Asthma Treatments

For asthma treatment, the doctor will prescribe the medication that suits us best. Some of the medication is taken using what’s called a delivery device. Treatment also involves using monitoring devices to check your lung function and degree of asthma control.

To get a quick indication of whether your asthma is under control, just answer 5 questions on this Asthma Control TestTM and discuss the results with your doctor. You should also ask your doctor to help you make an Asthma Action Plan.

Asthma medication

Asthma medication can help you with your asthma in two main ways.

Some types of medication combine both types of treatments.

Your doctor will first consider the severity of your asthma before prescribing any medications. Quick-relief medicine is meant for sudden asthma symptoms or attacks, while long-term medicine is normally taken daily to prevent symptoms.

Asthma medications have certain risks and side effects that your doctor will discuss with you when determining your treatment.

These are the four types of asthma medications a doctor might prescribe.

Whatever medication you are prescribed, do make sure you know how to take your medicine correctly.

Quick-relief medicines

Quick-relief medicines are used to help relieve sudden asthma symptoms. These medicines are bronchodilators, which means they work by relaxing the muscles around the airways to help you breathe better. Quick-relief medicine is usually taken through an inhaler.

Short-acting beta2-agonists (SABAs)

SABAs are common quick-relief medicines that act within minutes to relieve sudden asthma symptoms. SABA medicine is typically delivered through an inhaler. When you inhale a dose, the medicine quickly relaxes the muscles surrounding your airways so that air can flow more freely through your lungs, helping you feel better. For someone with only intermittent asthma, a SABA is sometimes the only medicine required.

What to note for quick-relief medicines

For better asthma control, keep track of how often you use your quick-relief medication. Using it more than usual may be a sign that you are having trouble controlling the inflammation – talk to your doctor to see what should be done. As a rough gauge, using rescue medication more than 2 times a week might mean the asthma is worsening.

  • Always carry your quick-relief medicine with you
    Asthma symptoms can happen at any time. Always be prepared.
  • Always replace your medicine before it expires or runs out
    You do not want to be without medicine when you need it. Some medicines have dose counters to help you keep track of how many puffs of medicine are left.
  • Always make sure you know how to use your inhaler properly
    The medicine might not relieve your asthma symptoms quickly if you’re not getting a full dose. Ask your doctor to demonstrate how to use the inhaler.

Long-term control medicines

Unlike quick-relief medicines, long-term asthma control medicines are used to prevent asthma symptoms. Most of them are anti-inflammatories that work by reducing airway inflammation; such long-term control medicines are taken daily, whether or not you have symptoms.

There are also other long-term medicines that work by regulating the immune system, and others that work as bronchodilators.

Anti-inflammatories

Inhaled corticosteroids

Inhaled corticosteroids treat the inflammation associated with asthma. Because they are inhaled, they can target your lungs directly to help reduce airway inflammation. They should be taken every day as prescribed, even when you are not experiencing symptoms. It is important to know that inhaled corticosteroids are not anabolic steroids, the steroids used by some athletes to build muscle. 

Leukotriene receptor antagonists

Leukotriene receptor antagonists work by blocking the action of leukotrienes, which are chemicals that can increase inflammation in the airways of your lungs. This medicine is available in pill or tablet form, not as an inhaler. Leukotriene receptor antagonists can be prescribed alone to treat mild persistent asthma, or in combination with inhaled corticosteroids to treat moderate or severe persistent asthma.

Immunomodulators

Immunoglobulin E (IgE) inhibitors

Anti-immunoglobulin E (anti-IgE) therapy may be helpful for asthma that is triggered by allergies and is not well controlled by other medications. Such IgE inhibitors are typically given by injection once or twice a month to people whose moderate to severe persistent allergic asthma is not controlled with inhaled corticosteroids.

Bronchodilators

Theophylline

Theophylline is a bronchodilator, a type of medicine that relaxes the muscles around the airways of the lungs. It is taken by mouth rather than inhaled. Theophylline is sometimes used alone to treat mild persistent asthma, but most of the time it is used in combination with inhaled corticosteroids to treat moderate or severe persistent asthma. This medicine should be taken every day as directed by your doctor. If you are prescribed theophylline, your doctor may watch your blood levels to make sure the dose is right for you.

Combination medicines

Your healthcare provider may prescribe a combination medicine if he or she decides your asthma symptoms are not well controlled with a long-term asthma control medicine.

Combination medicine helps treat asthma using more than one medication at a time, sometimes by delivering the combination medicine together using one inhaler device. Such combination inhalers are prescribed to be taken daily to help prevent symptoms.

Combination medicine is different from the quick-relief medicines used to help relieve sudden asthma symptoms.

Inhaled corticosteroids combined with long-acting beta2-agonists (LABA)

This medicine combines inhaled corticosteroids with long-acting beta2-agonists to treat both airway inflammation and bronchoconstriction (airway constriction). The inhaled corticosteroids work as anti-inflammatories for your airways, while the LABA is a bronchodilator that helps keep airways open by relaxing the surrounding muscles.

People with asthma who take LABA-containing medicines have an increased risk of death from asthma problems. Children and adolescents with asthma who take LABA-containing medicines may have an increased risk of hospitalisation for asthma problems. Your doctor will decide if and when a LABA-containing medicine is right for you.

Other types of medicines

In some situations, your doctor may prescribe these medicines for your asthma.

Long-acting beta2-agonists (LABAs)

LABAs are bronchodilators that help keep our airways open by relaxing the surrounding muscles. LABAs are not used alone to treat asthma symptoms. They must always be prescribed in combination with a long-term asthma control medicine. These medicines are prescribed to be taken daily to help prevent asthma symptoms and are not the same as the quick-relief medicines used to help relieve sudden asthma symptoms.

People with asthma who take LABA-containing medicines have an increased risk of death from asthma problems. Children and adolescents with asthma who take LABA-containing medicines may have an increased risk of hospitalisation for asthma problems. Your doctor will decide if and when a LABA-containing medicine is right for you.

Systemic corticosteroids

Typically, oral or injectable systemic corticosteroids like prednisolone are used in short "bursts" to reduce inflammation and help speed recovery following an asthma attack or illness. The oral corticosteroids are available in pill and liquid form. Though they may sound similar, oral corticosteroids are NOT the same as the anabolic steroids used to build muscles.

Delivery devices

Many asthma medications are taken using something called a delivery device. These help you inhale the medication so that it reaches your lungs. The most common delivery device is an inhaler, but there are also several other types of devices and accessories. Your healthcare provider will prescribe the medication and device he or she thinks work best for you.

Most importantly, make sure you know how to use your delivery device correctly. Improper use of the device can prevent you from getting the correct dose of medicine, resulting in less effective treatment for your asthma. You should ask your doctor to demonstrate how to use the device properly and carefully follow the instructions given for your specific product.

Dry-powder inhalers (DPIs)

Dry-powder inhalers deliver medication in the form of a fine powder directly into your lungs. More and more asthma medicines are becoming available in DPI form.

Metered-dose inhalers (MDIs)

Metered-dose inhalers use a propellant called HFA to deliver medication into your lungs. Because most MDIs require us to properly coordinate our hand movements and breathing to get the correct dose, patients like children and the elderly may find doing do tricky. In such instances, they can use accessory devices like a spacer or valved holding chamber to properly inhale their medication.

Spacers

Spacers are used to help you inhale your medication so it reaches the lower airways – where it's supposed to go – instead of ending up only reaching your throat. Basically, they help by containing the medication within the spacer, allowing you to steadily inhale the medication.

Spacers are especially helpful for children or people who have trouble breathing in while pressing the inhaler. Most spacers fit onto the end of most metered-dose inhalers (MDIs). If you are using an MDI, your doctor may recommend using a spacer to help with the delivery of your medication.

Nebulisers

A nebuliser is a machine that changes liquid medicine into a fine mist. This can then be inhaled through a mask or mouthpiece. Nebulisers are used by people who have trouble using an inhaler, including young children and people who are very ill. Delivery of quick-relief medicines through nebulisers is also sometimes used to help treat asthma attacks.

Monitoring devices

Monitoring devices indicate your level of asthma control, usually by measuring how strongly you can exhale. They are used to help you and your doctor better manage your asthma. For help using a monitoring device, ask your doctor to teach you.

Peak flow meters

A peak flow meter is a device you blow into to see how fast air moves out of your lungs. You can use it at home. If you keep track of your results and show those to your doctor, peak flow readings can help to determine:

  • What triggers may be making your asthma symptoms worse
  • Whether your Asthma Action Plan needs to be adjusted
  • Whether you need emergency treatment

There are several types of peak flow meters, including meters designed for the smaller airways of children. Your doctor can help you decide which is best. To get accurate readings with a peak flow meter, be sure to follow the instructions that come with your specific model.

Spirometry

Spirometry is a common breathing test that may be administered by healthcare providers to diagnose asthma and to monitor lung function in patients who already know they have asthma. All you have to do is breathe as hard as you can into the device. The spirometry test measures the rate and volume of air flowing out of your lungs. These measurements will help your healthcare provider to assess how well your lungs are working.

Asthma Toolbox

Asthma Control Test

This quick 5-question test indicates your level of asthma control.  

Asthma Action Plan

This is an important guide your doctor can prepare for you to help you stay ahead of asthma at all times.

References:

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SG/AST/0005/15a Certified 26/04/16.