When you have asthma, it can feel difficult to escape all the triggers that can take your breath away. Pollen, smoke, animal dander, a cold: Coming in contact with any of these can cause airway muscles to tighten and squeeze, blocking your breathing and secreting mucus that clogs up your passages even more.

Luckily, there are excellent treatments for the more than 25 million Americans who have asthma. Prescription bronchodilators (most often called inhalers) are a primary treatment. Some are short-acting inhalers — also called rescue inhalers. These are used when you’re having an asthma attack. They open those tightened airways and help you breathe. Others are long-acting inhalers, also known as maintenance or control inhalers. These are used regularly to help keep airways open and prevent attacks before they happen.

Both types can help reduce the damage that asthma attacks cause to your respiratory system. A healthier respiratory system can translate to fewer asthma flare-ups in the future. It can also reduce the need to rely on medications.

But to get to a place where your asthma is under control, you must use your medications the right way, as recommended by your provider. Unfortunately, between 30% and 70% of asthma patients don’t. To make sure your treatment is doing everything it can for you, follow this simple guide about how to use your asthma medications.

Get Smart About Inhalers

Anyone with asthma should have a rescue inhaler to address an attack in the moment. But many people also need a long-term preventive inhaler. Here’s what to know about each.

• Short-acting (rescue) inhalers: These work quickly. They’re designed to be used as soon as you feel an attack coming on. They can help you feel better right away. Short-acting inhalers open the airways swiftly. That gives you quick relief from symptoms such as wheezing, coughing, and shortness of breath.
  
  Two common types are albuterol and levalbuterol. If a short-acting inhaler doesn’t bring enough relief during a severe flare-up, other medications can be used too. Talk to your doctor to get a specific plan about when and how to use other medications.
   
• Long-acting (control) inhalers: These are meant to be taken daily to curb flare-ups. There are two main types of long-lasting control medicines. Inhaled corticosteroids, such as fluticasone and budesonide, are the most common. These reduce swelling and mucus production in your airways, making it easier to breathe. Long-acting bronchodilators may also be prescribed. These work by relaxing the muscles of the airway. Both types work for at least 12 hours.

Understand Your Action Plan

Planning to visit your best friend who just got a cat? Heading to a campfire cookout? Feel the flu coming on? Lots of triggers can make your asthma flare up at inconvenient times. That can make it a tough condition to manage. But working with your care team now to create an action plan can help you take control of your health.

An asthma action plan should spell out which inhaler to use and when. For example, your plan might explain:

• If you have severe wheezing, it’s time to use your rescue inhaler. Wheezing is a high-pitched whistling sound that comes with difficult and/or rapid breathing.
• If you aren’t breathing better after 2 days of using a short-acting inhaler, call your provider. You might need to increase your medication or add a control inhaler to your routine.
• If you miss a dose of your long-acting inhaler, you should skip it. Then get back on your regular schedule, according to the Mayo Clinic.

Have questions about your plan? Don’t be shy about asking. No question is too small or too specific.

Pinpoint Your Triggers

For some people, an asthma flare-up happens after being around an allergen, such as pet dander or pollen. For others, exercising can cause an asthma attack. And still others find that irritants, such as secondhand smoke, are their biggest triggers. Avoiding your own asthma triggers starts with figuring out exactly what they are.

To do that, your doctor might ask you to track when you have a flare-up. But keep in mind that it’s also possible to have a delayed asthma episode. That’s when the attack happens several hours after you’ve encountered a trigger. So it may take some time to figure out your triggers. If you’re still having trouble, ask your doctor about other strategies, such as testing for allergens.

Once you know what tends to set off your asthma, it’s important to steer clear of those triggers. You might need to meet your cat-loving sister outside her home. Or you may need to invest in mattress and pillow covers to keep dust mites away from your face and airways. Your doctor can share more strategies.

Measure Your Flow

A peak flow meter is a very useful tool for figuring out how well your asthma is controlled. You blow air into this handheld device in one fast blast. It measures how well you blow air out of your lungs. Peak flow readings may reveal that your asthma symptoms are worsening, even if you don’t feel it. And that intel may prompt your doctor to fine-tune your medications.

Your doctor will likely ask you to use the device daily for several days in a row. When you’re using a peak flow meter, consistency is key. You can use the device in the mornings or evenings, and before or after your medications. Whatever routine you settle on, try to stick with it. The more consistent you are, the easier it is for your healthcare team to spot trends and understand your true scores.

Each time you use a peak flow meter, repeat the test 3 times. The numbers should be fairly close together. That’s confirmation that you’ve used the device correctly. Then record the highest of your 3 readings. Healthcare providers typically put the scores into 3 zones:

• Green zone: This is 80% to 100% of your usual or “normal” peak flow rate. If you’re in this zone, you’re doing well. Not sure what’s normal for you? Ask your doctor.
• Yellow zone: This is 50% to 80% of your usual peak flow rate. This zone may signal that your airways are narrowing. You and your doctor should have a plan in place for when your peak flow rates are in the yellow zone.
• Red zone: Less than 50% of your usual peak flow rate. If you’re in the red zone, take your rescue medications right away. Then contact your healthcare provider for next steps.

An asthma flare-up can be scary. But being prepared can help you feel more empowered. By managing your asthma medications and having a clear action plan, you can prevent or cut short future flare-ups.

Sources:

[1] Lindsay JT and Heaney LG. “Nonadherence in Difficult Asthma — Facts, Myths, and a Time to Act.” Patient Preference and Adherence, vol. 7, 2013, pp: 329-336.

[2] “Asthma Trends and Burdens.” American Lung Association, https://www.lung.org/research/trends-in-lung-disease/asthma-trends-brief/trends-and-burden. Accessed September 12, 2021.

[3] “Measuring Your Peak Flow Rate.” American Lung Association, May 27, 2020, https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/measuring-your-peak-flow-rate. Accessed September 12, 2021.