Asthma begins with inflammation: The lining of the airways – the breathing tubes leading into the lungs – becomes swollen, inflamed and clogged with mucus and fluid.
Muscles surrounding the airways tighten and contract as they try to keep the passageways open. Inhaled allergens or irritants like secondhand smoke and air pollution act like sandpaper on the raw surfaces. You begin to cough and wheeze as you struggle to breathe. This is called bronchospasm.
Asthma care involves medications that target the lungs to keep you breathing well, as well as devices and management tools to help monitor your symptoms and prevent asthma flares.
You and your doctor will draw up your personal plan of treatment, called an Asthma Action Plan. This will include medicines to treat and prevent symptoms, as well as a plan to identify and avoid things that make your asthma worse (your triggers). When you understand what’s happening inside your lungs and how they respond to allergens and irritants like pollen, dust mites or smoke, you can take steps to prevent or minimize symptoms.
There are four basic types of asthma medications that each treat a different stage in the asthma process:
- bronchodilators relax and open the airways to relieve the noisy symptoms of asthma such as wheezing, coughing, choking and shortness of breath
- anti-inflammatories reduce and prevent lung inflammation – the quiet part of asthma that you can’t see or hear
- combination medications combine a bronchodilator and anti-inflammatory in one device
- leukotriene modifiers block the action of leukotrienes, chemicals involved in immune system responses
- anti-IgE biologics block the IgE antibodies that cause allergy symptoms.
Oral medications swallowed as pills, tablets or liquids reach the airways by circulating through the bloodstream.
Inhaled medications go straight to the airways, using one of three types of delivery devices:
- metered-dose inhaler (MDI): a pressurized device that releases medication in a fine spray for you to inhale
- dry powder inhaler (DPI): releases medication as a fine powder for inhaling; some DPIs require a forceful inhalation
- nebulizer: breaks liquid medicine into a mist that can be inhaled slowly; babies and toddlers should always use a mask with their nebulizer