Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2009;79(9):online

See related article on asthma.

What is asthma?

Asthma (AZ-muh) is a long-term lung disease that causes your breathing tubes to narrow. Many things can cause an asthma attack, including allergies, infections, and weather changes. Asthma causes wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. Although asthma affects people of all ages, it usually starts in childhood.

How can I control my asthma?

Make an action plan. This plan tells you what to do when your asthma is not doing well, and when to call or see your doctor. Studies show that people who follow an action plan go to the emergency department less often and have fewer serious problems. You can complete your action plan with your doctor.

Know what triggers your asthma, and learn how to avoid or cope with these triggers.

Learn how to use your medicines the right way. If you take inhaled medicines, you should practice using your inhaler at the doctor's office. If you take long-term control medicines, take them daily. Follow your doctor's instructions.

How do I know when my asthma is under control?

The easiest way to know if your asthma is under control is if you pass the “Rules of Two” test:

  • Are you using your fast-acting (rescue) inhaler more than twice a week?

  • Are you waking up at night more than twice a month with asthma symptoms?

  • Are you using more than one canister of your fast-acting inhaler per month?

If you answer “no” to ALL of these questions, your asthma is probably well controlled. If you answer “yes” to any of these questions, you should talk with your doctor.

How do I know when I'm at risk of an asthma attack?

Be aware of your triggers, and plan ahead to avoid them. If there are certain times of the year when you may have more triggers (for example: heavy pollen seasons, such as springtime), you may need to be more careful during those times.

If you answer “yes” to the “Rules of Two,” or if you enter the “Yellow Zone” (60 to 80 percent of your personal best peak flow meter reading) on your action plan, you are at a higher risk of an asthma attack.

Monitor your asthma between doctor visits by keeping track of your symptoms, triggers, fast-acting inhaler use, and peak-flow meter readings (if this has been helpful for you or your doctor).

What are the recommended treatments?

Treatment depends on the type of asthma you have. You and your doctor can make treatment decisions together.

Fasting-acting inhalers are used when you begin to wheeze or have other asthma symptoms. These act quickly but should not be used regularly, except by people who need to use them right before exercising. Talk with your doctor about how to use these inhalers. For persistent asthma, guidelines recommend long-term controller medications that are taken daily.

When should I see my doctor?

Having an action plan is the best way to know when to see your doctor.

You should get a checkup every year, or at least twice a year if you use a long-term controller medicine. It may be helpful to have these visits just before and after the time of the year when your asthma usually flares up.

Where can I get more information?

Your doctor

American Academy of Allergy, Asthma, and Immunology

American Academy of Family Physicians

American College of Allergy, Asthma, and Immunology

Asthma and Allergy Foundation of America

National Heart, Lung, and Blood Institute

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