WHAT ARE THE TREATMENTS Options For ASTHMA?
* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed
since that time.
1. Bronchodilators (Basic treatment)
A. Short acting beta-adrenergic drugs (Albuterol 2 puffs q 4-6 hours as needed)
B. Anticholinergics (Ipratropium q 6 hours as needed for acute onset)
C. Long acting beta-adrenergic drugs (Salmeterol 1 puff q 12 hours)
2. Newer treatments
A. Corticosteroids (which can be inhaled, taken by mouth, or given intravenously)
- Fluticasone DPI: inhaler 2 x/day
- beclomethasone dipropionate inhaled
- budesonide inhaled
- mometasone inhaled
B. Combination inhalers:
- budesonide/formoterol inhaled
- mometasone/formoterol inhaled
- fluticasone apropionate/salmeterol inhaled
- fluticasone furoate/vilanterol inhaled
C. Leukotriene modifiers
- Montelukast (Singulair) 10 mg / night {for adults}
D. Mast cell stabilizers
- Cromolyn - usually administered via a nebulizer 4 x day
For the most SEVERE CASES of asthma:
- oral corticosteroids: Prednisone ~7.5 mg (for chronic use)
- Biological medications: Lebrikizumab, Itepkimab
- Vitamin D
- Azithromycin (check EKG for QTc first) 500 mg 3 x / week
CAUTION:
1. All medication, including all oral antibiotics and all medications that come in lotions, ointment, and creams have a risk of side effects.
2. Possible Mild side effects are nausea, vomiting, diarrhea, itching, and light to moderate skin rash.
3. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.
4. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.
WHAT ARE COMMON SYMPTOMS OF ASTHMA?
Asthma attacks vary in frequency and severity. Some people who have asthma are symptom-free most of the time, with only an occasional brief, mild episode of shortness of breath. Other people cough and wheeze most of the time and have severe attacks after viral infections, exercise, or exposure to other triggers.
Wheezing is a musical sound that occurs when a person breathes out. It usually requires listening through a stethoscope which is applied to chest in the area of the lungs.
Coughing may be the only symptom in some people (cough-variant asthma). Some people with asthma produce a clear, sometimes sticky (mucoid) phlegm (sputum).
In some people, asthma attacks occur primarily at night (nocturnal asthma). Attacks that occur during the night may indicate poorly controlled asthma.
Surprisingly, some people with severe asthma do not realize they have it. In addition, their bronchioles may be so tightly shut they do not wheeze.
WHAT IS THE CAUSE OF ASTHMA?
The cause of asthma is complex and usually involves several abnormalities in a person’s body. The simplest explanation for asthma is that a person’s body over reacts to any of a number of triggers. This overreaction can lead to other changes in body such as the enlargement and strengthening of the muscles that constrict the bronchioles.
The triggers are often very simple irritants that occur in the environment. They include pollen from grass, trees and weeds; pet dander, dust mites, cockroaches, and molds; air pollution, smoke, and strong odors; a change in weather conditions; and exercise.
HOW IS ASTHMA DIAGNOSED?
Asthma can be diagnosed by taking a careful history and by a physical exam, which includes listening to the lungs. However, other tests such as Pulmonary Function Tests are recommended to confirm the disorder and determine the extent of the disorder. In addition, a blood test that determines a person’s eosinophil count is usually recommended.