How is asthma treated?
There are two main types of treatment: short-acting medicine that relieves asthma during an attack (bronchodilators) and longer acting or preventative medicine that helps to stop symptoms from occurring (eg, inhaled steroids). Treatment can be given in various forms. Usually, the first treatment your doctor will prescribe is an inhaler that can be used during an attack to relax the muscles and widen the airways, or to prevent symptoms occurring when a known trigger is present, such as before exercise. The inhaler will contain a type of bronchodilator called a beta-agonist. Short-acting beta-agonists include albuterol and terbutaline. There are various types of inhaler devices available, including accuhalers, clickhalers and turbuhalers. If you are using an inhaler containing a short-acting beta-agonist more than three times a week, a steroid inhaler will usually be added to your treatment.
Steroid inhalers act as a preventative by reducing the sensitivity of the airways to triggers. They also reduce inflammation and mucus production when symptoms do occur. Steroids such as beclomethasone (Qvar), budesonide (Pulmicort Flexhaler), ciclesonide (Alvesco), fluticasone (Flovent HFA), and mometasone (Dulera) need to be taken on a regular basis to be effective in reducing asthma symptoms. These steroids are corticosteroids, those produced naturally in the body, and not anabolic steroids, the type associated with body building.
Long-acting beta-agonists such as formoterol (Foradil Aerolizer) and salmeterol (Serevent Diskus) may be used for longer control while exercising or to relieve symptoms overnight. These will usually be added to therapy if treatment with an inhaled steroid plus a short-acting beta-agonist is not sufficient.
Other drugs that may be added to therapy to control asthma include aminophylline, theophylline (Theo-24) and oral beta-agonists (tablets, capsules or syrup). Montelukast (Singulair) and zafirlukast (Accolate) tablets are anti-inflammatory medicines that can be given as additional therapy if inhalers are not sufficient. Omalizumab (Xolair) is an injectable medicine that may be added to therapy in suitable patients. If the asthma becomes fairly severe, a short course of steroid tablets may be prescribed. These will contain a drug called prednisone.
A peak flow meter is a device that measures how well your lungs can expel air. Your doctor will explain how to use it. The device will give you a peak expiratory flow rate (PEFR) score. PEFR scores vary according to age, sex, and height. You will probably be given a chart on which to record your PEFR score at different times of the day before the inhalers are used. The PEFR scores will indicate how well your asthma treatment is working and will help your doctor to monitor how your asthma is being controlled. They will be useful if a new treatment is given.