Asthma medication

Question 1

How does Amazon One Medical define well-controlled asthma?

Answer

Asthma experts define well-controlled asthma by the following criteria:

• Your asthma symptoms require a rescue inhaler (quick-reliever medication like albuterol) no more than 2 days/week

• Your asthma doesn't wake you up more than 2 nights/month

• Your lung function (as measured by peak expiratory flow or spirometry) is normal or within 20% of your best PEF or FEV1)

• In the past 12 months, you haven't had more than one asthma exacerbation where you needed oral glucocorticoids and/or urgent medical care

• You're able to do all your normal activities

If you don't meet these criteria or you've needed to take oral steroids or receive urgent medical care for your asthma within the past 4 weeks, you'll need to see a primary care provider for an in-person evaluation. You may need a new medication or a different dose of medication to control your asthma symptoms.

Question 2

When should I go to the emergency room for asthma?

Answer

If you feel short of breath while sitting, you're lightheaded or wheezing, or you're experiencing severe chest pain, go directly to the nearest emergency room (ER).

If your symptoms feel more like asthma exacerbations you've had in the past, you should be seen today at your local primary care office or urgent care facility.

Question 3

How is asthma diagnosed?

Answer

There are several breathing tests your healthcare provider may recommend. The most common test of lung function is called spirometry. The test is a simple and painless way to check how well your lungs are working. To do the test, you blow into a tube connected to a machine called a spirometer. The spirometer measures how much air you can blow out and how quickly, which can show whether your airways are narrowed or blocked.

Another test for asthma measures how quickly you can blow air out after taking a deep breath. This is called the peak expiratory flow rate test, or PEFR.

Question 4

What does "severe asthma" mean?

Answer

People with severe asthma have frequent asthma attacks and trouble breathing most of the time, even when they are taking their medicine regularly. Their symptoms tend to be more difficult to control and may need more intensive treatments. Amazon One Medical providers can work with you closely to make sure you have access to effective treatments and partner with you to come up with an action plan for what to do during an asthma attack.

Question 5

What types of treatments are available for asthma?

Answer

There are two main types of medications prescribed for asthma: quick-relief (“rescue”) inhalers and long-term control medicines.

Quick-relief inhalers are used when you have asthma symptoms. They work quickly (within 5-15 minutes) to help you breathe better by relaxing the muscles around your airways. Long-term control medicines reduce swelling and mucus in the airways and are taken every day to prevent asthma attacks. Some medicines combine the two.

Each person's asthma is different. You and your healthcare provider can work together to establish the best treatment plan based on your symptoms and needs. By taking the right medicine at the right time, you'll be able to breathe better and do more of the things you want to do.

Question 6

I'm not great at carrying around multiple inhalers. Is there an option for me?

Answer

The latest research suggests that using a single inhaler that combines two treatments is a great option for many people with asthma. This type of inhaler includes two medicines: a steroid that helps to reduce inflammation and a medication called formoterol that acts quickly to relieve symptoms and helps keep the airways open for a longer time. Your provider can work with you to determine if this convenient treatment might be right for you.

Question 7

How do I know if I'm using my inhaler the right way?

Answer

Proper use depends on the type of inhaler you have and whether or not a spacer is used. The American Lung Association’s guide on how to use asthma medicine devices includes helpful instruction guides and videos for each type of inhaler. Your primary care provider or your pharmacist can also review the best technique for using your asthma medication.

Question 8

How do I get an inhaler for my asthma?

Answer

An asthma inhaler is a crucial part of treatment for people with asthma. If you're looking for a one-time renewal of your asthma prescription, Amazon One Medical can help.

Question 9

How do I know if my asthma treatments are working well?

Answer

Amazon One Medical providers will work with you to manage your asthma using a step-wise approach, adjusting the type and amount of medicine based on how well your asthma is controlled.

Asthma is considered well-controlled if you need your quick-relief inhaler less than 3 times per week, do not wake up with asthma during the night, and are able to do daily activities (including exercise) with few to no symptoms.

If your provider needs more detailed information to determine how well your asthma treatments are working, they may recommend breathing tests in addition to checking in about your symptoms.

Question 10

What are some ways I can control my asthma triggers?

Answer

People with asthma often experience triggers that make their asthma worse. Knowing what causes your asthma symptoms is an important step toward controlling your asthma. Common asthma triggers include:

• Respiratory infections ( (like colds, flu, and COVID-19) )

• Allergens (like pollen, pet dander, dust mites, and mold)

• Smoke and other air pollution

• Cold air

• Intense physical activity

• Strong emotions like stress or excitement

• Strong odors (like perfumes, cleaning supplies, and air fresheners)

Your provider can help you to track what makes your asthma worse and to find simple solutions to reduce or avoid your asthma triggers.

Question 11

How often should I see a healthcare provider for my asthma?

Answer

If you have asthma, it's important to review your asthma management plan with a heathcare provider at least once a year. Your medication could be stepped up or stepped down periodically, depending on your risk factors and how controlled your asthma is, but this requires careful monitoring.

If you've needed to take oral steroids more than 3 times in the past 12 months, it's especially important to review your asthma management plan with a trusted healthcare provider.

Question 12

Besides quick-relief or controller medication, what can help me manage my asthma?

Answer

• Avoiding environmental triggers

• Avoiding respiratory viruses

• Family support

• Having an asthma action plan

• Monitoring your peak expiratory flow (PEF)

• Quitting smoking

Question 13

What are the different ways of taking asthma medication?

Answer

Oral inhalation asthma medications can be delivered by metered dose inhaler (MDI), which uses HFA to propel medication into the lungs, or by dry powder inhaler (DPI), which is breath-actuated. Some asthma drugs can also be prescribed in vial form as nebulizer solution.

Question 14

What are the different types of asthma?

Answer

There are 4 main types of asthma:

• Intermittent

• Mild persistent

• Moderate persistent

• Severe persistent

Your type of asthma will determine what medication you're prescribed. But these 4 asthma diagnoses aren't set in stone. When managing asthma, healthcare providers frequently reassess their patients' symptoms, stepping up or down medication doses as appropriate. Although asthma is chronic, it's also dynamic, and it's not unusual for someone's type of diagnosis to change.

Question 15

Are people with asthma more likely to experience other atopic diseases?

Answer

Asthma, eczema (atopic dermatitis), and allergic rhinitis are all atopic diseases, meaning they're caused by an exaggerated and inappropriate immune response to a perceived threat. Essentially, your body's immune system recognizes a harmless substance (an antigen) as an enemy and launches a counterattack, leading to inflammation.

• Asthma: Bronchoconstriction caused by hyperresponsive airways

• Eczema (atopic dermatitis): Skin inflammation caused by dysregulation of the skin's barrier function

• Allergic rhinitis (AR): Nasal inflammation caused by sensitization to aeroallergens

These 3 conditions are often linked across the lifespan, with childhood eczema sometimes leading to allergic rhinitis and asthma in a process called the atopic march.

Did you know?

• Up to 80% of children with asthma are later diagnosed with asthma and/or allergic rhinitis

• Up to 40% of people with allergic rhinitis also have asthma

• Up to 50% of people with asthma also have allergic rhinitis

There's no clear consensus on what causes these atopic diseases, though experts know that our environment is at least partially responsible. Factors like diet, hygiene, infections, and air pollution have all been implicated in the atopic triad.

Question 16

What are the symptoms of an asthma attack in children?

Answer

Symptoms of an asthma attack in children can include the following:

• Shortness of breath (difficulty breathing)

• Wheezing (whistling when breathing)

• Coughing spells

• Rapid breathing

• Fatigue or low energy when playing

• Chest pain

• Skin discoloration (potential sign of respiratory distress or a closing airway)

• Fever

If your child is experiencing the symptoms of an asthma attack or has worsening asthma symptoms despite taking 3 doses of their rescue inhaler, seek in-person medical attention immediately.

Question 17

How is childhood asthma diagnosed?

Answer

Research shows that up to 80% of children with asthma will experience symptoms before they turn 5. These symptoms can include coughing, wheezing, shortness of breath, and chest tightness. They may be worse during certain times of day (like in the evening or early morning), and they may be triggered in specific situations, like during exercise or when exposed to allergens.

Before a healthcare provider diagnoses asthma, however, they'll want to take your child's full health history and rule out other potential causes for breathing symptoms, such as upper respiratory infections.

Question 18

How do you test for asthma in a child?

Answer

Asthma can be diagnosed through breathing tests like spirometry (measuring how much air a child can breathe in and out, and how fast) and the peak expiratory flow test (measuring how quickly your child can blow out air after taking a deep breath).

These breathing tests often aren't reliable in younger children, however, so family medicine providers may rely more on clinical assessments if a child is under 5 years old.

Question 19

How do doctors treat childhood asthma?

Answer

Healthcare providers recommend different treatments based on the frequency and severity of a child's asthma symptoms. The overall goal is to keep childhood asthma symptoms under control and prevent asthma attacks or asthma exacerbations, while also avoiding any adverse side effects of medication.

• If a child has mild, occasional asthma symptoms (intermittent asthma), a provider might prescribe quick-relief rescue inhalers like albuterol to help with breathing.

• If a child has persistent asthma symptoms (like more than twice a week or 2 nights/month), a provider might prescribe a low dose of daily inhaled corticosteroids (ICS).

• If a child has severe asthma, a provider might step up the dose of the steroid inhaler, add different types of inhaled or oral medication (like montelukast), or refer a child to an asthma specialist.

In addition to prescription asthma medication, providers may also recommend avoiding asthma triggers like known allergens, and having regular asthma check-ins to determine if a medicine or dose needs to be changed.

Question 20

Does childhood asthma go away?

Answer

Childhood asthma may go away by adulthood in up to 40% of cases, but the majority of children with asthma will continue to have symptoms as adults. Certain risk factors, like allergic sensitization and being younger when symptoms start, are associated with childhood asthma that persists into adulthood.

Question 21

Do I have to be the parent or guardian of the child seeking care?

Answer

Yes. A parent or legal guardian must initiate the child's care and be present during their treatment.

Question 22

What type of healthcare provider will treat my child?

Answer

Children are treated by family practice physicians or licensed family nurse practitioners (FNPs). You'll be able to see the credentials of your child's provider after they're assigned to your child's treatment.

Question 23

Can I get a doctor's note for my child?

Answer

Yes. After your child completes their treatment, their One Medical provider can write excused absence notes, back-to-school notes, and no-play notes for sports or other activities if medically appropriate.

Question 24

What kind of online treatments can I request for my child?

Answer

At this time, parents and legal guardians can request treatments for their children aged 2 through 11 years old for the following health conditions through Amazon One Medical On-Demand Care (formerly Pay-per-visit):

• Head lice

• Pink eye

• Skin issue

• Eczema

• EpiPen prescription renewals

• Asthma prescription renewals

Question 25

Clinical sources

Answer

1. Bel E. H. (2013). Mild asthma. The New England journal of medicine, 369(24), 2362.

2. Castillo, J. R., Peters, S. P., & Busse, W. W. (2017). Asthma Exacerbations: Pathogenesis, Prevention, and Treatment. The journal of allergy and clinical immunology. In practice, 5(4), 918–927.

3. Hill, D. A., & Spergel, J. M. (2018). The atopic march: Critical evidence and clinical relevance. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 120(2), 131–137.

4. Kemp, J. P., & Kemp, J. A. (2001). Management of asthma in children. American family physician, 63(7), 1341–1354.

5. Martinez, F. D., Wright, A. L., Taussig, L. M., Holberg, C. J., Halonen, M., & Morgan, W. J. (1995). Asthma and wheezing in the first six years of life. The Group Health Medical Associates. The New England journal of medicine, 332(3), 133–138.

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With your membership you can:

Asthma medication

How it works

Common types of asthma medication

Short-acting beta agonists (SABAs)

Inhaled corticosteroids (ICSs)

Long-acting beta agonists (LABAs)

ICS-LABA combination inhalers

Anticholinergic agents

Leukotriene inhibitors

Can I request an asthma prescription renewal for my child?

What is asthma?

What are asthma symptoms and how do you control them?

Frequently asked questions

About asthma treatment

About asthma care for children