Your Guide to Asthma Treatment
Asthma Treatment Options
When you have asthma, you will likely be prescribed with medications to help you control your condition — and it’s important to follow your treatment plan.
Your asthma management plan needs to detail all your medications and when to take them. “It should also describe how to handle your asthma during flare-ups and when to seek emergency attention,” Dr. Naimi says. Here are the main types of medications your doctor may prescribe:
- Long-term control medicationsThese should be taken regularly, even when you feel well. “Inhaled steroids are the cornerstone of long-term asthma treatment plans, but there are nonsteroid options (montelukast or anticholinergics) as well,” Naimi says. “Long-acting beta-agonists (LABAs) can be added to inhaled steroids for those with more severe asthma.”
- Quick-relief medicationsThese should be taken as needed. Also known as rescue medications — or officially, short-acting beta-agonists (SABAs) — these medications include albuterol or levalbuterol and are used to treat acute symptoms and exacerbations. “If you find yourself needing these more than twice a week, your asthma may not actually be well controlled,” Naimi says. So be sure to discuss this with your doctor.
- Medications for allergy-induced asthma/immunotherapyMedications like montelukast, antihistamines, or others that help control nasal symptoms and sinus disease may be helpful for people with asthma, Naimi says. If allergies trigger your asthma, another option is allergy immunotherapy (AIT), which is typically administered with allergy shots. “This is playing the long game,” says Naimi. “The treatment may take three to five years, but what you’re doing is desensitizing your body to factors that are setting off your asthma.”
- Biologic therapiesThese medications target molecules — such as antibodies, white blood cells, and proteins — that contribute to asthma, according to the AAAAI. Because they may help reduce asthma flare-ups and the need for steroids, these breakthrough treatments (including omalizumab, mepolizumab, and reslizumab) are being used more widely and changing the paradigm for the treatment of severe asthma, Naimi says.
Your Asthma Management Plan: Other Things to Consider
While following your treatment plan is one of the most important steps you can take, there are other things you can do to help control your asthma. Start with these steps:
Get regular checkups.If you have severe asthma, Naimi recommends that you see a board certified allergist or pulmonologist every three to six months to discuss any or flare-ups you’ve been experiencing. Your doctor can monitor your lung function, examine how you’re responding to treatment, and adjust your treatment plan accordingly. “The treatment plan you need this year might be different from what will be best for you a year from now, because so many factors of your environment and lifestyle may be changing,” Naimi says. Be sure to be honest with your doctor about whether you smoke and whether you’re taking your medications regularly and as directed. “Remember that no one is there to judge,” says Naimi. “Your doctor needs to know all the facts to give you the best treatment options.”
Avoid potential asthma triggers.This means you should do your best to reduce your exposure to indoor and outdoor allergens like dust mites, pet dander, and pollen; irritants like cigarette smoke and wood-fire smoke; as well as air pollution and weather or temperature changes, says Naimi. To avoid such triggers, he recommends these tips:
- Check local pollen reports before going outside.
- Keep an eye on air quality forecasts to monitor air pollution and limit your time outdoors when air quality is poor.
- Be aware that some common viruses (such as rhinovirus, which causes colds) are a common cause of asthma flare-ups.
- Get allergen-proof covers for pillows that prevent exposure to dust mites.
- Wash bedding in hot water — 130 degrees Fahrenheit, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).
- Keep your bedroom clear of clutter and stuffed animals.
- Bathe any furry pets weekly, and try to keep them out of the bedroom.
- Dust and vacuum often — at least once a week.
- Consider getting an air purifier with a HEPA filter: These can be particularly helpful for pet dander as well as during pollen season if the windows are left open, Naimi says.
- Shower after you’ve been outside, keep your windows closed, and use the recycle air button in your car during pollen season if you have a pollen allergy.
Make healthy lifestyle changes.Living a healthy lifestyle can help you keep your asthma under control. Start with these tips:
- Exercise regularly.“Exercise is a big one, as it helps with lung function,” Naimi says. It can help increase lung strength and improve breathing and may also lessen the narrowing of the airways that occurs with asthma, he explains.Combined with healthy eating, exercise can also help you maintain a healthy weight, which is important because extra weight in the chest and abdominal region can make it harder for you to breathe and can therefore worsen your asthma symptoms. “Generally, having asthma shouldn’t restrict your ability to exerciseifyour asthma is controlled properly,” Naimi says. “Use of albuterol before you exercise can be helpful.” Avoid strenuous exercise during an asthma flare-up, of course, and listen to your body during workouts and take it slowly when necessary.
- Eat a healthy diet.Healthy eating is important for maintaining a healthy weight. And be aware that sulfites, a preservative used in foods and drinks such as some dried fruits, sauerkraut, bottled lemon and lime juice, and wine and some beers, may trigger asthma in a small percentage of asthma patients — usually those with severe, steroid-dependent asthma, Naimi says. If you notice aggravated symptoms after eating foods with sulfites, talk to your doctor about whether you should avoid them.
- Avoid cigarette (and other) smoke.“Quit smoking, and try to reduce how much you’re around others when they’re smoking,” Naimi says. Smokinganythingis something to be candid about with your doctor. “Many people answer that they don’t smoke, when in fact they smoke marijuana regularly,” says Naimi. “They just didn’t think of it that way. As marijuana is increasingly being legalized, we’re seeing more and more of this issue.”
Keep a record of your symptoms.This can be as simple as using the notes function on your phone to enter a reminder of any symptoms — coughing, shortness of breath, tightness in the chest — and when they occurred, whether it was during exercise, when you laughed, when you slept. That way you can discuss them with your doctor at your next checkup, Naimi says. “Symptom recognition is important,” he says, “because it allows your doctor to know when to escalate a plan.”
Track your peak flow readings.A peak flow meter is a small device you blow into to check how well you blow air out of your lungs and therefore how well your asthma is controlled. “It’s a helpful way to determine the severity of asthma and to monitor the progress of treatment once it’s underway,” Naimi says. It’s especially useful if you have difficulty perceiving your own symptoms well. “People get used to living with their asthma, living a certain way,” Naimi says. “They think, ‘I cough when I run’ — and it becomes their new norm. But it isn’t normal, and it doesn’t have to be that way.” Peak flow readings can give you a better sense of how well (or not) you’re breathing, but the meter needs to be used regularly — at least daily, and ideally several times a day — since readings can vary, Naimi says. So be sure to follow your doctor’s instructions.
If your symptoms aren’t well controlled even though you’re following your asthma treatment and management plan, be sure to talk to your doctor. It may be a sign that you have severe asthma and may need additional treatments or lifestyle modifications to help you better manage your condition.
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