Asthma Therapy 101

If you have asthma, it is important to know the role of the different medications used for asthma and how they should be used to best control asthma.

The characteristic symptoms of asthma are cough, wheeze, shortness of breath, chest tightness. These symptoms can lead to difficulty with exercise, activities and with sleep. The goals of asthma therapy are to reduce symptoms, reduce the need for rescue inhaler and reduce the risk of exacerbations (worsening asthma symptoms that may require oral steroids, like prednisone). Health care providers will assess asthma control over time and add and adjust medications, in a step-wise approach, until asthma is controlled. Control of asthma means a patient is having infrequent symptoms (<2x/week), minimal disruption in activity, no nighttime awakenings due to asthma and is not requiring rescue medication often.

Rescue medications, typically albuterol, are inhalers (medications delivered to the lungs) used when symptoms are present. When used effectively, these medications improve symptoms within minutes. They work by relaxing the muscles in the airway, which allows the airways to open. Your doctor may suggest a spacer or valved holding chamber device, which helps hold the medication so it can be effectively delivered to the lungs. Rescue inhalers should be carried by asthma patients all the time, to treat any symptoms quickly.

If an asthma patient’s symptoms are occurring often (≥ 2x/week) or if a patient is waking up at night with asthma symptoms, a controller medication is added to the regimen. Controller medications are medications patients taken every day to prevent symptoms. These medications should be taken daily or twice daily. Most of these controller medications are inhalers. The inhalers typically contain inhaled steroids, which decrease the inflammation (or swelling) in the airway. Some controller medications are combination medications, which are generally prescribed if symptoms require a higher level of treatment. These combination medications contain both an inhaled steroid as well as a long acting beta agonist (LABA) which is a long acting form of albuterol. If asthma is not well controlled with a combination medication, a separate inhaler may be added to help open the airways even more or an injected therapy may be considered (biologic medications designed to target specific pathways in asthma).

Achieving asthma control is important to help minimize disruption in activity, sleep and exercise. It is also important to understand triggers (environmental allergens, temperature, exercise, etc) for your asthma. Working with your trusted Allergy Partners physician can help you find any underlying triggers and understand how to avoid these triggers as well as manage your asthma.