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Asthma - control drugs

Asthma - inhaled corticosteroids; Asthma - long-acting beta-agonists; Asthma - leukotriene modifiers; Asthma - cromolyn; Bronchial asthma - control drugs; Wheezing - control drugs; Reactive airway disease - control drugs

Control medicines for asthma are medicines you take to control your asthma symptoms. You must use these medicines every day for them to work well. You and your health care provider can make a plan for the medicines that work for you. This plan will include when you should take them and how much you should take.

Asthma

Asthma is a chronic disease that causes the airways of the lungs to swell and narrow. It leads to breathing difficulty such as wheezing, shortness o...

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You may need to take these medicines for at least a month before you start to feel the full effects.

Take the medicines even when you feel OK. Take enough with you when you travel. Plan ahead. Make sure you do not run out.

Test Your Knowledge About Inhalers

Most people with asthma use an inhaler to take their medicines.
A. True
B. False
The correct answer is true. When people with asthma use an inhaler, they breathe in their medicine. The medicines go directly to their airways. Asthma medicines also come as pills or liquid. Your doctor will help you find the right medicine for you and the best way to take it.
What are the main types of inhalers?
A. Metered-dose inhaler (MDI)
B. MDI with a spacer
C. Dry powder inhaler
D. All of the above
The correct answer is all of the above. Not all inhalers are used the same way. Follow the directions and ask your pharmacist if you have questions about them. Bring your inhaler to your medical appointments so your doctor can make sure you are using it correctly.
Can children use inhalers?
A. Yes
B. No
The correct answer is yes. Children can use an inhaler – and they should have a spacer for it. The spacer tube helps them get the medicine into their lungs properly. A nebulizer is another option, especially for younger children. This machine turns asthma medicine into a mist children can breathe in.
Which of the following statements about spacers is NOT true?
A. They come in different shapes and sizes
B. Spacers help you breathe in your medicine slowly and more completely
C. You should always use a spacer with a dry powder inhaler
The correct answer is you should always use a spacer with a dry powder inhaler. You do not need a spacer when using a dry powder inhaler. But a spacer makes it easier to use an MDI. Some inhaled medicines can irritate the mouth and throat. A spacer can help because it enables more medicine to get to your airways.
Inhaled steroids are usually the first choice for what type of asthma treatment?
A. Quick relief
B. Long-term control
The correct answer is long-term control. Inhaled steroids prevent asthma symptoms by reducing airway swelling. They're preferred medicines because they are safe and work well. The best way to manage your asthma is to take your long-term control drugs every day, even when you feel good.
Are inhaled steroids safe for children?
A. Yes
B. No
The correct answer is Yes. Inhaled steroids can slow a child's growth a small amount in the first months of use, but this is uncommon. Having asthma that is not controlled can also slow growth. Talk with your doctor about what's best for you or your child.
It's a good idea to do this after using your MDI.
A. Rinse your mouth
B. Take a nap
C. Get a new inhaler
The correct answer is rinse your mouth. This can also help reduce the chance of side effects -- such as throat and mouth irritation -- from your medicine. Rinse your mouth with water, gargle, and spit the water out.
Your MDI needs regular cleaning.
A. True
B. False
The correct answer is true. Cleaning your inhaler will help keep it working right. Remove the metal canister from the mouthpiece. Rinse the mouthpiece and cap in warm water and let dry. Place the canister back inside, and put the cap on.
Is there a way to know when I'll need to refill my control medicine?
A. Yes
B. No
The correct answer is yes. Divide the number of puffs listed on your canister by the number of puffs you take each day. This is how many days your canister will last. Write the date you need to replace it on the canister so you'll know when to get more.
How should I store my MDI?
A. Keep it in a cold room
B. Keep it as warm as you can
C. At room temperature
The correct answer is at room temperature. Your MDI may not work well if it is too cold. Also, the medicine in the canister is under pressure, so don't let it get too hot or poke a hole in it. Keep your inhaler in a place that's easy to remember, so you'll always have it when you need it.

Inhaled Corticosteroids

Inhaled corticosteroids prevent your airways from becoming inflamed in order to help keep your asthma symptoms away.

Inhaled steroids are used with a metered-dose inhaler (MDI) and spacer. Or, they may be used with a dry powder inhaler.

You should use an inhaled steroid every day as directed, even if you do not have symptoms.

After you use it, rinse your mouth with water, gargle, and spit it out.

If your child cannot use an inhaler, your provider may give you a medicine to use with a nebulizer. This machine turns liquid medicine into a spray so your child can breathe the medicine in.

Nebulizer

A nebulizer is a small machine that turns liquid medicine into a mist that can be easily inhaled. You sit with the machine and breathe in the medici...

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Long-acting Beta-agonist Inhalers

These medicines relax the muscles of your airways to help keep your asthma symptoms away.

Normally, you use these medicines only when you are using an inhaled steroid medicine and you still have symptoms. Do not take these long-acting medicines alone.

Use this medicine every day as directed, even if you do not have symptoms.

Combination Therapy

Your provider may ask you to take both a steroid medicine and a long-acting beta-agonist medicine.

It may be easier to use an inhaler that has both medicines in them.

Another class of medicines called antimuscarinic agents may help some people with asthma. Check with your provider to see if this might help you.

Leukotriene Modifiers

These medicines are used to prevent asthma symptoms. They come in tablet or pill form and can be used together with a steroid inhaler.

Cromolyn

Cromolyn is a medicine that may prevent asthma symptoms. It can be used either in an inhaler or a nebulizer, so it may be easy for young children to take.

Open References +

References

Drazen JM, Bel EH. Asthma. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 75.

Marcdante KJ, Kliegman RM, Schuh AM. Asthma. In: Marcdante KJ, Kliegman RM, Schuch AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 78.

National Heart, Lung and Blood Institute. Asthma Management Guidelines: Focused Updates 2020. www.nhlbi.nih.gov/health-topics/asthma-management-guidelines-2020-updates. Updated February 4, 2021. Accessed February 8, 2024.

O'Byrne PM, Satia I. Inhaled ß₂- agonists. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 93.

Pollart SM, DeGeorge KC, Kolb A. Asthma in children. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2024. Philadelphia, PA: Elsevier; 2024:1317-1324.

Vishwanathan RK, Busse WW. Management of asthma in adolescents and adults. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 52.

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Inhaler with spacer - ad...

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Inhaler with spacer - adults - Animation

If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. A spacer device will help. The spacer connects to the inhaler mouthpiece, and the medicine goes into the spacer tube first. This allows you to breathe in the medicine more easily. Using a spacer wastes a lot less medicine than spraying the medicine directly into your mouth. It also makes it less important to get the exact timing for activating the inhaler while taking in a breath. These are instructions for using an inhaler with a spacer. First off, if you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this. Take the caps off the inhaler and spacer. Look inside each mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Attach the inhaler mouthpiece to the open end of the spacer and hold it upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the spacer mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the spacer so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Your spacer may have a whistle that sounds if you breathe in too fast. Take the spacer out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the caps back on the inhaler and spacer. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler and spacer operating correctly, you need to keep them clean. Follow the manufacturer's instructions for when and how often to clean your inhaler and spacer. Using your inhaler with a spacer the right way ensures you get the medicine you need. It's a good idea to bring your inhaler and spacer to your medical appointments. That way your health care provider can make sure you are using them correctly.

Inhaler with no spacer -...

Animation

Inhaler with no spacer - adults - Animation

If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, if you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

Inhaler with spacer - ad...

Animation

Inhaler with spacer - adults - Animation

Inhaler with no spacer -...

Animation

Inhaler with no spacer - adults - Animation

If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, if you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

Self Care

Asthma - control drugs
Asthma - quick-relief drugs

Related Information

Asthma
Asthma and allergy resources
Wheezing
How to use a nebulizer
Asthma - quick-relief drugs
Exercise-induced asthma
How to use an inhaler - no spacer
How to use an inhaler - with spacer
How to use your peak flow meter
Make peak flow a habit
Stay away from asthma triggers
Signs of an asthma attack
Asthma in adults - what to ask the doctor
Asthma in adults - InDepth

All
Video
Images
Tog

Inhaler with spacer - ad...

Animation

Inhaler with spacer - adults - Animation

Inhaler with no spacer -...

Animation

Inhaler with no spacer - adults - Animation

If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, if you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

Inhaler with spacer - ad...

Animation

Inhaler with spacer - adults - Animation

Inhaler with no spacer -...

Animation

Inhaler with no spacer - adults - Animation

If you have a chronic lung disease, like asthma or COPD, a metered-dose inhaler is often your main type of therapy. An inhaler is a small, hand-held device that delivers medicine in the form of a spray that you breathe in. Using an inhaler may seem easy, but many people don't use them the right way. You need to know how to use your inhaler correctly for the medicine to get to your lungs and work effectively. In general, using the inhaler without a spacer requires more coordination in order to ensure that medicine reaches your lungs. So, when possible, it's best to use a spacer. These are instructions for using an inhaler without a spacer. First off, if you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this. Take the cap off the mouthpiece, and look inside the mouthpiece to make sure there is nothing in it. Shake the inhaler 10 to 15 times to mix the medicine with the propellant. Hold the inhaler upright. Stand or sit upright. Breathe out all the way to empty your lungs. Place the mouthpiece in your mouth so that it fits just past your teeth and above your tongue. Close your lips around the inhaler so that you form a tight seal. Tilt your head back slightly. As you slowly begin to breathe in through your mouth, press down once on the top of the inhaler. Keep breathing in slowly, as deeply as you can. Take the inhaler out of your mouth. Hold your breath for 5 to 10 seconds. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth. If you need a second puff, wait about 1 minute before you take your next puff. Put the cap back on the inhaler and make sure it is firmly closed. After using your inhaler, gargle and rinse your mouth with water. Do not swallow the water. This helps reduce side effects from your medicine. To keep your inhaler operating correctly, follow the manufacturer's instructions for when and how often to clean your inhaler. Using your inhaler the right way ensures you get the medicine you need. It's a good idea to bring your inhaler to your medical appointments. That way your health care provider can make sure you are using it correctly.

Self Care

Asthma - control drugs
Asthma - quick-relief drugs

Related Information

Asthma
Asthma and allergy resources
Wheezing
How to use a nebulizer
Asthma - quick-relief drugs
Exercise-induced asthma
How to use an inhaler - no spacer
How to use an inhaler - with spacer
How to use your peak flow meter
Make peak flow a habit
Stay away from asthma triggers
Signs of an asthma attack
Asthma in adults - what to ask the doctor
Asthma in adults - InDepth

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Asthma - control drugs

Asthma

Test Your Knowledge About Inhalers

Most people with asthma use an inhaler to take their medicines.

What are the main types of inhalers?

Can children use inhalers?

Which of the following statements about spacers is NOT true?

Inhaled steroids are usually the first choice for what type of asthma treatment?

Are inhaled steroids safe for children?

It's a good idea to do this after using your MDI.

Your MDI needs regular cleaning.

Is there a way to know when I'll need to refill my control medicine?

How should I store my MDI?

Nebulizer

References