Control of inflammation in the airways is the key to the treatment of persistent asthma.  There are drugs that work and make a real difference in quality of life.

There are two types of asthma medication: long-term control medicines and quick relief or "rescue" medicines.

• Long-term control medicines prevent or reduce asthma symptoms by reducing their causes: the inflammation in the airways and the muscle tightening that squeezes the airways.  They're taken regularly, usually daily, over long periods of time.  Their effects are first felt after several weeks.
• "Rescue" medicines offer quick, short-term relief from asthma symptoms or an asthma attack.  They work within minutes.

There are two main types of long-term control medicines: anti-inflammatories and bronchodilators. 

• Anti-inflammatories prevent or reduce the inflammation of the airways that makes them swollen and narrow; they also help prevent the production of mucous that clogs the airways.
• Bronchodilators open up the airways by relaxing the muscles that have tightened around them.

Long-term control anti-inflammatories include:

• Inhaled corticosteroids;  a variety of inhalers are available; each works differently and you need to learn how to use yours correctly; among the available inhalers are:
• Metered dose inhalers (or MDIs), popularly known as "puffers"
• Dry powder inhalers, available under several brand names
• Nebulizers  
• Oral corticosteroids (taken in pill, tablet or liquid form) may be used to control severe asthma, and are sometimes used short-term to treat severe asthma attacks.  Corticosteroids are different from the anabolic steroids athletes sometimes use illegally.
• Non-steroid anti-inflammatory drugs, such as:
• Cromolyn sodium (inhaled)
• Nedocromil sodium (inhaled)
• Leukotriene modifiers (tablets), a new type of medicine that controls leukotrienes, chemicals in the body involved in creating inflammation.  Montelukast, zafirlukast, and zileuton are the leading leukotriene modifiers.

Long-term control bronchodilators include:

• Long-acting beta agonists (inhaled), used to control moderate and severe asthma and  prevent symptoms at night and often taken with inhaled anti-inflammatories
• Theophylline, an oral bronchodilator

Short-term, quick-relief  "rescue" medicines are usually bronchodilators.  You use them to combat asthma symptoms when you first feel them; they act quickly but last only a short period of time. The most common are short-term beta agonists and anticholinergics. They're usually inhaled, and most people with asthma carry an inhaler with them.  But they can also be taken orally (in tablet or liquid form) or be injected.   In severe cases, an anti-inflammatory corticosteroid may be taken orally or injected.

All of the above medicines can have side effects, may interact with other medicines you are taking, and must be taken only in the prescribed doses and under a doctor's supervision.

Because allergens are one class of asthma triggers and so many people with allergies also have asthma, allergen immunotherapy, popularly known as "allergy shots," is often given to people with allergic asthma.  (For more information about allergies and asthma, go to Key Point 2.) 

Allergy shots work like a vaccine to reduce your sensitivity to allergens. They are given over a period of time and gradually increase your immunity to the allergens that bother you.  As you develop this immunity, the allergic reactions you suffer will disappear or be greatly reduced.  This can also prevent or greatly reduce asthma symptoms. 

Aside from taking medicines, asthma treatment involves working with your doctor to develop an action plan for asthma management to control your condition.  According to guidelines set up by the National Institutes of Health, a plan asks you to do four basic actions:

• Know what your asthma triggers are and take steps to avoid them.  This may mean making changes in your environment and lifestyle.
• Take your medicines as prescribed.
• Monitor the severity your asthma and your response to the medicines.  Use tools such as peak flow meters and spirometers to measure various aspects of your breathing.
• Stay educated and informed and know what to do if your condition worsens.  Develop a plan with your doctor, who is your partner in managing your asthma care.

The guidelines also suggest that an asthma management plan should enable you to:

• Prevent asthma symptoms and asthma attacks
• Maintain normal breathing and normal activities, including work, school and exercise
• Sleep all night with no asthma symptoms
• Have few or no side-effects from asthma medications
• Avoid hospital stays and emergency visits
• Meet your own expectations of satisfactory care

The bottom line is this: although we do not yet have a cure for asthma, modern treatment methods enable us to minimize and even prevent asthma symptoms and asthma attacks.