
| Step 7: Asthma drugs |
Your doctor will determine which medications you should take, the amount (dosage), and how often you should take them. The treatment plan will depend largely on the severity of your asthma episodes.
Guidelines developed by the National Institutes of Health recommend a "step-down, step-up" approach to asthma management. This simply means that when you are first evaluated, you may be given a dosage high enough to quickly bring your symptoms under control. Then, as your doctor monitors you with follow-up visits, your dosage may be lowered until you are taking the least amount of drug required to keep you symptom-free.
If the dose is lowered too far, your doctor will "step up" the dose back to a level needed for adequate control. This step-down, step-up strategy is not needed or appropriate for all patients.
The severity of your asthma will impact how fast your symptoms can be controlled, but you should notice a great deal of improvement after treatment is started. For people with mild to moderate persistent asthma, the doctor should be able to fine-tune the treatment within 3 months. For those with severe persistent asthma, it may take up to 6 months. All people with asthma should continue to visit their doctor at least twice a year to make sure that they are still achieving optimal control.
You may experience more side effects from the medications at the beginning when you are taking higher doses. These are likely to lessen if the dosages are lowered.

| Note: The inhalers pictured here are just examples. Inhalers for both control and quick relief medicine come in many sizes, shapes, and colors. In addition, your medicine can be taken through other methods, such as a nebulizer. |
Control vs. relief
There are two major types of asthma drugs. The first type are called long-term control drugs, which are used to treat persistent asthma on a daily basis to PREVENT asthma attacks. If you have young children with asthma, your child can call these the "quiet" drugs -- the drugs to take every day, even when your child is NOT wheezing, coughing, or experiencing other symptoms. (This is a term the consumer group Mothers of Asthmatics finds useful.)
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The second type are called quick-relief drugs, which are used DURING an asthma attack to bring fast relief. With children, you might want to refer to these as the "noisy drugs" -- the ones to take when your child IS coughing, wheezing, having breathing difficulties, or feeling chest tightness.
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