Asthma is a medical condition that affects the airways and often causes shortness of breath, coughing, and wheezing. Extra mucus may also be produced in your airways which also makes it more difficult to breathe. This is a life-long condition, but the symptoms can be managed with appropriate treatment.

People Affected

Asthma is a very common condition that affects approximately 1 in 13 people, according to the Center for Disease Control. Here are some trends regarding who asthma affects the most: 

  • Gender: Asthma is more common among adult women. However, it is more common among boys than girls under the age of 18. 

  • Race: African-American patients die at higher rates from asthma.

  • Age: Asthma is the “leading chronic disease” in children. There are approximately 6.2 million children with asthma. 

Risk Factors

Asthma can be triggered by different factors such as: 

  • Exercise

  • Workplaces that have chemical fumes, gases, or dust

  • Allergens such as pollen, dust mites, mold spores, certain insect waste, particles of skin, and pet saliva (pet dander)

  • Respiratory infections such as the common cold, bronchitis, or pneumonia. 

  • Cold or dry air

  • Smoke

  • Medications (beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen sodium)

  • Stress and other intense emotional states

  • Preservatives in foods such as shrimp, dried fruit, processed potatoes, beer, and wine

  • Gastroesophageal reflux disease (GERD)

Other risk factors can include: 

  • Family history of asthma

  • Medical conditions such as hay fever or atopic dermatitis

  • Smoking or exposure to secondhand smoke

  • Being overweight

  • Exposure to pollution

  • Exposure to chemicals in jobs such as farming, hairdressing, or manufacturing

Signs & Symptoms

Symptoms of asthma can include: 

  • Shortness of breath

  • Chest tightness

  • Chest pain

  • Wheezing

  • Trouble sleeping caused by breathing difficulties

  • Worsening symptoms when experiencing a respiratory virus

  • Coughing

Medical Experts

Primary Care Physician: Your general doctor can diagnose and treat asthma. Certain primary care doctors have also done additional training in allergies and immunology, giving them special expertise in respiratory conditions like asthma.

Pulmonologist: Pulmonologists are doctors who specialize in respiratory symptoms and diseases, including the lungs and asthma. 

Pulmonary Rehabilitation Therapist: Pulmonary Rehabilitation Therapists are not doctors. However, they can be a great addition to your medical team by helping with asthma treatment support.


First, a doctor will perform a physical exam to ensure your symptoms are not being caused by other conditions, such as a respiratory infection or chronic obstructive pulmonary disease. They may also perform additional tests to determine how well your lungs work. Spirometry is a test that checks your bronchial tubes by measuring how much air you exhale. Peak flow meters measure how hard you can breathe out, which can be used as a sign of suboptimal lung function.

Prescription Treatment

There are two main categories of prescription treatments for asthma: rescue medications for quick relief, and control medications for long-term treatment. Rescue medications help with short-term symptoms during asthma attacks, and they include treatments such as: 

  • Short-acting beta agonists: albuterol (ProAir HFA, Ventolin HFA, etc) and levalbuterol (Xopenex, Xopenex HFA)

  • Anticholinergic agents: ipratropium (Atrovent HFA) and tiotropium (Spiriva, Spiriva Respimat)

  • Corticosteroids: prednisone and methylprednisolone (Medrol)

Unlike Short-acting beta agonists that are taken as needed, control medications are typically taken once a day to help prevent asthma attacks long-term: 

  • Inhaled corticosteroids: fluticasone propionate (Flovent HFA, Flovent Diskus, Xhance), budesonide (Pulmicort FLexhaler, Pulmicort Respules, rhinocort), ciclesonide (Alvesco), beclomethasone (Ovar REdihaler), mometasone (Asmanex HFA, Asmanex Twisthaler), fluticasone furoate (Arnuity Ellipta)

  • Leukotriene modifiers: montelukast (Singulair), zafirlukast (Accolate), zileuton (Zyflo)

  • Combination inhalers: fluticasone-salmeterol (Advair HFA, Airduo Digihaler, etc), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera), fluticasone furoate-vilanterol (Breo Ellipta)

  • Theophylline: Theophylline (Theo-24, Elixophyllin, Thecchron)

If it is difficult to use an inhaler or if you have suboptimal lung function, your doctor might recommend using a nebulizer to help get medications straight into the lungs. A nebulizer is a machine that is used by people with Asthma, COPD, and other respiratory conditions such as cystic fibrosis that turns liquid medications into a very fine mist. Patients inhale the mist through a mouthpiece or mask while taking slow, deep breaths. Short-acting beta agonists, anticholinergic agents, and inhaled corticosteroids are used with the nebulizer. Often, you can combine vials of each based on your doctor's instructions to limit the amount of time you spend using a nebulizer. 

Nebulizers can often take up to 10 min or more to deliver all your medicine and aren't always portable. They usually have to be plugged and can be difficult to carry around as opposed to an inhaler that is much smaller and more suitable for travel.

Pharmacist Tip

It’s very important to always get vaccinated for influenza and pneumonia! These illnesses can trigger asthma attacks, so try to prevent yourself from getting them in the first place. 

Using an inhaler can be tricky. More than half of people with asthma use their inhalers incorrectly. There are two types of inhalers: Dry-powder inhalers and Metered-dose inhalers (MDIs).  Here are some tips for using them:

MDI tips: 

  1. Shake the inhaler before you used it: 10-15 shakes is enough. This is especially important if your inhaler is new or you haven’t used it in a while. 

  2. When using an HFA inhaler such as ProAir or Ventolin, prime the inhaler to get the optimal dose if you haven’t used the inhaler before or in a while. This means spraying the inhaler 1-2 times into the air to make sure it’s primed. These are sort of like test sprays.

  3. Use a spacer: A spacer is a clear, plastic tube that attaches to your inhaler at the mouthpiece to help the medication go directly into your lungs rather than into the air or your mouth. This helps people get their full dose rather. 

  4. Take a big exhale before your dose! Once you exhale, you can now take a slow, deeper inhalation. 

  5. Hold your breath for 10 seconds: This helps the medication get deep into the lungs. 

  6. Stand up: Standing up helps you to fully exhale and gives you a little more power to inhale deeply. 

  7. This might seem like common sense but ONE BREATH PER PUFF! Take each puff separately. This is also important when using a spacer. Do not spray multiple puffs into the spacer. 

  8. Seal your lips around the mouthpiece and don’t let your teeth or tongue get in the way. Aim for the back of your throat so that the medicine can get into your lungs. 

  9. Hear a whistling sound? You’re inhaling too quickly. Exhale big, then take a slow and deep breath. 


  1. Dry-powder inhalers such as Advair DISKUS should be held in a level and flat position. 

  2. Hold DISKUS in your left hand and place thumb of right hand in the thumb grip. Slide the level until you hear it click. Your dose is now ready. 

  3. Exhale deeply away from the diskus then put your mouth on opening and inhale deep and fast!

  4. Dry-powder inhalers often require more force to inhale your medicine.  

  5. Make sure to hold your breath for 10 seconds after inhaling your dose then breathe out fully. 

  6. After each dose, rinse your mouth out with water and spit it out. 

  7. Do not swallow the water! 

Nebulizer machine tips and instructions: 

  1. Wash your hands before opening vials of medicine and adding to the medicine cup. 

  2. Nebulizers can either be plugged in or battery powered. Before turning on the machine, make sure that tubing, mask, and mouthpiece are all ready to go. 

  3. It’s important to have the right size mask. Masks are made to fit your face so that you can relax and take slow and deep breaths. Masks should cover your whole mouth and nose. Pediatric masks are also available. 

  4. Detach medicine cup from tubing and rinse with warm water after use.


Lifestyle Remedies

It is important to learn and avoid your asthma triggers. Some tips that can help include: 

  • Air conditioners: Air conditioners can help keep levels of airborne pollen low inside your home, reduce humanity, and reduce exposure to dust mites. 

  • Keep dust out: Replacing your carpeting, encasing your sheets and pillows with dust proof covers, and washing your curtains frequently can help reduce the amount of dust you breathe in. 

  • Dehumidifier

  • Clean up mold: Frequently clean damp areas in order to prevent mold from developing. 

  • Avoid pets: If you are allergic to pets, either avoid having them or regularly bath and groom them. 

  • Face masks: Wear a face mask during allergy season, locations with asthma triggers, and if the air is cold or dry. 

Getting regular exercise and maintaining a healthy weight can also help reduce asthma symptoms.

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