Asthma Treatment

A key component of the asthma treatment plan is prevention because there are well-known triggers that can be avoided, or at least reduced. 

Medication is classified as either long-term asthma control drugs (controller medication) or quick-relief (or rescue) medication. Allergy medications and other therapies like bronchial thermoplasty may be used in some cases. Read on to learn more about asthma medications and the best asthma treatment. 

Long-term Asthma Control Drugs

Long-term asthma control drugs- these drugs are usually taken daily to keep the symptoms under control and reduce the risk of getting an acute attack. Drugs in this group include: 

  • Inhaled corticosteroids are the most prescribed asthma drugs for long term control, and they have strong anti-inflammatory qualities. There are many options of inhaled corticosteroids nowadays, the most commonly prescribed being fluticasone propionate (Flovent), budesonide (Pulmicort ), ciclesonide (Alvesco) and  mometasone (Asmanex). Unlike oral corticosteroids, the inhaled form is associated with  lower risk of side effects.
  • Inhaled corticosteroids combined with long-acting beta2 agonists (bronchodilators) are used in cases of persistent asthma. Fluticasone-salmeterol (Advair HFA), budesonide-formoterol (Symbicort) and formoterol-mometasone (Dulera) are examples of medication in this category. 
  • Leukotriene modifiers work by reducing certain chemicals involved in inflammation . They are used in combination with inhaled corticosteroids, but are less effective than long-acting beta2 agonists. Montelukast (Singulair), and zafirlukast (Accolate) are leukotriene modifiers. 
  • Theophylline (Theo-24) was commonly prescribed in the past, but not so often used anymore, as it requires monitoring and regular blood testing. 

Quick-relief (Rescue) Drugs

Quick-relief (rescue) medications are essential drugs during an acute attack. They can also be used before a workout if the asthma is triggered by exercise

  • Inhaled short-acting beta agonists  like albuterol  (Ventolin) and levalbuterol (Xopenex) provide symptom relief within minutes
  • Anticholinergic drugs like ipratropium (Atrovent ) and tiotropium (Spiriva) are commonly used in COPD, but can also be useful for asthma attacks, as they  work quickly to relax the airways. 
  • Oral corticosteroids and iv corticosteroids  like  prednisone (Prednisone) are effective in case of acute attacks and severe asthma. However, they have to be used short term because long term carry increased risk of glaucoma, cataracts, diabetes, increased risk of infections, osteoporosis and weight gain. 

What Is The Best Treatment For Asthma?

Prevention is the best treatment. Try to eliminate as many risk factors as possible: tobacco smoke (including secondhand smoke), dust mites, air pollution, pests like cockroaches, rats, mice as well as mold, viral infections, acid reflux, certain food additives, perfumes. Some medications can trigger an asthma attack, and your doctor may be able to find alternative drugs.

When it comes to the best asthma drug, Inhaled corticosteroids are the most commonly prescribed asthma drugs for long-term control, and they seem to be the most effective.  According to the  American Family Physician, inhaled corticosteroids improve asthma control as well as the quality of life. These drugs also decrease the severity of the symptoms, the need of oral steroids, and reduce visits to the emergency department, getting hospitalized and deaths. 

Long-acting beta2 agonists are also effective and are usually used in combination with inhaled corticosteroids for those who are over 12 years of age.  

Asthma Emergency Treatment

If you have asthma, your doctor likely created an asthma action plan to follow as needed. The plan includes the green zone, yellow zone, and red zone. 

Green zone means that you don’t have symptoms, and you are able to carry out day-to-day activities as usual. The peak flow readings are over 80% and you don’t need to make any changes to the daily medication. 

You are in the yellow zone when you experience symptoms, and the peak flow readings are somewhere between 50%-80%. As the symptoms are getting worse, you need to change the medication to prevent a serious asthma attack. 

You need asthma emergency treatment when you have severe symptoms consistent with an acute attack and the peak flow readings are 50% or lower. 

Severe attacks and life-threatening episodes usually require emergency visits and likely hospitalization. Oxygen therapy,  Inhaled short-acting beta2 agonist, oral or iv corticosteroids, and other therapies are used to manage severe symptoms. 

Generally speaking, the asthma treatment should be flexible, as the doctor has to adjust it based on the symptoms. If the symptoms are well managed, the dosage of the drugs may be decreased, if they get worse, the doctor may increase the dose or add new drugs to the treatment plan. 

If the symptoms are triggered by allergies, immunotherapy (or allergy drugs) may help over time. Biologics like omalizumab (Xolair) or dupilumab (Dupixent) are other options for severe asthma triggered by allergies. 

Bronchial thermoplasty is a newer treatment indicated in severe cases that do not respond to corticosteroids. This therapy involves the use of an electrode that heats the airways in the lungs, helping breathe easier and decreasing the risk of an asthma attack. 

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