Asthma treatment should be undertaken in consultation with an allergy and asthma specialist who will be actively involved in formulating a comprehensive program to best manage asthma. This comprehensive approach to asthma treatment should include Environmental Control, the use of asthma medications, and possibly immunotherapy, or desensitization, if there are strong allergic triggers.
Environmental Control is a cornerstone in the treatment of asthma. This simply means that one has to avoid exposure to allergens or environmental irritants which can trigger or worsen asthma symptoms. For example, those allergic to dust mites need to minimize exposure to dust mites by encasing ones mattresses and pillows. If one is allergic to cats and dogs, it is crucial that they live in a pet free environment. And, it goes without saying that, all asthmatics should totally avoid exposure to cigarette smoke.
Asthma medications are a critical component to asthma control. Depending on several factors including the frequently and severity of Asthma Symptoms and the objective measurement of lung function, your asthma specialist will decide whether one needs to be on daily controller or preventative medication or only on an as needed or on a rescue medication such as albuterol.
Controller medications are usually prescribed for patients who have asthma symptoms at least two or three days out of every week. Physicians have found inhaled corticosteroids (ICS) to be the most effective controller medications. They are effective in controlling symptoms of asthma and improve lung function by reducing the inflammatory component of asthma. Due to the fact that these are preventative medications, they must be taken daily, exactly as prescribed, and not on an as needed basis. These medications have an excellent safety profile and are appropriate even for young children and senior citizens.
Non-steroidal anti-inflammatory medications are also available, but they are generally less effective than ICS in preventing symptoms. These medications are often prescribed in combination with ICS to provide additional control.
Rescue medications such as albuterol, often referred to as short-acting bronchodilators, should be available to provide immediate relief of bronchial constriction. Albuterol and other bronchodilators may be given as an inhaler or aerosolized in a nebulizer. These medications also have a place in the prevention of exercise induced asthma and are commonly recommended to be used 10-15 minutes prior to exercise.
Corticosteroids are often given to reduce the symptoms of severe airway inflammation during acute or chronic asthma. These medications are most commonly taken orally, but they can be administered by injection. Contrary to popular belief, corticosteroids are extremely safe if given for short periods of time, even for several weeks. Long term daily use of steroids, on the other hand, can be associated with significant side effects. It is important to note that the steroids used to treat asthma are not the same as anabolic steroids which are sometimes taken by athletes to build muscle mass. The use of these and all medications should be discussed with the prescribing physician.
An allergist may recommend immunotherapy, or allergen desensitization, for those whose asthma symptoms are poorly controlled with medications alone. Allergy injection therapy or sublingual (under the tongue) immunotherapy works by making the immune system more tolerant to allergens and thus decreasing the hyper responsiveness of the airway to allergens in the environment. Immunotherapy should be viewed as an important component of a comprehensive asthma treatment plan in the allergic asthmatic. Studies suggest that immunotherapy can be effective in preventing asthma from getting worse, and even preventing an allergic individual from developing asthma.
Finally, a team approach with your physician should include an asthma action plan. Your doctor may give you a list of symptoms with corresponding recommendations about when to start medications, or when to seek medical attention. In addition, the asthma action plan may include monitoring lung function at home with a Peak Flow Meter. A peak flow meters is a simple tube device that measures airway obstruction by quantifying how much air a patient can blow out of his or her lungs. This information may reveal subtle and progressive asthma, allowing one to intervene early and begin a higher level of medication treatment in order to prevent worsening symptoms.
The good news is that a well thought out asthma treatment plan can lead to excellent asthma control. Fortunately, with good asthma care and follow-up, most hospitalizations for asthma are preventable. A close relationship with an asthma specialist and an individualized asthma treatment plan can reduce asthma symptoms, leading to more symptom free days and a better quality of life for both children and adults with asthma.