The National Heart, Lung, and Blood Institute of the National Institutes of Health offers the following helpful information on treating asthma and handling asthma attacks.

How is Asthma Treated?

You and your doctor together can decide about your treatment goals and what you need to do to control your asthma. Asthma treatment includes:

• Avoiding things that bring on your asthma symptoms or make symptoms worse. Doing so can reduce the amount of medicine you need to control your asthma. Allergy medicine and allergy shots in some cases may help your asthma.
• Using asthma medicines.

With proper treatment, you should ideally have these results:

• Your asthma should be controlled.
• You should be free of asthma symptoms.
• You should have fewer attacks.
• You should need to use short-acting bronchodilators less often.
• You should be able to do normal activities without having symptoms.

Your doctor will fill out an action plan for your asthma. Your action plan will tell you what medications you should take and other things you should do to keep your asthma under control. 

Medications for Asthma

There are two main types of medicines for asthma: 

1.  Quick Relief medicines give rapid, short-term treatment and are taken when you have worsening asthma symptoms that can lead to asthma episodes or attacks. You will feel the effects of these medicines within minutes.

2.  Long-term Control medicines are taken every day, usually over long periods of time, to control chronic symptoms and to prevent asthma episodes or attacks. You will feel the full effects of these medicines after taking them for a few weeks. People with persistent asthma need long-term control medicines.

Quick Relief Medicines

Quick relief medicines are used only when needed. A type of quick relief medicine is a short-acting inhaled bronchodilator. Bronchodilators work by relaxing tightened muscles around the airways. They help open up airways quickly and ease breathing. They are sometimes called "rescue" or "relief" medicines because they can stop an asthma attack. These medicines act quickly but their effects only last for a short period of time. You should take quick relief medicines when you first begin to feel asthma symptoms like coughing, wheezing, chest tightness or shortness of breath. Anyone who has asthma should always have one of these inhalers in case of an attack. For severe attacks, your doctor may use steroids to treat the inflammation.

Long-term Control Medicines

The most effective, long-term control medication for asthma is an inhaled corticosteroid (kor-ti-ko-STE-roid) because this medicine reduces the swelling of airways that makes asthma attacks more likely.

• Inhaled corticosteroids (or steroids for short) are the preferred treatment for controlling mild, moderate and severe persistent asthma. They are safe when taken as directed by your doctor.
• Inhaled medicines go directly into your lungs where they are needed. There are many kinds of inhalers that require different techniques, and it is important to know how to use your inhaler correctly. In some cases, steroid tablets or liquid are used for short times to bring asthma under control. The tablet or liquid form may also be used to control severe asthma.
• Long-acting beta-agonists are another kind of long-term control medication. They are bronchodilators, not anti-inflammatory drugs. These medicines are used to help control moderate and severe asthma and to prevent nighttime symptoms. Long-acting beta-agonists are taken together with inhaled corticosteroid medicine.
• Leukotriene modifiers (montelukast, zafirlukast and zileuton) are long-term control medicines used either alone to treat mild persistent asthma or together with inhaled corticosteroids to treat moderate persistent asthma or severe persistent asthma.
• Cromolyn and nedocromil are also long-term control medicines used to treat mild persistent asthma.
• Theophylline is a long-term control medication used either alone to treat mild persistent asthma or together with inhaled corticosteroids to treat moderate persistent asthma. People who take theophylline should have their blood levels checked to be sure the dose is appropriate.

If you stop taking long-term control medicines, your asthma will likely worsen again.

Many people with asthma need both a short-acting bronchodilator to use when symptoms worsen and long-term daily asthma control medication to treat the ongoing inflammation. Over time, your doctor may need to make changes in your asthma medication. You may need to increase your dose, lower your dose or try a combination of medications. Be sure to work with your doctor to find the best treatment for your asthma. The goal is to use the least amount of medicine necessary to control your asthma.

Use a Peak Flow Meter

As part of your asthma action plan, you may use a hand-held device called a peak flow meter at home to measure lung function. To use it, you take a deep breath and blow hard into a tube to find out how fast you can blow out. This gives you a peak flow number. You will need to find out your "personal best" peak flow number by recording the peak flow number daily for a few weeks until your asthma is under control. The highest number you get during that time is your personal best peak flow. Then you can compare future peak flow measurements to your personal best peak flow, and that will show if your asthma is staying under control or not. 

Your doctor will tell you how and when to use your peak flow meter and how to use your medication based on the results. You may be asked to use your peak flow meter each morning to keep track of how well you are breathing. The peak flow meter can help warn of a possible asthma attack even before you notice symptoms. If your peak flow meter shows that your breathing is getting worse, you should follow your action plan. Take your quick relief or other medication as your doctor directed. Then you can use the peak flow meter to see how your airways are responding to the medication.

Ask your doctor about how you can help take care of your own asthma. You should know:

• How to take your long-term daily medication correctly
• What things tend to make your asthma worse and ways to avoid them
• Early signs to watch for that mean your asthma is starting to get worse (like a drop in your peak flow number or an increase in symptoms)
• How and when to use your peak flow meter
• What medication and how much to take to stop an asthma attack and how to use it correctly
• When to call or see your doctor
• When you should get emergency treatment

Treating Asthma in Children

Children with asthma, like adults with asthma, should see a doctor for treatment. Treatment may include allergy testing, finding ways to limit contact with things that cause asthma attacks and taking medication.

Young children will need help from their parents and other caregivers to keep their asthma under control. Older children can learn to care for themselves and follow their asthma action plan with less supervision.

Medications for asthma in children are like those adults use, but doses are smaller. Children with asthma may need both a quick-relief (or "rescue") inhaler for attacks and daily medication to control their asthma. Children with moderate or severe asthma should learn to use a peak flow meter to help keep their asthma under control. Using a peak flow meter can be very helpful because children often have a hard time describing their symptoms.

Parents should be alert for possible signs of asthma in children, such as coughing at night, frequent colds, wheezing or other signs of breathing problems. If you suspect asthma or that your child's asthma is not in good control, take your child to a doctor for an exam and testing.

Your doctor will choose medication for your child based on the child's symptoms and test results. If your child has asthma, you will need to go to the doctor for regular follow-up visits and make sure that your child uses the medication properly.

Treating Asthma in Older Adults

Older adults may need to have adjustments in their asthma treatment because of other diseases or conditions they have. Some medicines (like beta blockers used for treating high blood pressure and glaucoma, aspirin and non-steroidal anti-inflammatory drugs) can interfere with asthma medications or even cause asthma attacks. Be sure to tell your doctor about all medications that you take, including over-the-counter ones. Using steroids may affect bone density in adults, so ask your doctor about taking calcium and vitamin D supplements and other ways to help keep your bones strong.

Treating Asthma in Pregnancy

If you are pregnant, it is very important to both you and your baby to control your asthma. Uncontrolled asthma can lower the oxygen level in your blood, which means that your baby gets less oxygen too. Most asthma medications are safe to take during pregnancy. If you are pregnant or thinking about becoming pregnant, talk to your doctor about your asthma and how to have a healthy pregnancy.

Treating Exercise-Induced Asthma

Regular physical exercise is important for good health. If exercise brings on asthma symptoms, work with your doctor to find the best way to avoid having symptoms when you exercise. Some people with asthma use inhaled quick relief medication before exercising to keep symptoms under control. If you use your asthma medication as directed and learn how to pace yourself, you should be able to take part in any physical activity or sport you choose. Many Olympic athletes have asthma.

Source: National Heart, Lung, and Blood Institute