After you've been diagnosed with asthma, work closely with your healthcare provider to control your asthma. This fact sheet describes common asthma medications and other actions you can take to control asthma.
Your Asthma Action Plan
An asthma action plan is a tool that you and your healthcare provider develop to help you manage your asthma. It will cover all your medications, including when to take them and teach you how to manage your breathing and asthma control. There are two primary issues with asthma: First, inflammation results in swelling within the airways; second, a tight muscle surrounds the airways, referred to as bronchoconstriction. As both can contribute to difficulties, treatments for asthma address the processes that impede breathing. There are several ways in which these medications can be taken: via inhaler, pill, or injection, also commonly referred to as "shots." Your doctor should only prescribe you medications via the methods he or she is directing you to use. You will most likely have a "rescue" inhaler described below. According to your treatment needs, your doctor will make a determination about any other medications you should have for asthma.Medicines to use when your asthma is worsening: Rescue inhalant medications
These most often come in the form of inhalers, which are called puffers and consist of taking in a dose of medication when the device is activated. You can also receive inhaled drugs using a nebulizer—a device that turns liquid medications into a formulation that you inhale as a mist. Talk to your prescribing doctor or pharmacist so he or she can instruct you in the administration of all medications. To avoid irritation of the oropharynx: Irrigate with water after every use of a device.
- Relief or rescue inhalers: symptom management medications Short-acting inhaled medications fall into the category of bronchodilator medication most asthmatics will be prescribed because of their relaxing effect on airway muscles, thus opening tight airways. Most of them are short-acting beta agonists such as albuterol or levalbuterol. The other type is ipratropium, a short-acting anti-cholinergic. Most people will take these along with other medications. In their proper doses, they usually act within 10 minutes to ease your breathing. These should be available to you at all times.
- Long-acting inhaled medications: You should coordinate closely with your provider about the most appropriate frequency of long-acting inhaled medications for you, depending on the severity and characteristics of your asthma. Sometimes these are referred to as controller medications. They work over time to keep your airway inflammation (swelling) and tightening under good control.
- Inhalation steroids: These reduce airway inflammation and prevent narrowing of the airways. Examples: Beclomethasone, Budesonide, Ciclesonide, Flunisolide, Fluticasone, Mometasone.
- Long-acting bronchodilators can be further subdivided into: ❍ Long-acting beta agonists—to be taken alongside inhaled steroids for a guaranteed open airway and enhanced control over asthma. Such drugs are salmeterol, formoterol, and vilanterol. ❍ Long-acting anticholinergics—a third additive to achieve greater control over the disease through relaxation of the muscles lining the airways and a reduction in mucus production. Examples include tiotropium and umeclidinium.
Oral (pill) medications
■ Leukotriene modifiers can be taken alongside your inhaled medications. For example, if you have allergies. They don't work as fast, and never use them without using your inhaler(s). The following are types of leukotriene modifiers: montelukast, zafirlukast, zileuton
■ Oral steroids, which are prednisone in the most commonly used form, are medication that can make your asthma better by reducing the inflammation that makes it so hard to get air into the airways.
Injections
If these additional drugs—that is, medications inhaled into your lungs or pills by mouth—don't better control your asthma, your asthma doctor will likely prescribe others. These are medications selected based on your test results and address parts of your immune system that contribute to the cause of your asthma symptoms. Examples are omalizumab, benralizumab, mepolizumab, and dupilumab.
In addition to medications, what else can you do to help improve control of your asthma?
If you have your asthma under control, you'll breathe more easily. You and your healthcare provider can be a team with each other, making it easier to follow your asthma action plan and take medications exactly as prescribed. Other things that will help keep your asthma under control include: ■ Thinking about your environmental triggers ■ Avoiding irritants such as tobacco smoke or vape ■ Managing your allergies
Irritants and triggers: Identify what exposures and experiences trigger your asthma so you can avoid these as much as possible. For most people, keeping a diary of activities and symptoms helps uncover patterns. Cut back on or use any smoking or vaping, which is important to avoid and should be quit completely.
Lifestyle: Keep your asthma under control by staying active regularly while staying healthy. This will also reduce stress. Discuss with your healthcare provider the safest way for you to start exercising. Learning about how to keep your excess stress under control may prove useful as well: Stress leads to your asthma.
Vaccinations: Get a flu shot yearly to prevent the flu or, at least, lessen its impact. Your healthcare provider may also talk with you about the pneumococcal vaccine, which can lower your chance of this form of bacterial pneumonia.
