How is severe asthma treated?
Severe asthma is treated with a combination of different inhalers and other medications. Although symptoms of severe asthma are more intense and difficult to treat, it is possible to still get them under control. In addition to your regular medications for asthma such as corticosteroid inhalers and bronchodilators, other medications that may be tried for severe asthma (usually in combination) include:
- higher doses of inhaled corticosteroids or using inhaled corticosteroids more frequently
- oral corticosteroids or corticosteroid injections
- continuous inhaled nebulizers
- ipratropium bromide aerosols
- long-acting beta-agonists (LABAs) such as albuterol or formoterol, which help keep the airways open for about 12 hours
- leukotriene receptor antagonists (LTRAs), such as montelukast or zafirlukast
- slow-release theophylline
- long-acting muscarinic receptor antagonists (LAMAs) such as tiotropium bromide or glycopyrronium bromide
- biologics such as omalizumab, mepolizumab, reslizumab, benralizumab, or dupilumab
- bronchial thermoplasty, a surgical procedure that may help some people with severe asthma.
References
- How is severe asthma treated? https://www.asthma.org.uk/advice/severe-asthma/treating-severe-asthma/how-is-severe-asthma-treated/
- Scow DT, Luttermoser GK, Dickerson KS. Leukotriene inhibitors in the treatment of allergy and asthma. Am Fam Physician. 2007 Jan 1;75(1):65-70. PMID: 17225706.
Read next
Can severe asthma lead to COPD?
Severe and poorly controlled asthma can lead to damaged lungs which may increase the risk of developing chronic obstructive pulmonary disease (COPD). Symptoms of asthma and COPD may frequently co-exist in smokers and the elderly. Continue reading
What is considered severe asthma?
Severe asthma is when you require medium to high-dose inhaled corticosteroids combined with other longer-acting medications. Severe asthma can also be defined as having a peak expiratory flow rate (PEF or PEFR) less than 50% of your personal best. This shows severe narrowing of your large airways and is considered a medical emergency and you should get help right away. Your symptoms may include coughing, being very short of breath, wheezing while breathing in and out, or retractions (this is when you can see the muscles between the ribs working hard to keep you breathing). Walking and talking may also be difficult. Continue reading
Which measure is the single best determinant of asthma severity?
A peak expiratory flow rate (PEF or PEFR) is the single best determinant of asthma severity. A PEF measurement is a quick test to measure air flowing out of the lungs. During the test, you blow forcefully into the mouthpiece of a device, usually a peak flow meter (PFM), which is a portable, light, handheld device made of plastic. If the test is done in a healthcare provider's office or a hospital a much larger device, called a spirometer, is usually used. This device has a handheld mouthpiece that’s attached by a cord to a larger electronic machine. Continue reading
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