The Asthma Program has been designed to provide comprehensive treatment with an individualized approach. Treatment for asthma may include traditional remedies, from rescue medicines to long-term control medicines. Non-traditional remedies such as herbal therapy, acupuncture and hypnosis are being investigated in terms of their benefit for certain patients.
Rescue medications such as short-acting beta agonists (e.g. albuterol, Proventil, Ventolin, MaxAir) work by relaxing the muscle that lines the airway so that the airway opens further, relieving asthma symptoms. Drugs in this category also help decrease mucus that can clog breathing passages in the lungs. Other rescue medications such as anti-cholinergic agents (e.g. ipratropium or Atrovent) act on some of the nerves that affect airway diameter and cause it to increase. They also decrease mucus production. Although they are generally less effective than the short-acting beta agonists at relieving asthma symptoms, they may be particularly useful for older individuals, for nighttime symptoms or during an asthma attack related to an upper respiratory infection (i.e., cold).
Long-Term Control Medications
Long term medications, such as inhaled corticosteroids (e.g., Pulmicort, Flovent, Azmanex, Alvesco), are first line therapies for asthma in any patient who experiences symptoms at least twice each week. The inhaled corticosteroids can suppress, control, and temporarily reverse inflammation and its consequences when taken regularly.
Other types of “controller” medications such as anti-leukotriene agents (e.g., Singulair, Zyflo), xanthines (e.g., Theophylline, Theodur, Slobid), long-acting beta agonists in combination with inhaled corticosteroids, long-acting anti-cholinergics in combination with inhaled corticosteroids, and anti-IgE (e.g., Xolair), also help to reduce asthma symptoms and gain better control of the disease.
Novel therapies for asthma are in various phases of development and often focus on targeting small molecules important in the asthma pathway. Some of these medications are given by inhalation while others are oral or given by injection. One therapy for asthma, called bronchial thermoplasty, is an FDA-approved therapy for treating severe asthma. It delivers radiofrequency energy to the airway smooth muscle in order to reduce the amount of muscle present (i.e., increased airway smooth muscle is believed to be an important problem in asthma).
Your Asthma Program physician will discuss the various asthma therapies and their side effects with you in order to develop the treatment plan that is right for you.
Adjuncts to Asthma Care
Adjuncts to asthma care include devices/instruments that improve the delivery of medicines to the lungs, monitor asthma control and/or assist in guiding therapy. Some of the tools that are used include:
- Action Plans – Every patient with asthma should have a written action plan for self-management that is developed in conjunction with a physician. This plan helps to guide the patient in terms of managing their asthma under different circumstances. Vital to the action plan is use of a peak flow meter. The peak flow meter provides a portable way for patients to assess their lung function outside of the doctor’s office. Peak flow readings provide the basis for the written action plan.
- Holding chambers (also known as spacers) – These devices are used with certain inhalers to increase delivery of medication to the lower airways (the site where they work).