Treatment and Management

The keys to controlling asthma are prevention and long-term management. This includes avoiding triggers, monitoring lung function, and taking asthma drugs.

The right treatments for you depend on your age, symptoms, triggers, and other personal factors. Your doctor may follow a stepwise approach to treatment. This means they will increase or decrease your medicines based on how controlled your asthma is.1,2

To treat an asthma attack, you may need to use quick-relief medicines such as short acting beta agonists (SABAs). A good sign that your asthma is under control is minimal use of a quick-relief inhaler. Follow your asthma action plan to determine when to take which medicines.

Long-term asthma control medicines

Long-term control drugs are key to managing asthma. They are usually taken daily to keep asthma under control. Long-term control drugs work by reducing airway inflammation. When airways are less inflamed, they are less sensitive. This reduces the risk of having an asthma attack.1,3

Types and examples of long-term asthma control drugs include:3

Inhaled corticosteroids are the most common long-term asthma control drugs. Other types may be used when inhaled corticosteroids do not control symptoms.2

Quick-relief asthma medicines

Quick-relief drugs are used for short-term symptom relief during an asthma attack. They are usually used as needed or before exercise if your doctor recommends it. They work by opening up swollen airways (bronchodilation).1,3

Types and examples of quick-relief drugs include:3

  • Short-acting beta agonists (SABAs) – ProAir (albuterol sulfate), Ventolin (albuterol sulfate), Xopenex® (levalbuterol)
  • Short-acting anticholinergic drugs – Atrovent® (ipratropium bromide), Spiriva® (tiotropium bromide)

Use these drugs exactly as your doctor describes. If you find yourself using them more often than prescribed, tell your doctor. This is a sign that your asthma is not well-controlled.1

Systemic steroids

If you are in an acute asthma flare that is not improving or is getting worse, your doctor may prescribe steroid pills. Typically you would take these for several days and continue to use your rescue medicine. Steroids taken by mouth are absorbed throughout your body. This provides a greater anti-inflammatory effect to treat your asthma. Examples of steroids include:2

  • Corticosteroids – Prednisone, Medrol® (methylprednisolone)

Allergy medicines

Allergy medicines may help if your asthma is triggered by allergies. Types of allergy medicines include:3

  • Allergy shots (immunotherapy)
  • Intranasal steroids (nasal sprays)
  • Antihistamines

In asthma immunotherapy, you take increasing doses of an allergen over time. This helps reduce your sensitivity to that allergen. It works best when you know exactly what allergen is triggering asthma symptoms.3

Biologics

Biologics target specific molecules in the body that lead to asthma. They are helpful for people with allergy-induced asthma or eosinophilic asthma. Biologics are usually used by people with severe asthma that is not controlled by other drugs.3

Bronchial thermoplasty

Bronchial thermoplasty is not widely recommended at this time. It may be helpful for some adults with uncontrolled, severe asthma. It is only considered if asthma symptoms do not improve with inhaled corticosteroids or other long-term medicines.3

During the procedure, your doctor uses a catheter to heat the inside of your airways. This reduces smooth muscle in your airways, which limits how much they can tighten. This makes breathing easier and reduces asthma attacks.3

This procedure is not right for everyone. Talk to your doctor about whether bronchial thermoplasty is right for you.

Lifestyle and home remedies

Along with medicines, lifestyle changes can help reduce the risk of asthma attacks. For example, you can reduce your exposure to asthma triggers by:3

  • Using an air conditioner instead of opening windows
  • Minimizing dust by using dust-proof bedding and removing carpeting
  • Using a dehumidifier
  • Cleaning damp areas to prevent mold from growing
  • Reducing pet dander
  • Cleaning your home weekly
  • Using a face mask outside in cold, dry, or polluted air

Maintaining a healthy lifestyle can also help control asthma symptoms. Some ways to stay healthy include:3

Monitoring your asthma at home is also important. You can monitor asthma based on symptoms or with a peak flow meter. Talk to your doctor about how you should monitor asthma symptoms. This can help notice the start of an asthma attack.3

Alternative medicine

There is not yet much evidence that complementary or alternative techniques can treat asthma. Some studies have shown promising results for relaxation techniques, breathing techniques, and yoga. But we need more research to understand how to use them safely.3

A few herbal and natural remedies may also improve asthma symptoms. For example, black seed, caffeine, and turmeric may be helpful. Some dietary supplements may also improve asthma symptoms. However, we do not yet have convincing evidence that any herbal or dietary supplements will work.3

Talk to your doctor before trying any alternative practices or herbal remedies. They can suggest how to safely incorporate these into your treatment plan.

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Written by: Matt Zajac | Last reviewed: September 2021