What medicines are available to treat asthma?
There are two categories of medicines available to treat asthma:
- “Controller” or preventative medicines work slowly over many days to weeks to stop airway swelling, mucus production, and the tendency of the airway muscles to squeeze.In order for these medicines to work, they must be taken every day, even when your child feels well. These medicines are considered the best and safest way to control asthma. They do not “rescue” or stop asthma symptoms once they start.
- “Quick relief” or rescue medicines help stop an asthma attack that has already started. They work fast making it easier to breathe by relaxing the bronchial muscles that surround the airways (bronchodilators) or by quickly decreasing swelling within the bronchial tubes (oral steroids).
What should you do if your child is having asthma symptoms?
Administer a “quick-relief” medicine if your child is experiencing wheezing, coughing or trouble breathing. If you are not sure, error on the side of caution and have your child take his/her “rescue” medication.
Once you have started treatment with a rescue medicine, keep giving it as directed and outlined by your healthcare provider in your child’s Asthma Action/Medicine Management Plan. Your child may need to take this medicine for several days. If your child takes a “controller” medicine, he/she should continue to take it every day even while experiencing asthma symptoms unless otherwise instructed by your healthcare provider.
How do I know if my child needs to take a daily “controller” medicine?
Not all children with asthma need to take daily “controller” medicine(s). Your child may need a “controller” medicine if he/she experiences:
- 2 or more events of symptoms per week
- 2 or more events of nighttime symptoms per month
- Asthma symptoms lasting more than a few days
- 3 or more visits per year for urgent medical care despite the proper use of a “rescue” inhaler
- More than 1 visit to an urgent care or emergency department per year for asthma symptoms
- Asthma symptoms triggered by allergies
- Needing treatment with oral steroids 2 or more times per year
My child is taking steroids. Aren’t steroids dangerous?
No. Taken under a healthcare provider’s direction, they are quite safe. They are not the same kind of steroids some athletes use to build muscles. They are not addictive and will not make your child bulk up. Inhaled steroids are long-term “controller” medicines that are used for persistent asthma. They reduce airway swelling (inflammation) and can prevent asthma symptoms.
Reported side effects of inhaled steroids include hoarseness, sore throat, dry mouth, unpleasant taste, respiratory infections, headache, upset stomach, pain (in muscle, bone, or back), and potentially short-term impairment in growth.
Oral steroids (taken by mouth in a tablet or liquid form) are sometimes prescribed for 3 to 10 days after a severe asthma episode to achieve control. Reported side effects of oral steroids include excitement, restlessness, headache, nausea, vomiting, stomach upset, trouble sleeping, and increased appetite.
How long does my child have to take “controller” medicines?
If your child’s asthma is under good control for several months, your healthcare provider may decide to “step down” therapy by gradually reducing the dose or number of your child’s medicines.
If your child still has asthma symptoms or if your child’s asthma symptoms increase, then your healthcare provider may decide to “step up” the dose or number of your child’s medicines. If your child experiences symptoms only at certain times of the year (for example, during a “sport” season, during the cold and flu season, or during an allergy season), your healthcare provider may “step up” (increase) your child’s medicines during that season, and then “step down” (decrease) the medicines after the season ends.