Asthma Treatment Using Step-Wise Approach

What Is Asthma?

The primary danger of asthma as a disease is the fact that it requires different interventions based on the symptoms that an individual has. Additionally, the nature of the condition implies that one can have either an attack or an asthma-free day, which requires different approaches to management. Asthma affects many people in the US, and thus an advanced practice nurse must be aware of all aspects that can help patients. Because the condition in question is chronic, cooperation between a healthcare provider and a patient is necessary to set appropriate goals and choose treatment options. Long-term control of the condition involves medications that help ease the symptoms and allow individuals to lead a normal life (Zahran, Bailey, Qin, & Johnson, 2017).

Medications for the Asthma Treatment

Even when they are symptom-free, many asthmatics need to take daily long-term management drugs. The following are some examples of long-term control drugs:

  • Inhaled corticosteroids
  • Leukotriene modifiers
  • LABAs
  • LAMAs
  • Combination inhalers

By relaxing the muscles in the airways, these asthma drugs, also known as short-acting beta-agonists (SABA), help to open the lungs. Frequently referred to as “rescue drugs,” they can lessen deteriorating symptoms or terminate an asthma attack already in progress:

  • Short-acting beta-agonists such as albuterol
  • Ipratropium
  • Oral corticosteroids

The medications that target allergens (allergen triggers) that can cause asthma:

  • immunotherapy
  • sublingual immunotherapy tablets
  • allergy medications (Huang & Pansare, 2021).

Stepwise Approach

Based on age and asthma severity, the National Asthma Education and Prevention Program suggests treating asthma in stages. The patient’s starting point in the stages will depend on how severe her asthma is right now. A patient’s course of therapy could change if his/her doctor adheres to different recommendations. If one medication is unable to control asthma in two to six weeks, the therapy is advanced in one step. This can entail raising the dosage or including a new medication. The patient may move down one step if asthma has been under good control for at least three months. If asthma is still under control after going down a step, the doctor may try a lower dose or stop using a medication.

In general, the types of asthma control medicines prescribed for the six steps of asthma severity include:

  • Inhaled steroids
  • Short-acting beta-agonists (SABAs)
  • Long-acting beta-agonists (LABAs)
  • Long-acting muscarinic antagonists (LAMAs)
  • Leukotriene receptor antagonists (LTRAs)
  • Theophylline
  • Asthma biologics
  • Immunotherapy.

How Can It Assist?

The method was developed to ensure that individuals are not over-treated with unnecessary medication in cases when their symptoms are less severe. The approach is viable because of asthma’s nature and the possibility of controlling the condition over extended periods. Siddaway (2018) states that “asthma management guidelines recommend an individualized approach, in which pharmacological treatment is reduced when appropriate to ensure the lowest effective dose of inhaled corticosteroid is being used” (p. 18).


Huang, J., & Pansare, M. (2021). New treatments for asthma. Immunology and Allergy Clinics of North America, 41(4), 555–569.

Meghdadpour, S., & Lugogo, N. L. (2018). Medication regimens for managing stable asthma. Respiratory Care, 63(6), 759–772.

Siddaway, D. (2018). Stepping down asthma treatment: perceptions of primary care staff. Nursing Times, 114(4), 18-21. Web.

Zahran, H. S., Bailey, C. M., Qin, X., & Johnson, C. (2017). Long-term control medication use and asthma control status among children and adults with asthma. Journal of Asthma, 54(10), 1065–1072.

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