Asthma medications for adults, teens, and children older than age 5

Content provided by Healthwise

Asthma medications for adults, teens, and children older than age 5

The U.S. National Asthma Education and Prevention Program (NAEPP) has recommended the following approach for treating asthma in adults, teens, and children older than 5 years of age.¹

**Asthma treatment recommendations**
Severity	Daily medications required to maintain long-term control
Severe persistent	Preferred: High-dose inhaled corticosteroids AND Long-acting inhaled beta₂-agonists AND IF NEEDED Corticosteroid tablets or syrup long-term (2 mg/kg/day, generally do not exceed 60 mg/day). (Make repeated attempts to reduce tablets or syrup, and maintain control with high-dose inhaled corticosteroids.) Treatment by a specialist is recommended if you are using oral corticosteroids long-term.
Moderate persistent	Preferred: Low- to medium-dose inhaled corticosteroids and long-acting inhaled beta₂-agonists Alternative: Increase inhaled corticosteroids within medium-dose range OR Low- to medium-dose inhaled corticosteroids and either leukotriene modifier (also called leukotriene receptor antagonist) or theophylline (a methylxanthine)
Moderate persistent	If needed (particularly in people with recurring severe asthma attacks): Preferred: Increase inhaled corticosteroids within medium-dose range, and add long-acting inhaled beta₂-agonists. Alternative: Increase inhaled corticosteroids within the medium-dose range, and add either leukotriene modifier or theophylline.
Mild persistent	Preferred: Low-dose inhaled corticosteroids Alternative: Leukotriene modifier Less commonly, your doctor may recommend mast cell stabilizers (cromolyn sodium or nedocromil) or theophylline (such as Uniphyl).
Mild intermittent	No daily medication needed. Severe attacks may occur, separated by long periods of normal lung function and no symptoms. A course of corticosteroid tablets, syrup, or injection is recommended.

**Recommendations for quick relief**
	Treatment recommendations
All patients	Short-acting bronchodilator: 2 to 4 puffs of short-acting inhaled beta₂-agonists as needed for symptoms Intensity of treatment will depend on severity of episode; up to 3 treatments at 20-minute intervals or a single nebulizer treatment as needed. Course of corticosteroid tablets, syrup, or injection may be needed. Use of short-acting beta₂-agonists more than 2 times a week (except for exercise) or more than 1 canister in 3 months may indicate the need to start (or increase) long-term control therapy.

Cromolyn and nedocromil (mast cell stabilizers) are alternatives in mild persistent asthma, but they do not control asthma as effectively as corticosteroids.²

In moderate persistent asthma, using long-acting inhaled beta₂-agonists along with inhaled corticosteroids is the best combination of medications to improve lung function and symptoms and to reduce overuse of quick-relief medications.¹

A leukotriene pathway modifier or theophylline also may be added to corticosteroids, but they do not improve asthma control as effectively as a long-acting inhaled beta₂-agonist along with corticosteroids.¹

Concerns for children

Leukotriene pathway modifiers are available in oral formulations (swallowed rather than inhaled) that may be more convenient for young children.

Young children should receive long-term treatment if they have had more than three wheezing episodes lasting more than 1 day in the past year and they have risk factors for asthma such as allergic rhinitis or a parent with a history of asthma.¹

If your child has severe asthma attacks, he or she may need to take corticosteroids by mouth. Corticosteroids by mouth also may be necessary at the beginning of a viral respiratory infection.

References

Citations
National Institutes of Health (2002). National Asthma Education and Prevention Program Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma—Update on Selected Topics 2002. Clinical Practice Guidelines (NIH Publication No. 02–5075). Bethesda, MD: U.S. Department of Health and Human Services.
National Institutes of Health (1997). Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. Clinical Practice Guidelines (NIH Publication No. 97-4051). Bethesda, MD: U.S. Department of Health and Human Services.

Credits

Author	Maria G. Essig, MS, ELS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Harold S. Nelson, MD - Allergy and Immunology
Last Updated	May 15, 2007

Last updated:	May 15, 2007
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Harold S. Nelson, MD - Allergy and Immunology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman

This information is not intended to replace the advice of a doctor. By using AOL Body, you indicate that you have read, understood, and agreed to our Terms of Service, and AOL Body Advertising Policy. Read more about our content partners.