What should you know about asthma therapy?

Treatment is adjusted to your symptom pattern, risk of attacks, age, other health conditions and ability to use a particular device. Feeling well does not necessarily mean airway inflammation has settled, so continue prescribed controller treatment unless your clinician changes the plan.

Asthma narrows sensitive airways through inflammation and tightening of the muscles around them. Controller medicines, commonly containing an inhaled corticosteroid, reduce that inflammation. Reliever medicines act more quickly when symptoms appear; some combination inhalers can serve as both maintenance and reliever treatment when prescribed that way.

Your clinician may step treatment up when control is poor and may consider stepping it down after a sustained period of good control. Before changing medicines, they will often check inhaler technique, regular use, exposure to smoke or allergens, and related problems such as nasal allergy. Tablets, injectable biological medicines or specialist assessment may be considered when inhaled therapy does not provide adequate control.

Use each inhaler exactly as labelled and ask a clinician or pharmacist to watch your technique. A spacer may help with certain pressurised inhalers. Know which device is your controller, which is your reliever and whether one prescribed combination inhaler has both roles; the instructions are not interchangeable.

Follow a written asthma action plan that reflects your own medicines. Track night waking, activity limits, wheezing, cough, chest tightness and reliever use, because a change can signal poorer control. Keep medicines available, check expiry dates and arrange a review if you are relying on the reliever more often, symptoms interrupt sleep, or usual activities become difficult.

Reduce exposure to triggers you have identified, including tobacco smoke, dust, strong fumes or workplace irritants. Do not stop a controller inhaler suddenly because you feel better. If side effects, cost, pregnancy, fasting or device handling make the plan difficult, discuss the specific barrier so the regimen can be adapted safely.

Seek urgent clinical advice when symptoms are getting worse, treatment is helping less than usual, you need your reliever increasingly often, or breathlessness limits sleep or normal activity. An assessment can check for an asthma flare, infection, poor inhaler delivery or another cause of breathing difficulty.

Call local emergency services if breathing is rapidly worsening, the prescribed reliever is not helping, you cannot speak comfortably in full sentences, your lips or skin look blue or grey, or you become drowsy or confused. Sit upright and follow the emergency instructions in your personal action plan while help is coming. Do not drive yourself when breathing is severely impaired.

Ask which inhaler treats inflammation, which one to use for sudden symptoms, and whether your regimen uses a single inhaler for both purposes. Request a demonstration with your actual device and confirm how to clean it, whether a spacer is suitable and what signs should trigger an urgent review.

It is also useful to ask how exercise, allergies, respiratory infections, pregnancy or other medicines affect your plan. Bring your inhalers and action plan to appointments so the clinician can compare the written instructions with how you are using them.