In patients with mild disease, this can be attained using intermittent inhaled beta agonist drugs. A trial of steroids may also be considered with monitoring for objective response as outlined below. Additional treatment decisions should be based on symptoms and response to treatment. A description of the drug classes available follows. However, the most appropriate dosing and dosing intervals have not been extensively studied.
Most patients use the short acting inhalers at two puffs four daily, either scheduled or as needed.
New, long-acting formulations might be useful when administered at bedtime to patients who report nocturnal symptoms. It is important to remember that the response to bronchodilators on spirometry does not identify all patients who will benefit from these agents. Clinical response should guide the use of the medication. Patients must use the metered dose inhalers appropriately to benefit, and instructions on the proper use of aerosol inhalers is mandatory for maximal effect. The National Asthma Education Program has published guidelines to aid health care professionals in instructing patients on the proper use of these inhalers.