Patient education: Asthma in adults (The Basics)
Written by the doctors and editors at UpToDate
What is asthma?
— Asthma is a condition that can make it hard to breathe. Asthma does not always cause symptoms. But when symptoms occur, they can be scary. Asthma attacks happen when the airways in the lungs become narrow and inflamed (figure 1). Asthma can run in families.
Figure 1 : When asthma flares, the muscles around the airways tighten (constrict), and the lining of the airways gets inflamed. Then, mucus builds up. All of this makes it hard to breathe.
Asthma medicines work in different ways. Short-acting beta agonists (SABAs) and long-acting beta agonists (LABAs) relax the muscle constriction around the airways. Steroids reduce inflammation in the airways. Leukotriene modifiers relax muscles and reduce inflammation and mucus buildup. Omalizumab lowers or stops the allergic reaction that starts inflammation. All these medicines make it easier to breathe and reduce the risk of asthma attacks.
What are the symptoms of asthma?
— Asthma symptoms can include:
●Wheezing or noisy breathing
●A tight feeling in the chest
●Shortness of breath
Symptoms can happen each day, each week, or less often. Symptoms can range from mild to severe. Although it is rare, an episode of asthma can sometimes even lead to death.
Is there a test for asthma?
— Yes. Your doctor will ask you about your symptoms and have you do a breathing test to see how your lungs are working.
How is asthma treated?
— Asthma is treated with different types of medicines. The medicines can be inhalers, liquids, or pills. Your doctor will prescribe medicine based on how often you have symptoms and how serious your symptoms are. Asthma medicines work in 1 of 2 ways:
●Quick-relief medicines stop symptoms quickly – in 5 to 15 minutes. Almost everyone with asthma has a quick-relief inhaler that they carry with them. People use these medicines whenever they have asthma symptoms. Most people need these medicines 1 or 2 times a week – or less often. But when asthma symptoms get worse, more doses might be needed. Some people can feel shaky after taking these medicines. A few people also need a machine called a “nebulizer” to breathe in their medicine.
●Long-term controller medicines control asthma and prevent future symptoms. People with frequent asthma symptoms take these 1 or 2 times each day.
It is very important that you take all the medicines the doctor prescribes, exactly how you are supposed to take them. You might have to take medicines a few times a day. You might not feel a medicine working, but that does not mean it is not helping you.
Not taking your medicines correctly can cause symptoms to get worse. If your symptoms get much worse all of a sudden, you might even need to go to the hospital for treatment.
What is an asthma action plan?
— An asthma action plan is a list of instructions that tell you:
●Which medicines to use each day at home
●Which medicines to take if your symptoms get worse
●When to get help or call for an ambulance (in the US and Canada, dial 9-1-1)
If you have frequent or severe asthma symptoms, your doctor might suggest that you have an asthma action plan. If so, you and your doctor will work together to make one. As part of your action plan, you might need to use something called a “peak flow meter.” Breathing into this device will show how your lungs are working. Your doctor will show you the right way to use your inhaler and peak flow meter.
Should I see a doctor?
— Yes. See your doctor if you have an asthma attack and the symptoms do not improve or get worse after using a quick-relief medicine. If the symptoms are severe, call for an ambulance (in the US and Canada, dial 9-1-1).
If you need asthma medicine every day, you should see your doctor every 6 months or more often.
Can asthma symptoms be prevented?
— Yes. You can help prevent your asthma symptoms. You can stay away from things that cause your symptoms or make them worse. Doctors call these “triggers.” If you know what your triggers are, avoid them as much as possible. Some common triggers include:
●Animals, such as dogs and cats
●Pollen and plants
●Getting sick with a cold or flu (that’s why it’s important to get a flu shot)
If you can’t avoid certain triggers, talk with your doctor about what you can do. For example, exercise can be good for people with asthma even if it is an asthma trigger. But you might need to take an extra dose of your quick-relief inhaler medicine before you exercise.
What if I want to get pregnant?
— If you want to get pregnant, talk to your doctor about how to control your asthma. Keeping your asthma well-controlled is important for the health of your baby. Most asthma medicines are safe to take if you are pregnant.