Health Education

Asthma treatment and medications

Cropped SingleCare logo By | March 24, 2020
Medically reviewed by Michael L. Davis, MD

What is asthma? | Asthma diagnosis | Asthma treatment options | Asthma medications | Best asthma medications | Side effects of asthma meds | Asthma home remedies | FAQ | Resources

The ability to take a breath is something most people don’t think twice about. Until you experience a breathing problem—such as shortness of breath, wheezing, or chest tightness—it’s easy to take for granted. Asthma is a common condition that can make breathing difficult, cause asthma attacks, and create other lung issues. It can be frustrating and frightening for some patients to deal with, but it’s a manageable condition with the right asthma treatment in place.

What is asthma?

Asthma, sometimes referred to as bronchial asthma, is a condition that affects the airways and a patient’s ability to breathe. Patients with asthma experience airway inflammation, which causes a variety of issues. Asthma is a common condition with an estimate of over 24 million cases in the United States, according to the Centers for Disease Control and Prevention (CDC).

For many sufferers, their condition is triggered or made worse by environmental irritants. Asthma triggers may include allergens, dust mites, pet dander, humid weather, smoke (including tobacco smoke), infections, cold air, pollution, mold, food additives, fragrances and physical activity. Most patients seek medical attention early on after persistent asthma symptoms or a sudden asthma attack. Symptoms of asthma include wheezing, chest tightness, frequent respiratory infections, and a chronic cough.

The treatment of asthma typically involves avoiding asthma triggers as well as addressing symptoms and preparing for attacks. The National Heart, Lung, and Blood Institute (NHLBI) also recommends having an asthma action plan.

How is asthma diagnosed?

Often, asthma symptoms are what lead to an initial diagnosis of a patient. These can include wheezing, cough, frequent respiratory infections, and difficulty breathing. Airway reactivity and inflammation causes these breathing problems. Asthma diagnoses usually happen in childhood, but the age of diagnosis may vary depending on when the patient’s first flare-up occurs.

A pediatrician, pulmonologist, primary care provider, or an allergist are all specialists that can diagnose asthma. During the exam, the healthcare provider will ask the patient about any potential risk factors such as asthma triggers and a history of asthma symptoms before moving onto a physical exam. Asthma is not contagious, but it may be hereditary.

During the physical exam, the doctor will evaluate the patient for signs of allergies and monitor the patient’s breathing. The doctor may also perform several diagnostic tests to determine if the patient has asthma. These tests include:

  • Peak expiratory flow rate tests (PEFR) track how fast the patient can exhale. The patient usually takes this test home to track measurements over time.
  • Pulmonary function tests can help determine the severity of asthma as the patient breathes through a tube that’s connected to a computer, which measures lung volume, capacity, flow rate, and gas exchange.
  • Spirometry with bronchodilator test can determine the efficacy of asthma medication by measuring the force of a patient’s inhalation after using a bronchodilator medicine.
  • Allergy tests identify allergens that the patient can learn to avoid. Avoiding asthma triggers can significantly help with the quality of life.

Asthma treatment options

There are two categories of asthma medications: control medications and quick-relief medications. Control medications are daily medicines used to prevent symptoms, reduce airway inflammation, and prevent further breathing issues.

“In maintenance, we recommend inhalers that include anti-inflammatories and bronchodilators,” says Amy Darter, MD, an allergist at Oklahoma Institute of Allergy, Asthma, and Immunology. “Asthma sufferers also need to find out what the triggers are, including infections, allergies, exercise, and weather change.” Identifying triggers can assist a patient in both the management of asthma and quick-relief treatments. It can also help in anticipating when an asthma action plan may be needed.

Quick-relief medications, like rescue inhalers, are used to alleviate symptoms during an asthma attack. They are usually a suitable solution for sudden asthma symptoms or mild asthma attacks.

If a patient has a severe asthma attack or needs emergency treatment, they may be given quick-relief medications before heading to a hospital to be treated with a nebulizer or receiving oxygen therapy. Additionally, patients with severe asthma may undergo a procedure called bronchial thermoplasty. During this procedure, the doctor applies heat in the airways in an attempt to decrease the muscles that cause the constricting (bronchoconstriction).

Asthma medications

Corticosteroids

Corticosteroids (also called, steroids or cortisone) are effective at preventing and maintaining asthma symptoms over time. They can be taken as a pill or liquid, inhaled, or injected. They work by reducing the body’s inflammatory response, leading to more manageable asthma symptoms. Commonly prescribed corticosteroids include fluticasone, prednisone, and beclomethasone.

Monoclonal antibodies

These asthma medications can be used as control medicines and injected. Sometimes referred to as biologic medicines, this drug class blocks the body’s responses to allergens. These medications are only given to patients with severe asthma. Commonly prescribed monoclonal antibodies include mepolizumab and omalizumab.

Leukotriene receptor antagonists

Often referred to as leukotriene modifiers, these long-term medications control the effects of leukotrienes (inflammation chemicals) that cells release in asthma. Commonly prescribed leukotriene modifiers include Accolate (zafirlukast) and Singulair (montelukast).

Mast cell stabilizers

Another popular class of drugs for controlling asthma is mast cell stabilizers. These medications can help to prevent inflammation of the airways caused by allergens or asthma triggers. The most commonly prescribed mast cell stabilizer is cromolyn.

Beta-agonists

There are two variations of beta-agonists (sometimes called beta 2-agonists). Long-acting beta-agonists are used for long-term control of asthma, while short-acting beta-agonists are quick-relief medicines. Beta-agonists often come in the form of inhalers or inhaler disks and work by relaxing the muscles in the airways and allowing the lungs to breathe more easily. The most commonly prescribed beta-agonists are salmeterol and albuterol.

What is the best medication for asthma?

Best medications for asthma
Drug name Drug class Administration route Standard dosage Common side effects
Flovent HFA (fluticasone) Corticosteroids Oral Inhalation 12 gm of 110 mcg inhaled twice daily Headache, stuffy or runny nose, hoarseness
Prednisone Corticosteroids Oral 20 mg taken one to 4 times daily Headache, dizziness, difficulty falling asleep
QVAR Redihaler (beclomethasone) Corticosteroids Oral Inhalation 10.6 gm of 80 mcg inhaled twice daily Headache, sore throat, runny or stuffy nose
Nucala (mepolizumab) Monoclonal antibodies Injection 100 mg given every 4 weeks Redness at the injection site, headache, back pain
Xolair (omalizumab) Monoclonal antibodies Injection 150 mg given every 2-4 weeks Redness at the injection site, pain of the joints, tiredness
Accolate (zafirlukast) Leukotriene receptor antagonists Oral 20 mg taken twice daily before a meal Headache, nausea, loss of appetite
Singulair (montelukast) Leukotriene receptor antagonists Oral 10 mg taken once daily Headache, heartburn, stomach pain
Gastrocrom (cromolyn) Mast cell stabilizer Oral 5 ml of 100 mg taken up to 4 times daily Sore throat, stomach pain, cough
Serevent (salmeterol) Beta-agonist Oral 50 mcg disk used twice daily Headache, nervousness, dizziness
Ventolin HFA (albuterol) Beta-agonist Oral 6.7 gm of 108 mcg used every 4-6 hours Nervousness, headache, nausea

Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

What are the common side effects of asthma medication?

All asthma medications can cause side effects that vary in type and severity. However, it is important to remember that every patient is different and may experience different side effects for their specific asthma treatment. All patients should consult their primary healthcare provider before starting asthma medication and if they experience side effects. Side effects of asthma medicine can include:

  • Headache
  • Stuffy or runny nose
  • Hoarseness
  • Fast heart rate
  • Sore throat
  • Nausea
  • Joint pain
  • Dizziness

What are the best home remedies for asthma?

Using natural remedies as part of a patient’s treatment plan for asthma may provide some benefits. However, most home remedies for asthma involve prevention, management, or lifestyle changes to control asthma and minimize asthma attacks. If an asthma attack occurs, it is best to seek immediate medical attention. Some natural remedies for asthma can include:

  • Avoid allergens. Asthma management starts by avoiding triggers. Making dietary changes, using air purifiers, and avoiding products with fragrance are some of the more common lifestyle changes for avoiding allergens. Other risk factors include weather changes and exercise, so wearing a scarf and bringing your inhaler to the gym are reasonable precautions to take.
  • Cook with ginger and garlic. These herbs have anti-inflammatory properties and can help when taken as a supplement. Their direct effect on asthma has not been studied; however, given their anecdotal history with inflammatory issues, they could be a way to help prevent asthma symptoms.
  • Drink a cup of coffee. As it turns out, caffeine is a bronchodilator and can help relax the muscles in your airways. Consuming caffeine may provide relief to the airways and allow them to function better for up to four hours.
  • Practice breathing techniques. There are a variety of different breathing techniques and breathing exercises patients can use to strengthen respiratory muscles and assist the airways in functioning. Buteyko Breathing Technique focuses on breathing out of the nose instead of the mouth. This method can help to prevent the drying out of airways by using the techniques involved with its practice. There is also the Papworth method, for which patients will sometimes participate in a training course before practicing a combined breathing and relaxation exercise.

Frequently asked questions about asthma

What is the main cause of asthma?

Asthma is caused by hyperactivity of the muscles in the airways and airway inflammation. This leads to breathing problems and other respiratory symptoms. Asthma triggers can vary depending on the patient, as different triggers affect different patients in different ways.

What are the types of asthma?

According to the American College of Allergy, Asthma, and Immunology, there are six major types of asthma:

  • Adult-onset asthma develops in adulthood.
  • Allergic asthma causes a respiratory reaction when exposed to specific triggers.
  • Asthma-COPD overlap (ACO) happens when someone presents symptoms of asthma and chronic obstructive pulmonary disease (COPD).
  • Exercise-induced bronchoconstriction (EIB) causes difficulty breathing during or after physical activity.
  • Nonallergic asthma is often caused by recurrent respiratory infections.
  • Occupational asthma is caused by exposure to a toxic substance as part of your job. For example, car mechanics breathe in gasoline and other fumes daily.

Can asthma kill you?

Unfortunately, asthma can lead to death if untreated. Asthma attacks constrict the airways, sometimes severely, and can keep a patient from breathing. Asthma can be a life-threatening health condition that almost always requires treatment. Asthma deaths are thought of as preventable since early treatment and patient education can be very effective.

What foods trigger asthma?

The eight most common food allergens are:

  1. Cow’s milk
  2. Eggs
  3. Tree nuts
  4. Peanuts
  5. Shellfish
  6. Soy
  7. Wheat
  8. Fish

However, any food allergies could be an asthma trigger. Visit a healthcare provider or allergist to identify food allergies.

What is the best medicine for asthma?

Every patient is different and will have different needs for their lifestyle and type of asthma. There is not one universal treatment for every person living with asthma. Some patients find relief with certain medicines, while others respond better to different ones. Using a nebulizer machine could be a convenient way to give children their asthma medication. Some of the more common asthma medications include fluticasone, prednisone, and salmeterol.

Are asthma inhalers bad for you?

There are two types of inhalers: metered-dose inhalers (MDI) and dry powder inhalers (DPI). There are no side effects associated with the inhaler itself, but rather the medication it dispenses. Overuse of any drug can lead to adverse side effects. Additionally, all medications do have the potential for side effects that could harm patients. Patients must check with their prescribing healthcare professional about any concerns they may have about their inhaler.

RELATED: How to properly administer an inhaler to your child

How can I treat asthma at home?

There are a variety of breathing exercises that can assist the airways and respiratory muscles in working correctly. Additionally, lifestyle changes may also help with asthma control at home, such as avoiding allergens in food or using an air purifier. Having an asthma action plan that you and your doctor develop together can be the single most important factor that keeps your asthma from getting the better of you.

What helps asthma naturally?

Using herbal supplements may reduce the inflammation that causes asthma symptoms. Supplements such as garlic and ginger have anti-inflammatory properties. However, home remedies are not a replacement for asthma medication, and patients should still seek medical attention for managing asthma.

Related resources for asthma