What is Asthma and its Treatment - Thumbay University Hospital

What is Asthma and its Treatment

Physical exam

Your doctor will do a physical exam to rule out other possible conditions, such as a respiratory infection or chronic obstructive pulmonary disease (COPD). Your doctor will also ask you questions about the signs and symptoms and about any other health problems.


Lung function tests

You may have lung function tests to determine how much air is going in and out as you breathe. These tests may include:


This test estimates narrowing of the bronchial tubes by checking how much the air you can exhale after a deep breath and how fast you can exhale.

Flow peak

A peak flow meter is a simple device that measures how hard it is to exhale. Lower than normal peak flow readings are a sign that your lungs may not be working well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and manage low peak flow readings.

Lung function tests are often done before and after you take a medicine to open your airway called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol. If your lung function has improved with a bronchodilator, you likely have asthma.

Additional tests

Other tests to diagnose asthma include:

1. The methacholine challenge

Methacholine is a known asthma trigger. When inhaled, this will narrow the airway slightly. If you react to methacholine, you likely have asthma. This test may be used even if the initial lung function test is normal.

2. Imaging tests

A chest X-ray can help identify any structural abnormalities or diseases (such as infections) that can cause or worsen breathing problems.

3. Allergy test

Allergy tests can be done with a skin exam or a blood test. They tell you if you are allergic to pets, dust, mold, or pollen. If an allergen is identified, your doctor may recommend allergy shots.

4. Nitric oxide test

This test measures the amount of the nitric oxide gas in your breath. When your airways are inflamed — a sign of asthma — you may have higher than normal levels of nitric oxide. This test is not widely available.

5. Sputum eosinophils

This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you produce when you cough. Eosinophils appear when symptoms develop and become visible when stained with pink pigment.

Provocative tests for exercise and cold-induced asthma

In these tests, your doctor measures airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air.

How is asthma classified?

To classify the severity of your asthma, your doctor will look at how often you have signs and symptoms and how severe they are. Your doctor will also consider the results of a physical exam and diagnostic tests.

Determining the severity of your asthma helps your doctor choose the best treatment. Asthma severity often changes over time, requiring adjustments in treatment.


Prevention and long term control are key to stopping asthma attacks before they start. Treatment usually involves learning to recognize triggers, taking steps to avoid triggers and tracking your breathing to make sure the medications you’re taking keep your symptoms under control. If your asthma flares up, you may need to use an inhaler for quick relief.

1. Pharmaceutical

Which medications are right for you depends on a number of things — your age, your symptoms, your asthma triggers, and what’s best for controlling your asthma.

Long-term preventive medications reduce the swelling (inflammation) in the airway that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that limit breathing. In some cases, the allergy medications are necessary.

Long term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep your asthma under control on a daily basis and reduce your chance of having an asthma attack. Types of long-term disease control medications include:

2. Inhaled corticosteroids

These medications include fluticasone propionate (Flovent HFA, Flovent Diskus, Xhance), budesonide (Pulmicort Flexhaler, Pulmicort Respules, Rhinocort), ciclesonide (Alvesco), beclomethasone (Qvar Redihaler), mometasone (Asmanex flutic TwisHFA, Asmanexhaler Twis) Ellipt.

You may need to use these medications for several days to weeks before you get maximum benefit. Unlike oral corticosteroids, the inhaled corticosteroids have a relatively low risk of serious side effects.

3. Leukotriene rates

These oral medications including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflu) — help relieve asthma symptoms.

Montelukast has been linked to psychiatric reactions, such as agitation, aggression, hallucinations, depression, and suicidal ideation. Seek medical advice immediately if you experience any of these reactions.

4. Combined inhalers

These medications — such as fluticasone-salmeterol (Advair HFA, Erdo Digihaler, others), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera) and fluticasone furoate-vilanterol (Brio Ellipta) — contain a long-acting beta-agonist corticosteroid.

5. Theophylline

Theophylline (Theo-24, Elixophyllin, and Theochron) is a daily pill that helps keep the airways open by relaxing the muscles around airways. It is not used as often as other asthma medications and requires regular blood tests.

Quick relief medications are used as needed for rapid, short term relief of symptoms during an asthma attack. They can also be used before exercise if recommended by your doctor. Types of quick-relief medications include:

1. Short-acting beta-agonists

These relaxing inhaled bronchodilators work within minutes to quickly relieve symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, and others) and levalbuterol (Xopenex, Xopenex HFA).

Short-acting beta-agonists can be taken using a hand-held inhaler or nebulizer, a machine that turns asthma medications into a fine mist. It is inhaled through a face mask or mouthpiece.

2. Anticholinergic agents

Like other bronchodilators, ipratropium (Atrovent HFA) and tiotropium (Spiriva, Spiriva Respimat) work quickly to relax the airways immediately, making breathing easier. Mostly used for emphysema and chronic bronchitis, but can be used to treat asthma.

3. Oral and intravenous corticosteroids

These medications — which include prednisone (Prednisone Intensol, Rayos) and methylprednisolone (Medrol, Depo-Medrol, Solomedol) — relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long-term, so these medications are only used short-term to treat severe asthma symptoms.