Asthma Treatment and Action Plan
Treatment for asthma usually depends on your age, how serious your symptoms are, and how your body responds to medicines. For some people, asthma can be hard to control even after stepping up treatment.
How is asthma treated?
Some people take daily medicines to control and prevent symptoms. You can also carry medicines, such as a reliever inhaler, to use during an asthma attack. Your healthcare provider may adjust your treatment until your asthma symptoms are controlled.
Learn more about NHLBI-supported asthma research on personalized treatments and other new approaches that improve the health and the quality of life for people who have asthma.
Quick-relief medicines
Quick-relief medicines, or relievers, help prevent or ease symptoms during an asthma attack. They may be the only medicines you need if your asthma is mild or happens only with physical activity.
Your healthcare provider will probably prescribe a quick-relief inhaler for you to carry at all times. For the treatment to work well, make sure to learn how to use your asthma inhaler correctly.
The following are common relievers.
- Inhaled short-acting beta2-agonists (SABAs) open the airways so air can flow through. Side effects can include tremors and rapid heartbeat.
- Oral corticosteroids reduce swelling in your airways.
- Short-acting anticholinergics help open the airways quickly. This medicine may be less effective than SABAs, but it is an option for people who may have side effects from SABAs.
Long-term control medicines
Your healthcare provider may prescribe controller medicines to take daily to help prevent asthma attacks and control symptoms:
- Corticosteroids (steroid hormone medicines) reduce inflammation in the body. They may be taken as a pill or inhaled. The pill form can have more serious side effects than the inhaled form. Over time, high doses can raise your risk of cataracts (clouding of the eye) or osteoporosis. Common side effects from inhaled corticosteroids include a hoarse voice or a mouth infection called thrush.
- Biologic medicines, such as benralizumab, may help with asthma that is difficult to control. These medicines are injected into a vein or below the skin.
- Leukotriene modifiers reduce swelling and keep your airways open. Your provider may prescribe these pills alone or with steroid medicine.
- Inhaled mast cell stabilizers, such as cromolyn, help prevent swelling in your airways when you are around allergens or other asthma triggers.
- Inhaled long-acting bronchodilators, such as long-acting beta2-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs), may be added to your inhaler to prevent your airways from narrowing.
- Allergy shots, called subcutaneous immunotherapy (SCIT), turn down the body’s response to allergens.
Bronchial thermoplasty
Bronchial thermoplasty may help if you have serious asthma and other treatments are not working. In this procedure, your healthcare provider inserts a bronchoscope, which is a tube with a camera at the end, through your mouth to see inside your airways. Your provider then applies heat to the muscles along the walls of your airways. This can make them thinner and help prevent narrowing.
Some risks of the procedure include worsening asthma, airway or lung infections, and bronchiectasis.
Create an asthma action plan
Your healthcare provider will work with you to create a treatment plan for your asthma. An asthma action plan is a written treatment plan that describes the following:
- How to identify allergens or triggers to avoid
- How to know if you are having an asthma attack and what to do
- Which medicines to take and when to take them
- When to call your provider or go to the emergency room
- Whom to contact in an emergency
You can download a sample Asthma Action Plan and use it to write down the plan you create with your provider to help you monitor and treat your symptoms.
Treating specific asthma types
Some people only have asthma symptoms in certain situations or around specific triggers. Your healthcare provider may give you special instructions to help with your asthma in those cases.
Exercise-induced asthma
In exercise-induced asthma, your symptoms start or get worse when you do physical activity. Your provider may recommend taking a reliever medicine before exercising to prevent symptoms short term. If you are taking inhaled corticosteroids to control your asthma, you may have fewer symptoms when you exercise. Training regularly and warming up before you exercise can also help prevent symptoms.
Talk to your provider if your asthma symptoms make it difficult to stay physically active. It may be a sign that your asthma is not well controlled or is getting worse.
Occupational asthma
Occupational asthma is asthma that develops or gets worse in the workplace. It can happen in an adult who is around allergens, for example, dust and mold, or other sensitizing agents at work.
Once you become sensitized to a substance, being around a very small amount can be enough to trigger serious symptoms. Your asthma can continue to get worse every time you are around the trigger. To prevent asthma flare-ups, you should remove the sensitizing agent from your place of work and avoid any further contact.
Allergic asthma
Allergic asthma often starts at a young age. Breathing can become difficult when you are around certain allergens, such as pollens, dust mites, or mold. Avoiding the allergens that trigger your asthma can help control your symptoms and prevent flare-ups. Typical treatment includes inhaled corticosteroids. Your healthcare provider may also recommend adding biologic medicines or allergy shots, which can be specific to the allergen.
Some people only have seasonal allergic asthma, which means that they do not have symptoms outside of a certain pollen season. Your provider may recommend medicines, such as a daily controller or a reliever inhaler, from the start of your allergy season until a few weeks after the season ends.
Nocturnal asthma
Nocturnal asthma refers to asthma symptoms that occur at night. It is not a separate type of asthma, but a sign of poor symptom control. It is common for asthma symptoms to get worse at night or in the early morning. Sometimes, your symptoms may wake you up at night. If this happens often, it may be a sign that your asthma is not well controlled.
Being around allergens while you sleep may also worsen your symptoms at night. Knowing your asthma triggers and avoiding them at night can help you manage your asthma and sleep better.