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Choosing the best bronchial asthma treatment begins with a doctor’s consultation and a review of the condition's symptoms, triggers and effect on the patient's lifestyle. Asthma is a lifelong disease for which there is no cure, so the goals of the doctor and patient should be to control the most bothersome symptoms, such as coughing, wheezing and shortness of breath, and to prevent future asthma attacks, especially those that can lead to hospitalization. To choose the best bronchial asthma treatment, consider whether short-term or long-term treatment is needed, the risks involved with various treatments and the ability of the patient to use certain types of treatment.
Two types of medication typically are used in bronchial asthma treatment, and choosing which one to try first depends on whether the medication will be used for quick relief or long-term control. Fast-acting inhalers, often called rescue inhalers, help control asthma symptoms that appear suddenly. These fast-acting medicines work best for patients who already take other prescribed approaches to controlling asthma and need an occasional boost of medication when airways tighten in response to environmental or other triggers.
Fast-acting inhalers include short-acting beta-agonists and anticholinergics. Short-acting beta-agonists are a good choice for patients whose asthma is exacerbated by exercise. Taken before physical activity, these medications can prevent an attack from coming on. Anticholingerics are a good choice when a patient wants to supplement or replace a short-acting beta-agonist inhaler.
For long-term control medication, the options include inhaled anti-inflammatory drugs. Some examples are corticosteroids and leukotriene modifiers. These sometimes are used with inhaled long-acting beta-2-agonists to open constricted airways.
Choosing an anti-inflammatory bronchial asthma treatment depends on several factors. Long-term corticosteroid use is associated with osteoporosis and eye cataracts, and a doctor should consider these risks for the individual patient before prescribing these medicines. Leukotriene modifiers block the inflammatory process but do not use steroids in the process and thus help the patient avoid such things as bone thinning and eye problems.
For most asthma patients, the best treatment plan is one that uses a long-term medication to control future asthma attacks and a fast-acting medication to handle unexpected flares of the disease. In some cases, when an asthma attack has overwhelmed a patient who is taking control medications, short-term use of oral steroids can gain quick control of severe symptoms. In addition, a newer, injectable medication called omalizumab has been developed to treat severe allergy-induced bronchial asthma when other medications have failed.
Finally, choosing the best delivery of asthma medication depends on how easily a patient can inhale. Standard handheld inhalers work for most patients, but those who have greater trouble inhaling deeply, including senior patients, often are prescribed nebulizers. Also known as breathing machines, nebulizers transform medication into a mist that’s easier to inhale.