with your health care provider if asthma symptoms develop.

    Call your health care provider or go to the emergency room if:

    • An asthma attack requires more medication than recommended
    • Symptoms get worse or do not improve with treatment
    • You have shortness of breath while talking
    • Your peak flow measurement is 50% - 80% of your personal best

    Go to the emergency room if the following symptoms occur:

    • Drowsiness or confusion
    • Severe shortness of breath at rest
    • A peak flow measurement is less than 50% of your personal best
    • Severe chest pain
    • Bluish color to the lips and face
    • Extreme difficulty breathing
    • Rapid pulse
    • Severe anxiety due to shortness of breath