By: Sally Bowman RN, quality care coordinator at Network Health
5/10/2022
Millions of people in the United States live with asthma, a chronic condition that affects the lungs.
Though we haven’t discovered a cure for asthma just yet, we have discovered and created several methods for controlling it and reducing the severity of its potentially fatal symptoms.
Like most conditions, every case of asthma is different. If you live with asthma, it’s important to factor in your unique case when creating a control and treatment plan with your personal doctor.
A central part of this plan will be your Asthma Action Plan which will have information about your asthma triggers and instructions for taking your medicines.
When you have asthma, you’ll experience three changes in the airways that can make breathing difficult or near impossible.
All three of these changes make your airways smaller or narrower, in turn making it more difficult for air to flow easily and limiting your ability to breathe.
As you may have guessed, asthma medications work by finding ways to limit or push back against these three changes, prioritizing open airways above all else.
Asthma remedies are typically broken down into four distinct types of medications and treatments.
Which asthma treatment is best for your case? There’s not a black-and-white answer to that question. While the difference between these asthma treatments can be confusing, understanding what each treatment does will help you and your personal doctor find the best for your unique case. Remember that we can’t cure asthma, but we can work to find a treatment plan and Asthma Action Plan that provide an equal quality of life as if you did not have asthma.
This is why it’s crucial to take medication as directed by your doctor and follow your Asthma Action Plan.
Unlike other conditions, which may be treated via an oral medication or a topical medication, you will take most asthma medication through an inhaler or nebulizer. These devices allow the medicine to go directly to your lungs, where it’s most needed.
Other asthma medication delivery devices include pills, infusions or injectables.
Also called ‘puffers,’ asthma inhalers come in four basic varieties.
For inhalers to work well, you must use them correctly. Some studies, however, indicate that 70 to 90 percent of people who use inhalers make at least one mistake when using their inhaler. Inhaler mistakes can lead to uncontrolled asthma. Ask your personal doctor or nurse to watch you use your inhaler to make sure you are using it correctly.
If you use an MDI, it is best to use a spacer or holding chamber with it. This device attaches to your MDI. It turns the medicine into smaller particles that are easier to inhale.
If an MDI is not easy for you to use, you can also talk with your doctor about a DPI or breath-actuated inhaler. These inhalers do not spray medicine out. Instead, you put your mouth around the inhaler’s mouthpiece and breathe in.
Also called a “breathing machine,” a nebulizer turns liquid asthma medicine into a fine mist, which can then be inhaled through a mask or a mouthpiece.
Some people prefer nebulizers over an inhaler. Once the nebulizer is set up and ready to use, simply breathe in and out as normal.
You will need a prescription for a nebulizer and the liquid medicine that goes into it. You can buy a nebulizer from a pharmacy or durable medical equipment (DME) company. Talk with your doctor about which nebulizer is best for your unique asthma plan.
Injectable asthma treatments (biologics) are shots or infusions given every few weeks. These injections may be administered at your doctor’s office or self-administered at home using an auto-injector device, depending on the type of treatment.
Infusions are given intravenously at the doctor’s office. This is when a needle attached to a tube is injected into a vein in your arm. The medicine then drips from a bag, through the tube and into your arm, getting it into your bloodstream quickly.
Asthma treatments work in a few important ways.
By “relieving the squeeze,” asthma medications help to open your airways. This process is called bronchodilation and medicines that achieve this are known as bronchodilators or beta-agonists.
Bronchodilators can be short- or long-acting. If you use short-acting bronchodilators (quick-relief medicines) more than two days a week, talk with your personal doctor about your asthma control. You may need to make changes to your treatment plan to better control your asthma.
Asthma medications also work as anti-inflammatories (steroidal and non-steroidal).
Anti-inflammatories (steroidal) come in many different forms. They are also called controllers because they help to control or prevent asthma symptoms. They reduce swelling and extra mucus inside the airways.
While they work as a long-term solution, they will not relieve sudden symptoms.
Inhaled corticosteroids (ICS) are corticosteroids that supplement the natural corticosteroids made by your adrenal glands. They are also called controllers because they help to control or prevent asthma symptoms. They target the airways specifically. They can be taken two ways – daily or as needed. ICS keep working for 12 to 24 hours.
Oral corticosteroids are taken in pill or liquid form. This medicine may be prescribed as a “rescue” for the treatment of asthma attacks that don’t respond to other asthma medicines. They also are used as long-term therapy for some people with severe asthma. Oral corticosteroids have serious long-term side effects compared to inhaled corticosteroids. These can include mood swings, weight gain, high blood pressure, cataracts, osteoporosis and infections.
No. Although medication helps a lot, it may not be able to do the job alone. You have to avoid the things that cause or trigger your asthma symptoms as much as you can. Asthma triggers can be found outside or inside your home, school or workplace.
Improving the indoor air quality in your home is an important part of asthma control. Surprisingly, the air inside your house may be more polluted than the air outside.
Probably not. Treatment and Asthma Action Plans vary person-to-person. As a general statement, however, you will probably take more medicine when you begin treatment to get control of your asthma.
Work with your doctor to learn which medicine(s) control your asthma best and how much you need. Once your asthma is well-controlled, your doctor may be able to reduce the amount of medicine you take.
Maybe, but probably not. Asthma is a chronic condition (which means you will have it all of your life), but it is controllable. For that reason, you may have asthma symptoms when exposed to triggers for your entire life.
This is the case even if you don’t have symptoms very often. Your triggers can change over time, and your treatment will depend on two things – the severity of your asthma and how often you have symptoms.
If your symptoms happen at certain times and you know what caused them, you and your doctor can use this information to determine the best treatment. If, for example, you have seasonal asthma because of a specific pollen allergy, you may take medication only when that pollen is in the air.
Probably, and almost definitely if you have nighttime asthma symptoms. Many people wake up with asthma symptoms such as coughing or wheezing. You can control nighttime symptoms by taking asthma medication as directed by your doctor.
Removing triggers where you sleep may help you sleep better as well. Many people are allergic to dust mites and mold found in bedding materials. Using mattress or pillow encasements can help contain those allergens.
Dehumidifiers can also be helpful to reduce the humidity in your home that dust mites and mold need to exist. Using air filters in your bedroom will reduce your exposure to allergens and irritants (animal dander, dust mites, air pollution, etc.).
Yes. Exercising, particularly in cold air, can cause airway swelling. Quick-relief asthma medicines, taken before exercise, usually control this. If you need repeated doses of quick-relief medicine during and after exercise, however, mention that to your doctor.
It is important for everyone, including people with asthma, to be as active as possible for good health. Talk with your doctor about how you can be physically active while keeping your asthma well-controlled.
Yes. All medicines have side effects. Share how you are responding to the treatment with your doctor, being sure to bring up any side effects that you are experiencing. Follow up often with your doctor so you can control your asthma with the least amount of medicines and with the fewest side effects.
An asthma diagnosis may seem daunting. It is, after all, uncurable. Its ability to be controlled and treated with a variety of medications, therapies and lifestyle adjustments, however, makes it a condition with which a healthy and fulfilling life is possible.
For more information about asthma control and management, visit the United States Centers for Disease Control and Prevention (CDC) webpage by clicking here.
For more information about how your Wisconsin-based health plan can help you feel your healthiest and strongest, contact us today.