Proper care leads to normal life function with minimal if any side effects and minimal if any use of rescue beta agonist therapy. Asthma is a continuum. Any patient no matter where they are on the continuum can have a fatal or near fatal asthmatic attack. Asthmatic patients all need to have peak expiratory flow meters and know how to use them. V. Stepwise approach to pharmacotherapy- dose and frequency are determined initially by physician, patient is educated about the use of the peak flow meter and taught how to adjust meds when needed and how to use rescue meds when needed.
Inhaled corticosteroids are the most effective meds for long term control.
Beclomethasone and triamcinolone may require up to 20 puffs per day to maintain asthma and there may be poor patient compliance because of this. Other steroid inhalers have less frequent dosing needed and hence are more apt to be used as directed. Mast cell stabilizers can be useful for suppression as are leukotriene modifiers in reducing inflammation. There are now two leukotriene receptor antagonists on the market and can be very effective. If a patient is going through one inhaler per month, then that patient needs to be put on antiinflammatories.