Although asthma cannot be cured, you can manage the symptoms with medications, especially inhaled corticosteroids and beta2-agonists. You will probably work with your health professional to develop a management plan consisting of a daily treatment plan and an asthma action plan. These plans help you meet treatment goals and get your asthma under control. The goals of asthma treatment are to:¹⁸

• Prevent symptoms.
• Keep your peak flow and lung function as close to normal as possible.
• Be able to do your normal daily activities, including work, school, exercise, and recreation.
• Prevent asthma attacks.
• Have few or no side effects from medicine.

For more information, see:

 Taking charge of asthma.

Emergency treatment

If you have a severe asthma attack (the red zone of your asthma action plan), use medication based on your action plan and talk with a health professional immediately about what to do next. This is especially important if your peak expiratory flow (PEF) does not return to the green zone or stays within the yellow zone after you take medication. You may have to go to the hospital or an emergency room for treatment. Be sure to tell the emergency staff if you are pregnant.

At the hospital, you will probably receive inhaled beta2-agonists and corticosteroids. You may be given oxygen therapy. Your lung function and condition will be assessed. Depending on your response, further treatment in the emergency room or a stay in the hospital may be necessary.

Some people are at increased risk of death from asthma, such as people who have been admitted to an intensive care unit for asthma or who have needed a breathing tube (intubation) for asthma. These people need to seek medical care early when they have symptoms.

Medical checkups

You need to monitor your asthma and have regular checkups to keep it under control and to ensure correct treatment. The frequency of checkups depends on how your asthma is classified. Checkups are recommended:

• About every 6 to 12 months for people with mild intermittent or mild persistent asthma that has been under control for at least 3 months.
• Every 3 to 6 months for those with moderate persistent asthma.
• Every 1 to 2 months for people with uncontrolled or severe persistent asthma.
• Every month if you are pregnant.

During checkups, your health professional will ask whether your symptoms and peak expiratory flow have held steady, improved, or become worse and will ask about asthma attacks during exercise or at night. You track this information in an asthma diary. You may be asked to bring your peak expiratory flow meter to an appointment so your health professional can see how you use it.

Initial treatment

There are many components to managing asthma. After your diagnosis, your health professional may only discuss the components you need to know immediately. These include:

• Oral or injected corticosteroids (systemic corticosteroids). These medications may be used to get your asthma under control before you start taking daily medication. In the future, you also may take oral or injected corticosteroids to treat any sudden and severe symptoms (asthma attacks), such as shortness of breath. Oral corticosteroids are used more than injected corticosteroids. Oral corticosteroids include prednisone and dexamethasone.
• Inhaled corticosteroids. These are the preferred medications for long-term treatment of asthma. They reduce the inflammation of your airways, and you take them every day to keep asthma under control and to prevent asthma attacks. Inhaled corticosteroids include beclomethasone dipropionate, triamcinolone acetonide, fluticasone propionate, budesonide, and flunisolide.
• Short-acting beta2-agonists. These medications are used for asthma attacks. They relax the airways, allowing you to breathe easier. Short-acting beta2-agonists include albuterol and pirbuterol.
• A combination of an inhaled corticosteroid and long-acting beta2-agonist. This combination is often used to treat persistent asthma.
• Basic education about asthma. The more you know about asthma, the more likely it is you will control symptoms and reduce the risk of asthma attacks. Keep in mind that even severe asthma can be controlled, and cases where the condition cannot be controlled are unusual.
• Instruction on how to use a metered-dose inhaler (MDI) or dry powder inhaler (DPI). Inhalers deliver medicine directly to the lungs. If you use your inhaler correctly, you can control your symptoms and avoid asthma attacks that can send you to the emergency room. Most health professionals recommend using a spacer with an MDI. For more information, see:

  Using a metered-dose inhaler.

  Using a dry powder inhaler.