Asthma Treatment and Medications

Asthma is a common chronic condition that affects millions of Americans every year.

When you have asthma, it means that your lungs are sensitive to triggers in the environment and your body.

When you make contact with an asthma trigger, the airways that carry air in and out of your lungs can react, becoming inflamed and swollen.

The smooth muscles that surround your airways can also begin to spasm and tighten, and your lungs may start to produce excess mucus, or phlegm. 

When asthma symptoms flare, they impact how much air you can move in and out of your lungs.

As symptoms worsen into an asthma attack, you may find that you have shortness of breath, that you are wheezing, coughing, and that you feel chest tightness or pain.

In severe cases, asthma can lead some patients to feel as though they are struggling to breathe, speak, or sleep.

If left untreated, severe asthma can become life-threatening. 

Fortunately, asthma is well-understood, and its symptoms are usually reversible with proper treatment.

If you believe you or someone you know has asthma, talk to a doctor about what you are experiencing.

They will take note of your symptoms, diagnose your condition, and, if appropriate, recommend the best treatment options for you to use for short-term relief and long-term asthma control.

In this article, I will cover the medications, therapies, surgeries, injections, and other treatments available to asthma patients.

I’ll also talk about some at-home and lifestyle changes that can reduce the frequency of asthma symptoms.

Finally, I’ll explain how you can get asthma treatment, when you should talk to a doctor, and how K Health can help.

Asthma Treatment

Asthma is a long-term condition that affects people’s ability to breathe.

It is one of the most common ailments globally, with studies suggesting that more than 300 million people have asthma across the globe.

Asthma is the most common chronic disease among patients under 18 years of age, and it is responsible for billions of dollars in healthcare costs in the United States alone.

Researchers haven’t identified the exact cause of asthma, but we know that some factors put certain individuals at a higher risk for developing the condition.

They include: 

• A family history of asthma 
• Regular exposure to environmental factors like air pollution, gases, fumes, or allergens
• Seasonal or food allergy issues
• A history of viral infections like the flu, the common cold, bronchitis, or COVID-19

Asthma can evolve with age.

Some patients develop the condition as young children and have the same symptoms all their life, but others may experience fewer or changed symptoms as they become older adults.

Some people develop the condition well into adulthood, after having never experienced signs or symptoms when they were growing up. 

Asthma is a serious condition that requires medical care.

Fortunately, researchers have worked for decades to develop a range of medicines, devices, and other effective treatments to help patients reduce airway inflammation and maintain an active lifestyle. 

Not every asthma medication or treatment plan is appropriate for everyone.

If you believe you have asthma, talk to a healthcare provider about your symptoms so that they can develop an asthma action plan that’s right for you. 

Medications

Several asthma medicines on the market offer both quick relief and long-term control over your condition.

Common medications include:

• Quick-relief medication: Often used in quick-relief inhalers (rescue inhalers) and other devices, these medicines dilate airways and improve symptoms immediately.

• Long-term control medications: Taken as tablets or syrup, or used in preventer inhalers, these medicines support persistent asthma patients who need help with ongoing symptoms.

• Combination asthma medicine: These drugs combine quick relief and long-term therapy into a single treatment.

• Biologics: These treatments help people with severe, persistent asthma address their symptoms and manage their condition.

Asthma medications come as oral tablets or syrup that you should take by mouth, or a liquid you breathe in using an inhaler, atomizer, or nebulizer machine.

Because asthma patients require consistent medical care, most medications are only available by prescription. 

Inhalers

Many asthma patients rely on a metered-dose inhaler (MDI) as a part of their asthma treatment plan.

Inhalers have a chemical propellant that pushes a specific dose of medicine from a pressurized canister, and delivers it directly into your lungs.

Dry powder inhalers (DPI) provide medicine without propellants, but patients must be able to coordinate their breathing enough to use their inhaler correctly.

If they can’t operate an inhaler correctly, patients can use other devices, like a nebulizer or atomizer, to breathe medication into their lungs as a liquid mist.

Doctors will often suggest a nebulizer or atomizer to pediatric patients who are too young or weak to use an inhaler.

There are several types of inhaler medications:

• Short-acting beta-agonists (SABA): These medicines are used in a quick-relief inhaler or reliever inhaler. They include albuterol (AccuNeb, Proventil HFA, ProAir HFA, Ventolin HFA), and levalbuterol (Xopenex, Xopenex HFA).

• Inhaled corticosteroid medications: These medicines are used in a preventer inhaler. They include budesonide (Pulmicort Flexhaler), mometasone (Asmanex Twisthaler), beclomethasone (Qvar RediHaler), fluticasone (Flovent HFA), and ciclesonide (Alvesco).

• Long-acting beta-agonists (LABA): Most often used in tandem with inhaled corticosteroid medicines, these medicines include salmeterol (Serevent) and formoterol (Foradil).

Different people can experience the same medications in different ways.

Some patients who use a rescue inhaler to take quick-relief medicines report mild to moderate side effects.

The most common side effects include nervousness or agitation, shaky hands or tremor, heart palpitations, headache, dizziness, anxiety, nausea, upset stomach, or diarrhea. 

People who use an asthma inhaler to take long-term control medicines like inhaled corticosteroids and long-acting beta-agonists can report feeling hoarse or having a sore throat, developing a cough, or experiencing oral thrush, among other possible side effects. 

Doctors often suggest patients take LABA medication along with an inhaled corticosteroid.

Using the medication on its own can put people at higher risk of developing a life-threatening asthma attack.

Never start or stop a medication without talking to your doctor.

Tablets

Many patients with asthma use oral tablets along with, or instead of, inhaled medication for their asthma management.

The most common include: 

• Leukotriene modifiers or leukotriene receptor antagonists (LTRAs): These medicines include montelukast (Singulair), zileuton (Zyflo CR, Zylflo), and zafirlukast (Accolate). LTRAs are not an appropriate medication for quick relief if you are having an asthma attack—doctors usually recommend them to those who have persistent symptoms and want long-term control over their chronic lung disease. Potential side effects of LTRA medications include headache, vomiting, and diarrhea.

• Xanthines: Doctors will prescribe a xanthine medication called theophylline (Theochron, Elixophyllin, Uniphyl) for asthma patients. The medicine can help patients manage asthma but is not recommended as a treatment for asthma attacks. Possible side effects include nausea, vomiting, headache, gastroesophageal reflux (GERD), irritability, dizziness, seizure, and heart problems.

• Oral corticosteroids: The four oral steroid medications that doctors most commonly prescribed for asthma include prednisone, prednisolone, methylprednisolone, and dexamethasone. You can use oral corticosteroids to help treat sudden asthma attacks and gain long-term control over your symptoms. Side effects include swelling in your legs, high blood pressure, emotional dysregulation, vision changes, hallucination, confusion, weakness, indigestion, and weight gain.

Surgery

Sometimes, when patients suffer from severe, persistent asthma that does not improve with treatment, a doctor will suggest they undergo a procedure to help them breathe more easily.

Surgeries do not cure asthma, but evidence suggests that they can offer patients who struggle with the condition a higher quality of life. 

Bronchial Thermoplasty

A bronchial thermoplasty is a procedure that uses heat to reduce the smooth muscle in your lungs and open up your airways.

There is evidence that it can help reduce symptoms in patients over the age of 18 who have severe, persistent asthma, do not smoke, and need to take an oral steroid to maintain control over their symptoms. 

A bronchial thermoplasty takes three separate sessions to complete. In each session, patients complete a lung function test using a peak flow meter to measure their expiratory flow rate and how much air they can exhale.

Then the doctor uses anesthetics to sedate the patient before using a small tube to warm the airways and open up the lungs. 

Side effects of the procedure include coughing, wheezing, and feeling fatigued or short of breath, particularly in the week after the procedure.

In rare cases, the process can trigger an asthma attack that can require emergency care.

Complementary Therapies

Some asthma patients use natural or home remedies to complement and augment their prescribed treatment plan.

Most have not been studied enough for doctors to know whether they are safe or effective enough to recommend.

A few practices show promise when used in combination with prescription medication, though research is still ongoing.

• Breathing Exercises: Some studies suggest that breathing training may help patients with asthma adjust irregular breathing patterns.

• Hypnotherapy: Initial evidence suggests that hypnosis may help people with asthma reduce their symptoms and manage stress (an emotional response that exacerbates breathing problems), though more research is required.

• Massage Therapy: Multiple studies have shown that massage therapy can improve lung function in pediatric patients with asthma.

Injections

Occasionally, patients require regular injections of medications called biologics to manage their asthma and reduce their symptoms.

Treatments are given every few weeks, usually by an asthma specialist.

The most common biologic drugs prescribed for asthma patients include: 

• Benralizumab (Fasenra)
• Omalizumab (Xolair)
• Mepolizumab (Nucala)
• Reslizumab (Cinqaero)

The most common side effects of these medications include headache, fatigue, muscle or joint aches, sore throat, and a skin reaction at the injection site. 

Very rarely, patients will experience a severe allergic reaction to biologic treatments. Symptoms to watch out for include: 

• Shortness of breath
• Chills
• Itchy eyes or lips
• Redness 
• Warm skin or skin that is tender 
• A full-body rash
• A rash that starts on your face and gets worse in sunlight
• Joint or body pain
• Numbness or tingling  
• Sudden loss of vision
• Swelling of the hands or ankles 
• Heart failure

If you have recently received a biologic treatment and experience any symptoms that you believe might be related to an allergic reaction, call your doctor, dial 9-1-1, or go to the nearest emergency room immediately.

At-home and Lifestyle Changes

While there is no cure for asthma, making healthy lifestyle choices can support an effective treatment plan and improve your quality of life. 

Asthma action plan

If you have asthma, you must have an asthma action plan that you can refer to anytime.

Yours should include the medicines you take, the symptoms you should watch out for, and what to do in case of an emergency.

Following your action plan can help you stay organized, understand your symptoms, and better manage your symptoms over time.

Avoid triggers

Every patient has different asthma triggers that can initiate and worsen their symptoms.

The most common include cigarette smoke or secondhand smoke, air pollution, dust mites, pollen, pet dander, physical activity, and respiratory infections.

Noting what kinds of triggers set off your symptoms and learning to avoid them can be a helpful way of reducing the number and severity of your asthma attacks over time.

Stay healthy

Committing to your health is a vital part of being able to control asthma over the long term.

Taking simple steps to quit smoking, take your prescription medication properly, eat a well-balanced diet, exercise regularly, and avoid exposure to illness, can help you manage your asthma symptoms and feel better in the long run.

Asthma and dairy

Eating cheese or drinking milk for patients with a dairy allergy can trigger symptoms and cause an asthma attack.

If you react poorly to dairy, cutting those products from your diet can help you take control of your asthma symptoms.

How to Get Asthma Treatment

If you are experiencing asthma symptoms and believe you might benefit from a treatment plan, make an appointment to go to a doctor’s office or talk to one online.

They will evaluate your symptoms, take note of your health history, and, if appropriate, recommend a course of medications and other therapies that are best for you. 

When to See a Doctor

If you have asthma, you must be under a doctor’s regular care.

For most patients, the condition is manageable but may require treatment adjustments from time to time. Untreated or inappropriately treated asthma can be life-threatening.

Call your doctor if you experience shortness of breath, wheezing, coughing, or chest pain after coming into contact with a trigger, exercising, or coming down with a respiratory infection.

If at any point you feel like you are struggling to breathe, speak, or sleep, or notice your lips or face turning blue, you may be experiencing a severe asthma attack that requires emergency care.

Call 9-1-1 or go to the nearest emergency room. 

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K Health to check your symptoms, explore conditions and treatments, and, if needed, text with a clinician in minutes. K Health’s AI-powered app is based on 20 years of clinical data.