How Is Asthma Treated?
Your doctor can work with you to decide about your
treatment goals and what you need to do to control your asthma to achieve these
goals. Asthma treatment includes:
- Working closely with your doctor to decide what
your treatment goals are and learning how to meet those goals.
- Avoiding things that bring on your asthma
symptoms or make your symptoms worse. Doing so can reduce the amount of
medicine you need to control your asthma.
- Using asthma medicines. Allergy medicine and
shots may also help control asthma in some people.
- Monitoring your asthma so that you can recognize
when your symptoms are getting worse and respond quickly to prevent or stop an
asthma attack.
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 quick-relief medicines
less often.
- You should be able to do normal activities
without having symptoms.
Your doctor will work with you to develop an asthma
self-management plan for controlling your asthma on a daily basis and an
emergency
action
plan for stopping asthma attacks. These plans will tell you what medicines
you should take and other things you should do to keep your asthma under
control.
Medicines for Asthma
There are two main types of medicines for asthma:
- Quick-relief medicinestaken at the first
signs of asthma symptoms for immediate relief of these symptoms. You will feel
the effects of these medicines within minutes.
- Long-term control medicinestaken every day,
usually over long periods of time, to prevent symptoms and 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
Everyone with asthma needs a quick-relief or
"rescue" medicine to stop asthma symptoms before they get worse. Short-acting
inhaled beta-agonists are the preferred quick-relief medicine. These medicines
are bronchodilators. They act quickly to relax tightened muscles around your
airways so that the airways can open up and allow more air to flow through.
You should take your quick-relief medicine when you
first begin to feel asthma symptoms, such as coughing, wheezing, chest
tightness, or shortness of breath. You should carry your quick-relief inhaler
with you at all times in case of an asthma attack.
Your doctor may recommend that you take your
quick-relief medicines at other times as wellfor example, before
exercise.
Long-term control medicines
The most effective, long-term control medicine for
asthma is an inhaled corticosteroid (kor-ti-ko-STE-roid) because this medicine
reduces the airway swelling that makes asthma attacks more likely.
Inhaled corticosteroids (or steroids for short) are
the preferred medicine for controlling mild, moderate, and severe persistent
asthma. They are generally safe when taken as directed by your doctor.
In some cases, steroid tablets or liquid are used
for short periods of time to bring asthma under control. The tablet or liquid
form may also be used to control severe asthma.
Other long-term control medicines include:
- Inhaled long-acting beta-agonists. These
medicines are bronchodilators, or muscle relaxers, not anti-inflammatory drugs.
They are used to help control moderate and severe asthma and to prevent
nighttime symptoms. Long-acting beta-agonists are usually taken together with
inhaled corticosteroid medicines.
- Leukotriene modifiers (montelukast, zafirlukast,
and zileuton), which are used either alone to treat mild persistent asthma or
together with inhaled corticosteroids to treat moderate or severe asthma.
- Cromolyn and nedocromil, which are used to treat
mild persistent asthma.
- Theophylline, which is 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
medicines to treat the ongoing inflammation.
Over time, your doctor may need to make changes in
your asthma medicine. You may need to increase your dose, lower your dose, or
try a combination of medicines. 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.
Most asthma medicines are inhaled. They go directly
into your lungs where they are needed. There are many kinds of inhalers, and
many require different techniques. It is important to know how to use your
inhaler correctly.
Use a Peak Flow Meter
As part of your daily asthma self-management plan,
your doctor may recommend that you use a hand-held device called a peak flow
meter at home to monitor how well your lungs are working.
You use the peak flow meter by taking a deep breath
in and then blowing the air out hard into the peak flow meter. The peak flow
meter then gives you a peak flow number that tells you how fast you moved the
air out.
You will need to find out your "personal best" peak
flow number. You do this by recording your peak flow number every day 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.
Your doctor will tell you how and when to use your
peak flow meter and how to use your medicines based on the results. You may be
advised to use your peak flow meter each morning to keep track of how well you
are breathing.
Your peak flow meter can help warn you 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 emergency asthma
action plan. Take your quick-relief or other medicines as your doctor directed.
Then you can use the peak flow meter to see how your airways are responding to
the medicine.
Ask your doctor about how you can take care of your
asthma. You should know:
- What things tend to make your asthma worse and
how 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 medicines to take, how much to take, when to
take them, and how to take them 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 of their asthma. Treatment may include
allergy testing, finding ways to limit contact with things that bring on asthma
attacks, and taking medicine.
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 self-management plan with less
supervision.
Asthma medicines for 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 medicine 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 that your child has asthma or that
your child's asthma is not well controlled, take your child to a doctor for an
exam and testing.
Your doctor will choose medicines 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 to make sure that
your child uses the medicines properly.
Treating Asthma in Older Adults
Older adults may need to adjust their asthma
treatment because of other diseases or conditions that 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 medicines or even cause asthma attacks. Be sure to tell your doctor
about all medicines 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 medicines are generally safe to take
during pregnancy. Doctors recommend that it is safer to take asthma medicines
during pregnancy than to take the chance that you will have an attack.
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 activity is important for good
health. If exercise brings on your asthma symptoms, talk to your doctor about
the best ways to control your asthma when you are active. Some people with
asthma use inhaled, quick-relief medicines before exercising to keep symptoms
under control.
If you use your asthma medicines as directed, you
should be able to take part in any physical activity or sport you choose. Many
Olympic athletes have asthma. |