Asthma Basics – Control and Treatment


This post discussions asthma basics – control and treatment. The previous post discussed asthma triggers and symptoms.

As we move into discussing asthma treatment, remember that asthmatics die at an alarming rate.  I mentioned yesterday (and it bears repeating) that death rates have increased over 50% in the last few decades.  If you’re an asthmatic, avoid taking care of yourself at your own peril.  Your next asthma attack could be your last.

The other thing to remember is that asthma is a reversible disease – until it’s not.  At some point (beginning somewhere around age 35 or so), the ongoing inflammation and damage to the lungs will create some irreversible changes. At that point, the situation becomes completely different. These changes predisposes asthmatics to other conditions such as chronic bronchitis, COPD (chronic obstructive pulmonary disease) and lung cancer.  These points simply reiterate the importance of identifying and removing those triggers.

Asthma Control is the Best Treatment

Given that, let’s talk about asthma control as treatment.  Consider the following quick tips you might use to help you reduce or virtually eliminate asthma attacks:


  • Eliminate your exposure to cigarette smoke (including second hand smoke)!
  • Avoid long haired animals, especially cats.
  • Avoid shaggy carpets, window treatments or other household fixtures that retain dust.
  • Wear a mask to avoid triggers! It’s better to not look cool for a few moments than to have to look at an emergency room for a few hours or a hospital room for a few days. The conditions for which you should consider these include the following:
    • If you’re spraying any kind of aerosol
    • During allergy season
    • If you’re handling trash
    • If you react to cold weather
  • Be careful to avoid colds and the flu.  Get a flu shot yearly.

Asthma Treatment Options

If and when all of this fails, and you’re actually in the midst of an asthma attack, treatment options primarily center around two types of medications.


  • Short (and quick) acting bronchodilators (e.g. albuterol, ventolin, proventil, xopenex, alupent, maxair) functionally serve as props (‘toothpicks’, no not real ones, and don’t try to use toothpicks at home) to keep the airways open against the onslaught of mucous buildup inside the lungs combined with other inflammatory changes trying to clog the airways.  These medications do not treat the underlying condition.  They only buy you time and attempt to keep the airways open for…
  • Steroids (e.g. prednisone, prelone, orapred, solumedrol, decadron – none of which are the muscle building kind) are the mainstay of acute asthma treatment, as they combat the inflammatory reaction and other changes that cause the asthma attack.  One can functionally think of steroids as a dump truck moving in to scoop the snot out of the airways.  The only issue with the steroids is they take 2-4 hours to start working, so you have to both get them on board as early as possible while continuing to use the bronchodilators to stem the tide until the steroids kick in.

If you are not successful in avoiding those triggers over the long term, you may need to be placed on ‘controller’ medications at home, which include lower doses of long-acting bronchodilators and steroids.

So in summary, the best treatment of asthma is management of its causes.  Avoid the triggers, thus reducing your acute attacks.  Become educated about signs of an attack.  When needed, get help sooner rather than later.  And always keep an inhaler on you.  It could be the difference between life and death.

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