Medicine does not cure
asthma. But it is an important part of managing the
condition. Medicines for asthma treatment are used to:
- Prevent and control the
airway inflammation to minimize long-term lung
- Decrease the severity, frequency, and duration of
- Treat the attacks as they
Asthma medicines are divided into two groups: those for
prevention and long-term control of inflammation and those that provide quick
relief for asthma attacks. Most children with persistent asthma need to use
long-term medicines daily. Quick-relief medicines are used as needed and
provide rapid relief of symptoms during asthma attacks.
Most medicines for asthma are
inhaled, because a specific dose of the medicine can
be given directly to the bronchial tubes. Delivery systems include metered-dose and dry powder
nebulizers. A metered-dose inhaler is used most
Many doctors recommend that every child who uses a
metered-dose inhaler (MDI) also use a
spacer , which is attached to the MDI. A spacer may
deliver the medicine to your child's lungs better than an inhaler alone. And
for many people a spacer is easier to use than an MDI alone. Using a spacer
corticosteroids can help reduce their side effects and
the need for oral corticosteroids.
- Asthma: Using a Metered-Dose Inhaler
- Asthma in Children: Helping a Child Use a Metered-Dose Inhaler and Mask Spacer
- Asthma: Using a Dry Powder Inhaler
The most important asthma
- Inhaled corticosteroids. These are the
preferred medicines for long-term treatment of asthma. They reduce inflammation
of your child's airways and are taken every day to keep asthma under control
and to prevent sudden and severe symptoms (asthma attacks).
Inhaled corticosteroids include beclomethasone, triamcinolone, fluticasone,
budesonide, and flunisolide.
- Oral or injected corticosteroids (systemic corticosteroids) to get your child's asthma
under control before he or she starts taking daily medicine. Your child may
also need these medicines to treat asthma attacks. Oral corticosteroids include
prednisone and dexamethasone.
- Short-acting beta2-agonists (quick-relief medicines) for asthma attacks. They relax the airways, allowing your
child to breathe easier. These medicines include albuterol and
Long-term medicines sometimes used alone or with other
medicines for daily treatment include:
Other medicines may be given in some cases.
- Anticholinergics (such as ipratropium) are usually
used for severe asthma attacks.
- Other medicine such as
omalizumab or magnesium sulfate may be used if asthma
does not improve with treatment.
Medicine treatment for asthma depends on your child's
age, his or her type of asthma, and how well the treatment is controlling
- Children up to age 4 are usually treated a
little differently than those 5 to 11 years old.
- The least amount
of medicine that controls your child's symptoms is used.
- The amount
of medicine and number of medicines are increased in steps. So if your child's
asthma is not controlled at a low dose of one controller medicine, the dose may
be increased. Or another medicine may be added.
- If your child's
asthma has been under control for several months at a certain dose of medicine,
the dose may be reduced. This can help find the least amount of medicine that
will control your child's asthma.
- Quick-relief medicine is used to
treat asthma attacks. But if your child needs to use quick-relief medicine a
lot, the amount and number of controller medicines may be changed.
Your child's doctor will work with you and your child to
help find the number and dose of medicines that work best.
Concern about medicines and growth
Some parents worry that children who use inhaled
corticosteroids may not grow as tall as other children. A very small difference in height and growth was found in children using
inhaled corticosteroids compared to children not using them.19 And one study showed a very small difference in height [about 0.5 in. (1.3 cm)] in adults who used inhaled corticosteroids as children compared to adults who did not use inhaled corticosteroids.20 But the use of inhaled corticosteroids has important health benefits for children who have asthma. If you are worried about the effects of asthma medicines on your child, talk with your doctor.
What to think about
- Controller medicines. One of the best tools for managing asthma is a daily controller medicine that has a corticosteroid ("steroid"). But some people worry about using steroid medicines because of myths they've heard about them. If you're making a decision about a steroid inhaler, it helps to know the facts.
- Quick-relief medicines. Because these medicines
quickly reduce symptoms, children sometimes overuse them instead of
adding the slower-acting, long-term medicines. But
overuse of quick-relief medicines may have harmful
effects, such as decreasing how well these
medicines work in the future.21 Overuse of quick-relief medicine is also
a sign that asthma symptoms are not being controlled. You should talk
with your doctor right away.
- Corticosteroid pills. Research shows that the most
important factor in reducing the severity and length of an asthma attack in
children is giving a corticosteroid pill early in a severe attack. These pills work best when given at the first sign of
- Inhaled medicines. Try
to avoid giving your child an inhaled medicine when he or she is crying,
because not as much medicine is delivered to the lungs.