Please call 911 immediately if you are having chest pain, difficulty breathing, severe bleeding, sudden weakness or numbness, or if you think you have a medical emergency.

The goals of asthma therapy are to prevent your child from having chronic and troublesome symptoms, to maintain your child's lung function as close to normal as possible, to allow your child to maintain normal physical activity levels (including exercise), to prevent recurrent asthma attacks and to reduce the need for emergency department visits or hospitalizations, and to provide medicines to your child that give the best results with the fewest side effects.

Medicines that are available fall into two general categories. One category includes medications that are meant to control asthma in the long term and are used daily to prevent asthma attacks (controller medications). These can include inhaled corticosteroids, inhaled cromolyn or nedocromil, long-acting bronchodilators, theophylline, and leukotriene antagonists. The other category is medications that provide instant relief from symptoms (rescue medications). These include short-acting bronchodilators and systemic corticosteroids. Inhaled ipratropium may be used in addition to inhaled bronchodilators following asthma attacks or when asthma worsens.

In general, doctors start with a high level of therapy following an asthma attack and then decrease treatment to the lowest possible level that still prevents asthma attacks and allows your child to have a normal life. Every child needs to follow a customized asthma management plan to control asthma symptoms. The severity of a child's asthma can both worsen and improve over time, so the type (category) of your child's asthma can change, which means different treatment can be required over time. Treatment should be reviewed every 1-6 months, and the choices for long- and short-term therapy are based on how severe the asthma is.

Talk to your doctor about the various medications available to treat asthma.

Acute severe asthmatic episode (status asthmaticus) often requires medical attention. It is treated by providing oxygen or even mechanical ventilation in severe cases. Repeat or continuous doses from an inhaler (beta-2 agonist) reverse airway obstruction. If the asthma isn't corrected using the inhaled bronchodilator, injectable epinephrine and/or systemic corticosteroids are given to reduce inflammation.

Fortunately, for most children, asthma can be well controlled. For many families, the learning process is the hardest part of controlling asthma. A child might have flares (asthma attacks) while learning to control asthma, but don't be surprised or discouraged. Asthma control can take a little time and energy to master, but it's worth the effort!

How long it takes to get asthma under control depends on the child's age, the severity of symptoms, how frequently flares occur, and how willing and able the family is to follow a doctor's prescribed treatment plan. Every child with asthma needs a doctor-prescribed individualized asthma management plan to control symptoms and flares. This plan usually has 5 parts.

Please call 911 immediately if you are having chest pain, difficulty breathing, severe bleeding, sudden weakness or numbness, or if you think you have a medical emergency.

Exercise-Induced Asthma Treatment

Since exercise-induced asthma is a chronic disease, treatment goes on for a very long time. Some people have to use medication for the rest of their lives. The best way to improve your condition and live your life on your terms is to learn all you can about your asthma and what you can do to make it better.

• Become a partner with your health care provider and his or her support staff. Use the resources they can offer —information, education, and expertise —to help yourself.
• Follow the treatment recommendations of your health care provider. Understand your treatment. Know what each drug does and how it is used.
• See your health care provider as scheduled.
• Promptly report any changes or worsening of your symptoms.
• Report any side effects you are having with your medications.

The goals of treatment are as follows:

• To prevent attacks
• To carry on with normal activities
• To maintain normal or near-normal lung function
• To have as few side effects of medication as possible

Self-Care at Home

Work with your health care provider to develop an action plan. Follow your treatment plan closely to avoid an asthma attack during and after exercising. If you do have an asthma attack, the action plan will help you control the attack and make the decision about when to seek medical care.

If you should have an asthma attack, move to the next step of your action plan. Keep the following tips in mind:

• Take only the medications your health care provider has prescribed for your asthma. Take them as directed.
• If the medication is not working, do not take more than you have been directed to take. Overusing asthma medications can be dangerous.
• Do not take cough medicine. These medicines do not help asthma and may cause unwanted side effects.
• Aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen, can cause asthma to worsen in certain individuals. These medications should not be taken without the advice of your health care provider.
• Do not use nonprescription inhalers. These contain a very short-acting inhaler that may not last long enough to relieve an asthma attack and may cause unwanted side effects.
• Do not take any nonprescription preparations, herbs, or supplements, even if they are completely "natural," without talking to your health care provider first. Some of these may have unwanted side effects or interfere with your medications.
• Be prepared to go on to the next step of your action plan if necessary.

If you think your medication is not working, let your health care provider know right away.

Medical Treatment

Most people with exercise-induced asthma, if exercise is their only trigger, do not have to take medication every day (unless they exercise every day). Medication is taken before exercising, each time you exercise, to prevent an attack.

• The medications most widely used by people with exercise-induced asthma are the short- and long-acting beta2-agonist bronchodilator inhalers.
• Other preventive medications are inhaled cromolyn sodium and oral leukotriene inhibitors.

Precautions that may help reduce your chance of having an asthma attack include the following:

• Spending time warming up before starting strenuous exertion can help prevent asthma symptoms. Similarly, a gradual cooling down after exertion can prevent symptoms after exertion.
• Avoid exertion when you have a respiratory tract infection, such as a cold, flu, or bronchitis.
• Avoid exertion in extremely cold weather.
• If you smoke, quit.
• If you have allergies, avoid exertion when a reaction is likely to be triggered, as when the pollen count is high or the pollution index is high.

If you have frequent exercise-induced asthma attacks despite using preventive medication, or if you have attacks when you are not exercising, you need to see your health care provider right away. You may need to use daily medication to control the underlying inflammation that is causing your frequent attacks.

Together, you and your health care provider will develop an action plan for you in case of asthma attack. The action plan will include the following:

• How to use rescue medication
• What to do if the rescue medication does not work right away
• When to call the health care provider
• When to go directly to a hospital emergency department

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Please call 911 immediately if you are having chest pain, difficulty breathing, severe bleeding, sudden weakness or numbness, or if you think you have a medical emergency.

Treatment of asthma in pregnancy

The best way to treat asthma is to avoid having an attack in the first place. Avoid exposure to your asthma triggers. This might improve your symptoms and reduce the amount of medication you have to take.

• If you smoke, quit. Smoking can harm you and your fetus. Avoid being around others who are smoking; secondhand smoke can trigger an asthma attack. Secondhand smoke also can cause asthma and other health problems in your children.
• If you have symptoms of gastroesophageal reflux (for example, heartburn), avoid eating large meals or lying down after eating.
• Stay away from people who have a cold, the flu, or other infection.
• Avoid things you are allergic to.
• Remove contaminants and irritants from your home.
• Avoid your known personal triggers (cat dander, exercise, whatever sets you off).

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Please call 911 immediately if you are having chest pain, difficulty breathing, severe bleeding, sudden weakness or numbness, or if you think you have a medical emergency.

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