Other long-term control medicines. Other long-term control medicines include:
- Cromolyn. This medicine is taken using a device called a nebulizer. As you breathe in, the nebulizer sends a fine mist of medicine to your lungs. Cromolyn helps prevent airway inflammation.
- Omalizumab (anti-IgE). This medicine is given as a shot (injection) one or two times a month. It helps prevent your body from reacting to asthma triggers, such as pollen and dust mites. Anti-IgE might be used if other asthma medicines have not worked well.
A rare, but possibly life-threatening allergic reaction called anaphylaxis might occur when the Omalizumab injection is given. If you take this medication, work with your doctor to make sure you understand the signs and symptoms of anaphylaxis and what actions you should take.
- Inhaled long-acting beta2-agonists. These medicines open the airways. They might be added to inhaled corticosteroids to improve asthma control. Inhaled long-acting beta2-agonists should never be used on their own for long-term asthma control. They must used with inhaled corticosteroids.
- Leukotriene modifiers. These medicines are taken by mouth. They help block the chain reaction that increases inflammation in your airways.
- Theophylline. This medicine is taken by mouth. Theophylline helps open the airways.
If your doctor prescribes a long-term control medicine, take it every day to control your asthma. Your asthma symptoms will likely return or get worse if you stop taking your medicine.
Long-term control medicines can have side effects. Talk with your doctor about these side effects and ways to reduce or avoid them.
With some medicines, like theophylline, your doctor will check the level of medicine in your blood. This helps ensure that you’re getting enough medicine to relieve your asthma symptoms, but not so much that it causes dangerous side effects.
All people who have asthma need quick-relief medicines to help relieve asthma symptoms that may flare up. Inhaled short-acting beta2-agonists are the first choice for quick relief.
These medicines act quickly to relax tight muscles around your airways when you're having a flareup. This allows the airways to open up so air can flow through them.
You should take your quick-relief medicine when you first notice asthma symptoms. If you use this medicine more than 2 days a week, talk with your doctor about your asthma control. You may need to make changes to your asthma action plan.
Carry your quick-relief inhaler with you at all times in case you need it. If your child has asthma, make sure that anyone caring for him or her has the child's quick-relief medicines, including staff at the child's school. They should understand when and how to use these medicines and when to seek medical care for your child.
You shouldn't use quick-relief medicines in place of prescribed long-term control medicines. Quick-relief medicines don't reduce inflammation.
Track Your Asthma
To track your asthma, keep records of your symptoms, check your peak flow number using a peak flow meter, and get regular asthma checkups.
Record Your Symptoms
You can record your asthma symptoms in a diary to see how well your treatments are controlling your asthma.
Asthma is well controlled if:
- You have symptoms no more than 2 days a week, and these symptoms don't wake you from sleep more than 1 or 2 nights a month.
- You can do all your normal activities.
- You take quick-relief medicines no more than 2 days a week.
- You have no more than one asthma attack a year that requires you to take corticosteroids by mouth.
- Your peak flow doesn't drop below 80 percent of your personal best number.
If your asthma isn't well controlled, contact your doctor. He or she may need to change your asthma action plan.
Use a Peak Flow Meter
This small, hand-held device shows how well air moves out of your lungs. You blow into the device and it gives you a score, or peak flow number. Your score shows how well your lungs are working at the time of the test.
Your doctor will tell you how and when to use your peak flow meter. He or she also will teach you how to take your medicines based on your score.
Your doctor and other health care providers may ask you to use your peak flow meter each morning and keep a record of your results. You may find it very useful to record peak flow scores for a couple of weeks before each medical visit and take the results with you.
When you're first diagnosed with asthma, it's important to find your "personal best" peak flow number. To do this, you record your score each day for a 2- to 3-week period when your asthma is well-controlled. The highest number you get during that time is your personal best. You can compare this number to future numbers to make sure your asthma is controlled.
Your peak flow meter can help warn you of an asthma attack, even before you notice symptoms. If your score shows that your breathing is getting worse, you should take your quick-relief medicines the way your asthma action plan directs. Then you can use the peak flow meter to check how well the medicine worked.
Get Asthma Checkups
When you first begin treatment, you'll see your doctor about every 2 to 6 weeks. Once your asthma is controlled, your doctor may want to see you from once a month to twice a year.
During these checkups, your doctor may ask whether you've had an asthma attack since the last visit or any changes in symptoms or peak flow measurements. He or she also may ask about your daily activities. This information will help your doctor assess your level of asthma control.
Your doctor also may ask whether you have any problems or concerns with taking your medicines or following your asthma action plan. Based on your answers to these questions, your doctor may change the dose of your medicine or give you a new medicine.
If your control is very good, you might be able to take less medicine. The goal is to use the least amount of medicine needed to control your asthma.
Most people who have asthma, including many children, can safely manage their symptoms by following their asthma action plans. However, you might need medical attention at times.
Call your doctor for advice if:
- Your medicines don't relieve an asthma attack.
- Your peak flow is less than half of your personal best peak flow number.
Call 9–1–1 for emergency care if:
- You have trouble walking and talking because you're out of breath.
- You have blue lips or fingernails.
At the hospital, you'll be closely watched and given oxygen and more medicines, as well as medicines at higher doses than you take at home. Such treatment can save your life.
Asthma Treatment for Special Groups
The treatments described above generally apply to all people who have asthma. However, some aspects of treatment differ for people in certain age groups and those who have special needs.
It's hard to diagnose asthma in children younger than 5 years. Thus, it's hard to know whether young children who wheeze or have other asthma symptoms will benefit from long-term control medicines. (Quick-relief medicines tend to relieve wheezing in young children whether they have asthma or not.)
Doctors will treat infants and young children who have asthma symptoms with long-term control medicines if, after assessing a child, they feel that the symptoms are persistent and likely to continue after 6 years of age. (For more information, go to "How Is Asthma Diagnosed?")
Inhaled corticosteroids are the preferred treatment for young children. Montelukast and cromolyn are other options. Treatment might be given for a trial period of 1 month to 6 weeks. Treatment usually is stopped if benefits aren't seen during that time and the doctor and parents are confident the medicine was used properly.
Inhaled corticosteroids can possibly slow the growth of children of all ages. Slowed growth usually is apparent in the first several months of treatment, is generally small, and doesn't get worse over time. Poorly controlled asthma also may reduce a child's growth rate.
Many experts think the benefits of inhaled corticosteroids for children who need them to control their asthma far outweigh the risk of slowed growth.
Doctors may need to adjust asthma treatment for older adults who take certain other medicines, such as beta blockers, aspirin and other pain relievers, and anti-inflammatory medicines. These medicines can prevent asthma medicines from working well and may worsen asthma symptoms.
Be sure to tell your doctor about all of the medicines you take, including over-the-counter medicines.
Older adults may develop weak bones from using inhaled corticosteroids, especially at high doses. Talk with your doctor about taking calcium and vitamin D pills, as well as other ways to help keep your bones strong.
Pregnant women who have asthma need to control the disease to ensure a good supply of oxygen to their babies. Poor asthma control increases the risk of preeclampsia, a condition in which a pregnant woman develops high blood pressure and protein in the urine. Poor asthma control also increases the risk that a baby will be born early and have a low birth weight.
Studies show that it's safer to take asthma medicines while pregnant than to risk having an asthma attack.
Talk with your doctor if you have asthma and are pregnant or planning a pregnancy. Your level of asthma control may get better or it may get worse while you're pregnant. Your health care team will check your asthma control often and adjust your treatment as needed.
People Whose Asthma Symptoms Occur With Physical Activity
Physical activity is an important part of a healthy lifestyle. Adults need physical activity to maintain good health. Children need it for growth and development.
In some people, however, physical activity can trigger asthma symptoms. If this happens to you or your child, talk with your doctor about the best ways to control asthma so you can stay active.
The following medicines may help prevent asthma symptoms caused by physical activity:
- Short-acting beta2-agonists (quick-relief medicine) taken shortly before physical activity can last 2 to 3 hours and prevent exercise-related symptoms in most people who take them.
- Long-acting beta2-agonists can be protective for up to 12 hours. However, with daily use, they'll no longer give up to 12 hours of protection. Also, frequent use of these medicines for physical activity might be a sign that asthma is poorly controlled.
- Leukotriene modifiers. These pills are taken several hours before physical activity. They can help relieve asthma symptoms brought on by physical activity.
- Long-term control medicines. Frequent or severe symptoms due to physical activity may suggest poorly controlled asthma and the need to either start or increase long-term control medicines that reduce inflammation. This will help prevent exercise-related symptoms.
Easing into physical activity with a warmup period may be helpful. You also may want to wear a mask or scarf over your mouth when exercising in cold weather.
If you use your asthma medicines as your doctor directs, you should be able to take part in any physical activity or sport you choose.
People Having Surgery
Asthma may add to the risk of having problems during and after surgery. For instance, having a tube put into your throat may cause an asthma attack.
Tell your surgeon about your asthma when you first talk with him or her. The surgeon can take steps to lower your risk, such as giving you asthma medicines before or during surgery.