For details on asthma classifications and the recommended stepwise treatment, see Table 2. The patient's condition may fluctuate between the four steps, so treatment varies depending on her symptoms and peak flow values. Tell the patient to monitor her symptoms and peak flow values at home and teach her what action to take depending on peak flow values. Drug therapy is a mainstay of asthma treatment. Many new asthma medications have been developed in the last 10 years and more are in the works, including genetically engineered drugs.
Bronchodilators cause smooth muscle relaxation of the airways.
Because these drugs take up to 30 minutes to work and last 12 hours or longer, they are maintenance medications only and cannot be used to treat acute episodes. Adverse effects of beta 2 -agonists include nausea, headache, tachycardia, tremors, hypertension, nervousness, and dizziness. Overusing these medications can reduce their efficacy. Theophylline, a methylxanthine, is another long-acting bronchodilator and was once the only medication available to treat asthma. As newer medications were developed, theophylline fell out of favor, but it has recently had a resurgence in popularity.