Controlling Asthma

What is Asthma?:

Asthma is a disease of the lungs that can be controlled but not cured. If you have asthma, your airways can swell and tighten making it hard to breathe. When you breathe normally, air goes in and out of your lungs through small tubes called airways. An asthma attack (flare-up or exacerbation) happens when your airways get smaller making it hard to breathe. When you have an asthma attack two things happen:

  1. The inside of the airways swell and fill with mucus.
  2. The muscles around the airways tighten. This makes the airways smaller.

Before having an asthma attack, you often have warning signs that tell you that an asthma attack is coming. Everyone has different warning signs, but some of the most common ones are:

  • Wheezing
  • Getting out of breath
  • Tightness in the chest
  • Increased cough
  • Breathing fast
  • Fast heart rate

Asthma cannot be cured, but it can be controlled by taking the right medications and removing asthma triggers from daily life.



A trigger is something in the environment that makes asthma worse. By avoiding or removing triggers, you can improve you or your child’s asthma. There are three main kinds of asthma triggers

  1. Infections such as a cold or the flu
  2. Allergies to pollen, mold, animals, dust mites, or cockroaches
  3. Irritants such as tobacco smoke, perfume, chemicals, incense, or other strong smells

Some of the most common triggers are:

  • Colds/Flu
  • Mold
  • Grass/Pollen
  • Exercise
  • Animals with fur (cats, or dogs)
  • Dust Mites
  • Detergents/Strong Smells
  • Bedding
  • Diesel Fuel Fumes
  • Tobacco Smoke
  • Weather Changes


Controlling Asthma

There are two types of asthma medications Rescue (Quick-Relief) medicines and Controller Medicines. Everyone diagnosed with asthma needs a rescue inhaler because: it works very quickly to make it easier for you to breathe; helps to open your airways; should be used as directed by your doctor. Keep your rescue inhaler with you at all times to reduce the severity of your asthma attacks.

Controller medicines are just as important for some individuals. They can work in two different ways: by reducing the swelling inside the airways or by helping to relax the muscles that squeeze the airways. Controller medicines may reduce the number of flare-ups and help you stay well. They should always be taken as prescribed by your doctor, even when you feel fine.

**Always follow the advice of your doctor. Asthma treatment can be generalized, but every case needs to be evaluated on an individual basis.


Asthma Action Plans

An Asthma Action Plan (AAP) gives instructions to help you when an asthma attack happens. The AAP helps you decide:

  1. What medicine to take
  2. When to take medicine
  3. How much medicine
  4. When to go to the doctor or the emergency room

Every individual should have an AAP. For children, it is especially important to give copies of your child’s AAP to the school nurse, day care center, babysitter, or anyone else who cares for your child so that they know what to do when your child has an asthma attack.

An AAP should be filled in by your doctor. Sometimes your doctor will provide you with an AAP. To be certain that you recieve an AAP we recommend bringing one with you to your next doctor appointment. A sample AAP can be found here. English Spanish

Just like a traffic light, an AAP is divided into three color zones to help you decide a treatment method.

Green Zone Tells you what to do if your breathing is good
Yellow Zone Tells you what to do when you start to have an asthma attack
Red Zone Tells you what to do if you are having a serious asthma attack


Rules of Two

It is important for everyone with asthma to make sure that their asthma is well controlled. Asthma should not keep you from going to school or work, exercising, sleeping, or doing things that you love. How do you know if your asthma is not under control? Follow the Rules of Two. If you answer yes to any of the questions, your asthma might not be under control.

Do you…

  • Take your quick-relief inhaler more than two times a week?
  • Awaken at night with asthma more then two times a month?
  • Refill your quick-relief inhaler more than two times a year?

You can keep your asthma under control by avoiding things that cause asthma attacks, keeping track of your symptoms, and taking medicine. If you think your asthma is not under control, talk to your doctor about steps that you can take to improve your life with asthma.


How to Take Medications

Taking medications according to how they are prescribed by your doctor is extremely important to keeping your asthma controlled. Always be sure to take your medications, even if you are feeling okay. The medications may be working well enough that your asthma symptoms disappear for the most part, but this is not a sign to stop taking them.

There are lots of different types of medications on the market today. These general instructions are provided for each type of medication device.

  • Inhaler with a Spacer — Directions [PDF]
    • Clean your inhaler 1 or 2 times per week. That way, germs cannot build up on the mouthpiece. Frequent cleaning also keeps the inhaler from becoming clogged. To clean the inhaler:
      • Remove the medicine canister from the plastic case (called the activator)
      • Rinse the plastic case with warm, soapy water
      • Dry the plastic case and put the medicine canister back in place when fully dry
    • Spacers help deliver asthma medicine deep into your lungs. Spacers also avoid problems with spraying and breathing at the same time, or with inhaling medicine too fast. Without the spacer, most of the medicine hits the back of your throat instead of going down into your lungs. When the spacer is put onto the inhaler, the medicine squirts into the center of the spacer. That way, the medicine breaks into smaller droplets. And when you breathe in the medicine, the smaller droplets can move deeper into your lungs.
    • You can buy a spacer at most drug stores. Many insurance companies do not cover the cost of a spacer. If the spacer available on the shelves at the pharmacy is too expensive for your budget, talk with the pharmacist. Your pharmacist may be able to order a less expensive model for you.





  • Inhaler without a Spacer — Directions [PDF]
    • Clean your inhaler 1 or 2 times per week. That way, germs cannot build up on the mouthpiece. Frequent cleaning also keeps the inhaler from becoming clogged. To clean the inhaler:
      • Remove the medicine canister from the plastic case (called the activator)
      • Rinse the plastic case with warm, soapy water
      • Dry the plastic case and put the medicine canister back in place when fully dry



  • Dry Powder Inhalers — Directions [PDF]


Aerolizer – Directions [PDF]

Diskus – Directions [PDF]

Turbuhaler – Directions [PDF]

Twisthaler — TwisthalerDirections [PDF]

Nebulizers — NebulizerDirections [PDF]

Many of the medicines above are sprays or powders. They are breathed in through your mouth, and work best when they get deep down into your lungs. The devices used to deliver these medicines must be used correctly so that the medicine will reach your lungs.

After using many of the above medications you may be advised by your doctor to rinse your mouth with water and spit it out. This will help you avoid developing a yeast infection in the throat or mouth.


Questions to Ask Your Doctor

If you are unsure of how to discuss your asthma with a doctor try visiting the American Lung Association’s NexProfiler Treatment Option Tool. By answering a few questions about yourself it will narrow down the questions which you may want to talk over with your doctor. And don’t worry, the reason you are asked to register at the website is so that your answers are saved for the next time you return to the site.



Para la informaciĆ³n sobre asthma en espaƱol vaya por favor:

Visite nuestro propio Web site en:

Allergy & Asthma Network Mothers of Asthmatics (AANMA)

American Lung Association (ALA)


American Lung Association PA
Pennsylvania Department of Health
Funding for this website has been provided by the Pennsylvania Department of Health
through a grant from the Centers for Disease Control and Prevention.