Asthma in Teens and Adults - Treatment Overview

Although asthma cannot be cured, you can manage the symptoms with medicines,
especially inhaled corticosteroids and beta2-agonists. You will probably work with
your doctor to develop an asthma action plan. This plan will help you meet
treatment goals and get your asthma under control. The goals of asthma treatment
are to:19

* Prevent symptoms.
* Keep your peak flow and lung function as close to normal as possible.
* Be able to do your normal daily activities, including work, school, exercise,
and recreation.
* Prevent asthma attacks.
* Have few or no side effects from medicine.

For more information, see:

Asthma: Taking Charge of Your Asthma.

Emergency treatment

If you have a severe asthma attack (the red zone of your asthma action plan), use
medicine based on your action plan and talk with a doctor immediately about what to
do next. This is especially important if your peak expiratory flow (PEF) does not
return to the green zone or stays within the yellow zone after you take medicine.
You may have to go to the hospital or an emergency room for treatment. Be sure to
tell the emergency staff if you are pregnant.

At the hospital, you will probably receive inhaled beta2-agonists and

corticosteroids. You may be given oxygen therapy. Your lung function and condition
will be assessed. Depending on your response, further treatment in the emergency
room or a stay in the hospital may be needed.

Some people are at increased risk of death from asthma, such as people who have
been admitted to an intensive care unit for asthma or who have needed a breathing
tube (intubation) for asthma. These people need to seek medical care early when
they have symptoms.
Medical checkups

You need to monitor your asthma and have regular checkups to keep it under control
and to ensure correct treatment. Checkups are recommended every 1 to 6 months,
depending on how well your asthma is controlled.

During checkups, your doctor will ask whether your symptoms and peak expiratory
flow have held steady, improved, or become worse and will ask about asthma attacks
during exercise or at night. You track this information in an asthma diary. You may
be asked to bring your inhaler and peak expiratory flow meter to an appointment so
your doctor can see how you use them.
Initial treatment

There are many components to managing asthma. After your diagnosis, your doctor may
only discuss what you need to know immediately. These include:

* Oral or injected corticosteroids (systemic corticosteroids). These medicines

may be used to get your asthma under control before you start taking daily
medicine. In the future, you also may take oral or injected corticosteroids to
treat any sudden and severe symptoms (asthma attacks), such as shortness of breath.
Oral corticosteroids are used more than injected corticosteroids. Oral
corticosteroids include prednisone and methylprednisolone.
 * Inhaled corticosteroids. These are the preferred medicines for long-term
treatment of asthma. They reduce the inflammation camera of your airways, and you
take them every day to keep asthma under control and to prevent asthma attacks.
Inhaled corticosteroids include mometasone, triamcinolone, fluticasone, budesonide,
and ciclesonide.
* Short-acting beta2-agonists. These medicines are used for asthma attacks.
They relax the airways, which allows you to breathe easier. Short-acting beta2-
agonists include albuterol and pirbuterol.
* A combination of an inhaled corticosteroid and long-acting beta2-agonist.
This combination is often used to treat persistent asthma.
* Basic education about asthma. The more you know about asthma, the more likely
it is you will control symptoms and reduce the risk of asthma attacks. Keep in mind
that even severe asthma can be controlled. And cases where the condition cannot be
controlled are unusual.
* Instruction on how to use a metered-dose inhaler (MDI) or dry powder inhaler
(DPI). Inhalers deliver medicine directly to the lungs. If you use your inhaler
correctly, you can control your symptoms and avoid asthma attacks that can send you
to the emergency room. Most doctors recommend using a spacer camera with an MDI.