Treatment of asthma should accomplish three things:
1. Establish control or best results.
2. Maintain control or best results with the smallest amount of medication possible.
3. Prevent severe attacks by early effective treatment. What is meant by "control or best results"?
1. Minimal symptoms. Ideally none.
2. Ability to function normally, including exercise.
3. Need for temporary relief medication less than twice a day. Ideally not at all.
4. No side effects form medications.
5. If peak flow rates are being measured, they should be equal to your best value.
Variation in peak flow rates during the day should be less than 10%. Asthma control can be achieved in most people, most of the time.
If your asthma is not well controlled:
1. More asthma control medication may be required. Occasionally, vigorous treatment with high dose inhaled steroid and prednisone tablets are required to achieve the best result. Medications may then be decreased as long as symptoms are controlled.
2. Inhaler technique may need improvement.
3.
Symptoms that are being attributed to asthma may be due to another condition which needs to be identified and treated.
4. Factors such as smoke, heartburn or allergy may be contributing to symptoms. When is more asthma control medication required?
1. Increased requirement for temporary relief with bronchodilators.
2. More frequent or severe symptoms.
3. Worsening symptoms with exercise.
4. Need for medication on awakening.
5. Symptoms disturbing sleep.
6. If peak flow rates are being measured, the reading after bronchodilator is 15% lower than your best value, or there is variation during the day of greater then 20%.
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