Asthma

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Asthma Treatment

Treatment is aimed at avoiding known allergens and respiratory irritants and controlling symptoms and airway inflammation through medication. Allergens can sometimes be identified by noting which substances cause an allergic reaction.

Allergy testing may also be helpful in identifying allergens in patients with persistent asthma. Common allergens include: pet dander, dust mites, cockroach allergens, molds, and pollens. Common respiratory irritants include: tobacco smoke, pollution, and fumes from burning wood or gas.

There are two basic kinds of medication for the treatment of asthma:

• Long-term control medications -- used on a regular basis to prevent attacks, not for treatment during an attack.
  • inhaled steroids (e.g., Azmacort, Vanceril, AeroBid, Flovent) prevent inflammation
  • leukotriene inhibitors (e.g., Singulair, Accolate)
  • long-acting bronchodilators (e.g., famoterol, Serevent) help open airways
  • cromolyn sodium (Intal) or nedocromil sodium
  • aminophylline or theophylline (not used as frequently as in the past)
  • combination of anti-inflammatory and bronchodilator, using either separate inhalers or a single inhaler (Advair Diskus)
• Quick relief (rescue) medications -- used to relieve symptoms during an attack.
  • short-acting bronchodilators (e.g., Proventil, Ventolin, Xopenex, and others)
  • oral or intravenous corticosteroids (e.g., prednisone, methylprednisolone) stabilize severe episodes

People with mild asthma (infrequent attacks) may use relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms from occuring. A severe asthma attack requires a medical evaluation and may require hospitalization, oxygen, and intravenous medications.

A peak flow meter, a simple device to measure lung volume, can be used at home to help you "see an attack coming" and take the appropriate action, sometimes even before any symptoms appear. If you are not monitoring asthma on a regular basis, an attack can take you by surprise. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of an individual's personal best indicate a moderate asthma attack, while values below 50% indicate a severe attack.