Asthma Treatment

In general, there are 2 types of asthma medications: rescue and controller medicines. Most asthmatics require both medications. Many people with asthma are under-treated with only a rescue inhaler, which is a common mistake for physicians to make. Find out if your asthma is controlled, or if you might need additional therapy (such as a controller medicine).

Rescue medicines are those medicines that are taken as needed. This means that these medicines should be carried with the person with asthma, since an asthma attack can never be predicted. Rescue medicines help relax the muscle around the airways for a few hours, but do not help the inflammation and swelling of the airways. Frequent use of a rescue medicine is a sign that asthma is not controlled.

Controller medicines are those medicines that are taken every day (sometimes multiple times a day) regardless of asthma symptoms. These medicines are taken all of the time in order to control the inflammation and swelling of the airways. This leads to less irritation and constriction of the muscles around the airways and therefore less asthma symptoms. These medicines usually take a few days to a few weeks in order to start working, but then a person with asthma notices that less and less rescue medicine is needed.

Examples of rescue medicines include: ProAir (albuterol) Proventil (albuterol) Ventolin (albuterol) Maxair (pirbuterol) Alupent (metaproterenol)

Examples of controller medicines include: Inhaled steroids {Pulmicort (budesonide), Flovent (fluticasone), Advair (fluticasone/salmeterol combination), Azmacort (triamcinolone), QVAR (becloomethasone) and Asmanex (mometasone)} Long-acting beta-agonists {Foradil (formoterol), Serevent(salmeterol)} Leukotriene blockers (Singulair (montelukast), Accolate (zafirlukast), Zyflo (zilueton)}. Theophylline (Theodur, Theo-24, Uniphyl, generics) Mast cell stabilizers {Tilade (nedocromil), Intal (cromolyn)} Xolair (omalizamab)It is easy to calculate how long a controller medicine inhaler will last: for example, Flovent inhalers contain 120 puffs. If your doctor has prescribed 2 puffs to be inhaled twice a day, then you will use 4 puffs a day. 120 divided by 4 is equal to 30. The canister will last 30 days.

In the case of a rescue inhaler, such as albuterol, most canisters have between 100 and 200 puffs. Since these medicines are only used “as needed”, how long a canister lasts depends on how much a person uses the medicine. Once the canister seems to be less than half-full with shaking the device, it is probably time for a new one.

Keep in mind that an inhaler will continue to spray propellant long after the medicine has run out. It is common for asthmatics to continue to use the inhaler, which no longer contains medicine, until their asthma worsens and requires a doctor visit. Always make sure your asthma medicines are in good supply and not past the expiration date.

DO: Use your medicines as prescribed. See your doctor for “healthy” appointments twice a year, more often if needed. Get a flu shot each year. See your doctor early with cold and flu symptoms.

DON’T: Don’t use tobacco products, which can worsen asthma symptoms Don’t let heart-burn symptoms go untreated, which can also worsen asthma. Don’t use “over-the-counter” asthma medicines (such as Primatine Mist). Don’t use your rescue medicine more than twice a week without telling your doctor.

Sources: 1. Practice Parameters for the Diagnosis and Treatment of Asthma. J Allergy Clin Immunol 1995;96:S707-870.2. National Asthma Education and Prevention Program Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. NIH Publication No. 97-4051. 1997/EPR-2 Update 2002.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.