CPMC Asthma Treatments and Procedures

Asthma is a lifelong disease, and everyone's asthma is different. Some people have little or no symptoms, while others have those that are frequent or constant. Some have allergies, while others do not. Although asthma may be a lifelong condition, you can manage and control it. At California Pacific Medical Center, asthma specialists, particularly at the Comprehensive Asthma Program, work with you to develop an individualized treatment plan that fits your lifestyle and helps you reduce symptoms. We also offer a self-guided, online asthma management class, with videos and handouts on a wide variety of asthma topics.

First we confirm your asthma diagnosis, so that we can be sure that there’s no other reason for your symptoms. We can then focus on treatment. Treatment plans vary from person to person and may include a mix of therapies, procedures and medications.

Your doctors may first help you identify triggers to avoid, such as pollen, dander, fumes or smoke. They will then diagnose and treat related diseases such as heartburn or seasonal allergies.

Regular exercise and a healthy diet can also help you control your asthma.

Your doctors will prescribe asthma medications based on your age, symptoms, severity of your asthma and possible side effects.

Allergen Immunotherapy

Your doctor may recommend allergen immunotherapy with a referral to an allergist for allergy shots or under-the-tongue tablets.

Controller Medications

Controller medications — also called long-term control medications or maintenance medications – prevent asthma symptoms from happening by preventing airway inflammation.

You take them daily, and they can be inhaled or swallowed, as a pill or liquid. Options include:

• Inhaled corticosteroids
• Leukotriene modifiers
• Combination inhalers: Corticosteroids and long-acting beta agonists

Inhaled corticosteroids are the most common controller medications, usually given through an inhaler or nebulizer. They are not the same steroid drugs used by some athletes – corticosteroids are a safe and proven form of asthma treatment.

Rescue Medications

Asthma rescue medications, or quick-relief medicines may not address the underlying problem, but they quickly open up and help relax the muscles of your airways when you’re having trouble breathing or an asthma attack.

The most prescribed rescue medications are bronchodilators, which are usually given through an inhaler or nebulizer.

Short-acting Beta-agonists are also common rescue medications that are typically used right before exercising to help prevent asthma symptoms.

If you use rescue medications twice a week or more, you may need to have your medication routine changed. Ask your doctor.

Biologic Therapy

If you’re taking controller medications but still have moderate to severe asthma with persistent symptoms, your doctor may recommend biologic therapy. Examples of biologic therapies include anti-IgE and anti-IL5, while more are currently in development.

With recent advances in asthma care, we can modify how your body's immune system responds to allergic triggers and inflammatory signals. When you’re exposed to allergens, they can cause inflammation in your lungs that then cause your asthma symptoms. Anti-IgE therapy prevents that inflammation from occurring by blocking the antibody immunoglobulin E.

Eosinophils—a type of white blood cell normally found in our bodies—can also drive asthma inflammation. Anti-IL5 therapy helps control inflammation by decreasing the amount of eosinophils in your body.

Biologic therapies complement your current asthma treatment medications but do not replace them. Your doctor or another healthcare professional would tailor your particular drug, dosage, and frequency to your specific situation and give you an injection once every two to four weeks.

Bronchial Thermoplasty

This incision-free, minimally invasive procedure was developed for treating severe persistent asthma. Bronchial thermoplasty takes place over three sessions, and each session is about one hour long.

During each session, a small, flexible tube called a bronchoscope is inserted through your nose or mouth. It is guided to your lungs and airways, where it places and expands a catheter to reduce airway smooth muscle. Your airways’ ability to tighten and cause an asthma attack is reduced when there is less muscle.

After having bronchial thermoplasty, some patients have shown improved asthma control, fewer severe asthma attacks, fewer visits to emergency departments, and fewer missed school and/or work days.

Vaccines and Immunizations

Your doctor might recommend vaccines or immunizations that minimize or prevent severe illness from the flu and Pneumococcus, a bacteria that causes pneumonia and bloodstream infections.

During asthma flares or exacerbations, lung function and asthma symptoms worsen. You can often manage mild flares at home, but severe flares can lead to hospitalization. Our goal for your management plan is that it not only controls your symptoms, but also prevents flares.

Remember, your lungs do not get stronger or better at dealing with asthma if you "tough out" an attack without medication. Always take your medications as prescribed, and if you have any questions or side effects, call your doctor.

Helpful Resources:

• How to use a Metered-dose Inhaler (PDF) when your spacer isn't available
• How to use a DISKUS Inhaler (PDF)
• Asthma Check-Up Questionnaire (PDF)