Treatment Options for Asthma Explained
Asthma can be a minor inconvenience for some and a major hindrance for others. Either way, there are various treatment options available for those who grapple with the condition.
Asthma attacks a person’s airways in a multitude of ways. It can swell the airways, produce extra mucus that clogs the airways, and cause muscles to tighten and squeeze around the airways.
Whether your case of asthma is severe or mild, it’s important to know your treatment options.
Long-term controller medications
These medicines are to be taken regularly to control chronic symptoms, prevent asthma attacks and help control the condition by correcting the underlying changes in the airways, such as swelling and excess mucus.
Inhaled corticosteroids (ICS): ICS are the most effective anti-inflammatory medications for asthma. ICS are inhaled directly into the lungs using an inhaler to reduce inflammation and help prevent symptoms. ICS are generally safe when you take them exactly as your doctor prescribed. When used daily, they can decrease the number and severity of asthma attacks.
Inhaled corticosteroids carry side effects, the most common being an infection of the mouth called thrush. When taken for long periods of time, ICS raise your risk for osteoporosis and cataracts.
Long-acting beta-agonists (LABAs): LABAs are taken daily to relax the muscles lining the airways that carry air to the lungs. This allows the tubes to remain open, making breathing easier. LABAs should be taken only in combination with a corticosteroid to treat asthma. They are used in a metered-dose or dry-powder inhaler and are available as combination ICS/LABA inhalers.
Leukotriene modifiers: Also known as leukotriene antagonists, leukotriene modifiers are typically used as an alternative treatment method to prevent the chain reaction that increases airway inflammation and tightness. These medicines, which are taken orally, should not be used alone to treat an acute asthma attack.
Add-On Controller Medications
Long-acting antimuscarinic antagonists (LAMAs): In some individuals whose asthma is not well controlled with ICS-LABA, a LAMA can be used. A LAMA is another class of inhaled bronchodilators that are used to help open the airways. As with LABAs, LAMAs should only be taken in combination with an inhaled corticosteroid.
Also known as injectables, biologics are shots or infusions given ever few weeks. This treatment type targets a cell or protein to prevent airway swelling. They are for moderate-to-severe asthma that is hard to treat with ICS and/or other medicines. They are for specific types of asthma and will not work for everyone.
Biologics can be given at a doctor’s office, or they can be self-administered at home using an auto-injector device.
Allergy shots, another injection-based treatment method, can help gradually reduce the immune system’s reaction to certain allergens over time. These shots are usually administered once per week for two to three months, and once per month for three to five years.
Some medications can quickly relieve tight airways, coughing, wheezing, and other symptoms associated with asthma. If you have asthma, you should carry some form of quick relief medication with you in case you experience a flare up and require rapid, short-term relief.
Inhaled short-acting beta2-agonists (SABAs): SABAs provide quick relief of asthma symptoms and can be prescribed to be taken before exercising to prevent exercise-induced bronchoconstriction. SABAs should be used no more than twice per week for shortness of breath. They are commonly inhaled by using a metered-dose or dry-powder inhaler.
Single Maintenance and Reliever Therapy (SMART) – Low dose ICS-formoterol: Inhaled ICS-formoterol is the reliever medication for patients prescribed SMART or “single maintenance and reliever therapy.” Studies show that SMART treatment consistently reduced asthma exacerbations requiring unscheduled medical visits or systemic corticosteroids. For patients with SMART therapy, their maintenance ICS-formoterol inhaler (common brand name Symbicort®) is used as needed as a quick relief medication instead of SABA. Ask your provider for more information on SMART therapy and if it is appropriate for you.
Anticholinergics (Ipratropium bromide): Ipratropium is used to control and prevent symptoms while relaxing the airways. It is typically inhaled into the lungs through a nebulizer, which converts solution to mist. Atrovent is a common brand name ipratropium prescription.
Oral corticosteroids (OCS): OCS help relieve airway inflammation and swelling caused by severe asthma. They come in pill or liquid form and may be prescribed to people who don’t respond to other asthma medications. However, OCS can carry significant short and long-term side effects,
Importance of taking medications as prescribed and proper technique
It’s very important to take your controller medications as prescribed to prevent an asthma attack. If you need help understanding how to use your asthma inhaler, ask your pharmacist or provider. Videos for proper inhaler technique are available to watch as well.
Asthma action plan
Anyone with asthma should work with their health care provider to create an asthma action plan.
An asthma action plan zone is divided into three zones: green, yellow and red. The green zone is where you want to be every day, and means you are doing well. The yellow zone means your asthma is getting worse and you are feeling symptoms. The red zone means your symptoms are severe and you may require medical treatment.
Your health care provider may suggest using a peak flow meter to track lung function. Peak flow meters can show if your asthma is getting worse, even before you experience symptoms.
Photo credit: Getty Images