There's no cure for asthma, a chronic lung disease marked by inflammation of the bronchial tubes (airways) of the lungs.
Without proper treatment, asthma may get worse with age, with asthma attacks increasing in frequency and severity.
Asthma treatment aims to do the following:
- Quickly resolve symptoms when they pop up
- Prevent symptoms and attacks
- Improve your sleep and activity levels
Today, inhalers are synonymous with asthma. There are two main types of inhaler devices.
The most commonly used type is called a metered-dose inhaler (MDI). It has a boot-shaped mouthpiece into which a pressurized, medicine-containing canister is inserted.
You deliver a measured dose of the medicine to your lungs by placing the mouthpiece into your mouth and pushing down on the canister while inhaling.
Your MDI may have a counter that tells you how many doses are left in the canister.
It can be difficult to coordinate your inhalation with pushing down on the canister at the same time. This is an essential step to ensure that the medicine is inhaled into your lungs, the main goal of inhaled therapy.
To decrease the chance that the medicine stays in your mouth, you can attach a holding chamber called a spacer to your MDI. (Some MDIs have built-in spacers.)
Spacers temporarily hold the released medicine, allowing you to inhale slowly, deeply, and at your own pace to get the full dose into your lungs.
Some MDIs, called breath-actuated inhalers, automatically release a puff of medicine when you inhale.
Dry-powder inhalers, on the other hand, don't use a chemical propellant to launch medicine into your lungs. Instead, these devices contain a powdered formula that you draw into your lungs with a deep, fast inhale.
If you have severe asthma and are unable to use an inhaler, a nebulizer may be a better option.
This machine turns liquid medicine into a fine mist that you inhale through a mouthpiece, a mask that fits over your nose and mouth, or into your mouth alone.
Nebulizers let you take your medicine while breathing normally, but they're more time-consuming to set up and use than inhalers.
Asthma medication falls into two general categories: quick-relief and long-term control medication.
Quick-relief medication, which includes short-acting beta2-agonists and anticholinergics, is inhaled to relieve flare-ups of asthma symptoms.
Short-acting beta2-agonists — which include albuterol, levalbuterol, and terbutaline — are the first choice for quick relief of attacks. This medication relaxes the smooth muscles around the airways and reduces swelling of the lining of the airways.
Quick-relief medication that combines ipratropium and albuterol is also available.
Long-term control medication helps prevent asthma symptoms by reducing the inflammation that makes your airways more sensitive to asthma triggers.
Numerous types of long-term control medication are available, including:
- Inhaled corticosteroids, the standard treatment and most effective medicine to prevent attacks
- Inhaled long-acting beta-agonists, which should always be taken in combination with inhaled corticosteroids
- Oral corticosteroids
- Omalizumab, a shot that prevents your body from reacting to allergenic triggers
- Leukotriene modifiers (such as montelukast, zafirlukast, zileuton), which are taken by mouth and block either the production or the effect of leukotrienes, chemicals that can lead to asthma attacks
- Cromolyn sodium, which prevents cells from releasing inflammation-causing chemicals
- Methylxanthines, which relax and open the airways
There are various steps you can take at home to help manage your asthma.
Work with your doctor to create an asthma action plan that covers how to:
- Take your medication properly
- Avoid asthma triggers unrelated to physical activity, such as allergens and airborne irritants
- Track your asthma control
- Respond to worsening symptoms
- Seek emergency care
- Quit smoking or not start
In addition, monitor your symptoms carefully: Keep track of what they are, when they occur, and their severity.
A peak flow meter is an inexpensive, handheld device that can help you monitor your condition.
It measures how quickly you can breathe air out of your lungs, an indicator of how well your lungs are functioning.
It's also important to maintain a healthy diet and weight, as being overweight can worsen asthma symptoms.
Taking certain precautions can help prevent exercise-related asthma symptoms. Specifically, avoid exercising:
- In cold, dry air
- Shortly after you get a cold or have an asthma attack
- During high pollen conditions
- In environments with airborne irritants, such as cigarette smoke
- How Is Asthma Treated and Controlled? National Heart, Lung, and Blood Institute.
- Asthma Treatment; Asthma and Allergy Foundation of America.
- Inhaled Asthma Medications; American Academy of Allergy, Asthma & Immunology.
- W. Bailey and L. B. Gerald (2015). "Patient information: Asthma inhaler techniques in adults (Beyond the Basics)." UpToDate.
- Asthma Medicines Chart; American Lung Association.
- Asthma Overview; Cleveland Clinic.
Last Updated: 6/30/2016