What not to do in asthma?

Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children.

To control asthma successfully, it is essential to follow your asthma action plan as prescribed by your doctor. It is also important to avoid triggers that can exacerbate asthma symptoms or provoke an asthma attack. This article discusses what not to do when you have asthma.

Do Not Skip Medications

One of the biggest mistakes people make in managing their asthma is skipping medications, even when symptoms improve. Asthma is a chronic disease that requires daily management, even when you are feeling well. Skipping medications can cause asthma symptoms to flare up again.

There are two main types of medications used to treat asthma:

Long-Term Control Medications

These medications must be taken daily on a long-term basis to keep asthma under control, even in the absence of symptoms. They include:

– Inhaled corticosteroids – These are anti-inflammatory drugs that reduce airway inflammation and swelling that narrow the breathing tubes. They are the most effective and important medications for long-term asthma control. Examples include beclomethasone (Qvar), budesonide (Pulmicort), fluticasone (Flovent), mometasone (Asmanex), ciclesonide (Alvesco).

– Long-acting bronchodilators – these drugs keep the airways open by relaxing the muscles around the airways. They include long-acting beta2-agonists such as salmeterol (Serevent) and formoterol (Foradil, Perforomist). They are usually taken with an inhaled corticosteroid.

– Leukotriene modifiers – these oral medications block leukotrienes, which are immune system chemicals that cause symptoms of asthma. Examples include montelukast (Singulair), zafirlukast (Accolate), zileuton (Zyflo).

– Theophylline – this oral medication relaxes airway muscles to open up breathing passages.

– Anti-IgE therapy – Omalizumab (Xolair) is an injectable drug for patients 12 years and older with moderate or severe persistent allergic asthma that is not controlled with ICS. It blocks the antibody IgE which plays a role in allergy and asthma.

Skipping long-term control medications can cause increased airway inflammation and narrowing of airways over time. This makes symptoms worse and increases the risk of severe asthma attacks. Even if you are feeling well, taking long-term control medications as prescribed is crucial in keeping asthma under control.

Quick-Relief Medications

These medications provide rapid, short-term relief of asthma symptoms during an asthma attack. They include short-acting beta2-agonists such as albuterol (ProAir, Proventil, Ventolin). They quickly relax tightened airway muscles to help breathing problems.

People with persistent asthma need to carry their quick-relief inhalers with them at all times to treat acute symptoms and flare-ups. Skipping quick-relief medications during an attack prolongs asthma symptoms and can worsen airflow obstruction. This is dangerous as it increases the risk of an asthma emergency.

Do Not Ignore Asthma Triggers

Asthma triggers refer to factors that can inflame your airways and lead to asthma symptoms. Triggers cause existing airway inflammation to worsen. Different people have different asthma triggers. Common triggers include:


Allergens such as pet dander, pollens, mold, and dust mites can trigger an allergic response and asthma symptoms in people with allergic asthma. Up to 80% of people with asthma have allergies. To control allergen-induced asthma:

– Use allergen-proof bed covers and wash bedding weekly in hot water to reduce dust mites.

– Keep pets out of bedrooms and clean up pet dander.

– Close windows and stay indoors when pollen and mold counts are high. An air conditioner also filters out allergens.

– Remove carpets and choose hardwood or leather furniture to reduce dust mites and pet dander. Clean regularly.


Substances like cigarette smoke, air pollution, chemicals, and strong fragrances can irritate airways and worsen asthma. Avoiding these lung irritants can prevent asthma flare-ups:

– If you smoke, quit smoking, and avoid secondhand smoke. Avoid polluted areas.

– Use unscented laundry detergent and cleaning products. Avoid room deodorizers and scented candles.

– Ask smokers not to smoke around you. Don’t allow smoking in your home or car.


Respiratory infections like flu, common cold, and sinus infections can exacerbate asthma. Good hygiene and flu vaccines can reduce infections. Get immediate treatment for respiratory infections to avoid complications.

Weather Changes

Cold, dry air can trigger asthma symptoms in some people. Cover nose and mouth with a scarf on cold, windy days. Use a humidifier at home to humidify dry indoor air during winter.


Vigorous activity can induce asthma symptoms due to drying and cooling of airways with heavy breathing. Using an inhaler before exercise can prevent symptoms. Warming up and cooling down slowly also helps.

Strong Emotions and Stress

Laughing, crying, anxiety, and stress can sometimes precipitate asthma episodes by altering breathing patterns. Stress management, therapy, and relaxation techniques help in controlling mood-associated asthma.

Certain Medications

Some medications like aspirin, ibuprofen, and beta-blockers can worsen asthma. GERD medicines, ACE inhibitors, NSAIDs, and hormone therapy have also been implicated. Discuss your medications with your doctor.

Staying away from your specific triggers is vital in keeping asthma under control. Keeping an asthma diary can help identify your triggers.

Do Not Take Insufficient Medication During an Attack

During an asthma attack, take your quick-relief inhaler (short-acting bronchodilator) as prescribed. Using too little medication can make the attack last longer and get worse.

Follow these steps during an asthma attack:

– At the first sign of symptoms, use your short-acting bronchodilator inhaler. Albuterol is the most common one. This quickly relaxes tight airway muscles to ease breathing.

– Sit upright and take slow, steady breaths. Avoid lying down as it makes breathing more difficult.

– If symptoms persist after 10-15 minutes, repeat the inhaler.

– For severe symptoms, take 2-3 puffs every 20 minutes for up to 1 hour or until you get medical help. This rapidly delivers adequate doses of medication needed to relieve severe attacks.

– For mild attacks, 1-2 puffs may be sufficient till symptoms remit.

– Seek emergency care if symptoms do not improve after initial treatment and repeat dosing. Call 911 if you are too breathless to speak, lips or fingernails turn blue, or you are struggling for breath.

Using your quick relief inhaler correctly and sufficiently during an asthma attack can rapidly ease symptoms and prevent a medical emergency. Underusing medication can worsen airflow obstruction and be life-threatening.

Do Not Delay Seeking Medical Care for Severe Symptoms

Severe asthma attacks can take a life-threatening turn very quickly. Lower than normal oxygen and dangerously high carbon dioxide levels can develop rapidly during severe asthma exacerbations. Never take chances with severe symptoms. Urgent medical treatment is crucial.

Call 911 or go to the emergency room right away if:

– Your medications do not provide quick relief from an asthma attack. Symptoms get worse instead of better.

– Breathing becomes extremely difficult and airways close up badly.

– You have chest tightness and chest pain along with shortness of breath.

– You are unable to speak more than short, gasping phrases.

– Your chest and neck are pulling in with breathing effort.

– Lips or fingernails turn blue from lack of oxygen.

– Your peak flow meter reading drops significantly below your personal best number.

– You develop other medical problems like fever, chest pain, heart palpitations, confusion, fainting, or have a seizure.

Severe asthma attacks can result in respiratory failure if left untreated. Seeking prompt medical care can provide oxygen, breathing treatments, steroids, and other measures to open up airways and prevent a life-threatening emergency. Call 911 without delay with serious symptoms.

Do Not Adjust Medications Without Consulting Your Doctor

When asthma is under good control, there may be a temptation to lower your medication doses on your own or stop medications altogether. But this should never be done without consulting your doctor. Asthma requires careful, regular monitoring and medications need to be adjusted under medical guidance.

Arbitrarily increasing medication doses during worsening asthma is also ill-advised. This can result in excessive dosing and intolerable side effects. Your doctor may need to reassess your condition and adjust medications appropriately to achieve better asthma control.

Reasons not to alter your asthma treatment plan on your own:

– Your doctor prescribes the lowest effective doses needed to control your asthma. Reducing doses risks losing asthma control.

– Suddenly stopping long-term control medications like inhaled steroids can trigger dangerous symptom flare-ups and asthma attacks.

– Increasing quick-relief bronchodilators without medical advice can result in excessive, harmful dosing if asthma deteriorates. You may need oral steroids instead.

– You may be overmedicating yourself if increasing doses does not give symptomatic relief. See your doctor to identify issues.

– Symptom changes over time can mean your treatment plan needs adjustment to achieve better asthma control. Your doctor needs to evaluate changes.

Consult your doctor before making any changes to your medications. Proper medication adjustments require medical supervision. Make sure to keep regular appointments even when your asthma seems stable. Let your doctor assess asthma control and modify treatment as needed.

Do Not Ignore Signs of Poorly Controlled Asthma

Asthma is well controlled when you have:

– No chronic asthma symptoms like coughing, wheezing, shortness of breath, chest tightness

– No asthma flare-ups that disrupt daily activities

– No nighttime awakenings due to asthma

– No need for quick-relief inhaler more than twice a week

– No asthma attacks requiring oral steroids

Pay attention to signs that your asthma may be worsening or becoming uncontrolled:

– Asthma symptoms requiring quick-relief medication more than 2 days a week

– Waking up most nights due to asthma symptoms

– Limited physical activity due to asthma

– Frequent use of quick-relief inhaler without symptom improvement

– Peak flow readings below your personal best

– Reduced lung function shown in pulmonary function tests

– Worsening or lack of symptom control after using oral steroids

Worsening asthma control increases your risk of attacks. Chronic uncontrolled asthma can cause permanent lung damage over time. Seeing your doctor promptly when your asthma destabilizes enables timely treatment changes to regain control before serious consequences occur.

Do Not Miss Scheduled Medical Appointments

Consistent follow-up with your asthma doctor is essential for staying healthy. Make sure to keep regular medical appointments even when your condition is stable. Follow-up visits enable your doctor to:

– Track your asthma control status and lung function

– Review your medications and adjust as needed

– Assess if your action plan needs updating

– Identify potential issues that destabilize your asthma

– Check for side effects of medications

– Catch early signs of declining lung function from chronic uncontrolled asthma

– Recommend additions or changes to treatment when asthma is unstable

– Renew asthma device prescriptions so you don’t run out of medications

Regular doctor visits allow modifying your treatment plan when needed to prevent exacerbations. Especially make sure to visit your doctor if your asthma worsens. Missing appointments prevents your doctor from assessing changes in your condition over time. This can delay needed treatment adjustments.

Do Not Stop Asthma Medications During Pregnancy

If you have asthma and get pregnant, it is crucial to continue taking your asthma medications as prescribed during pregnancy. Stopping asthma drugs can seriously endanger both mother and baby due to uncontrolled asthma. Well controlled asthma is vital for a healthy pregnancy.

Some key points on managing asthma during pregnancy:

– Poorly controlled asthma increases risks of pregnancy complications like high blood pressure, preeclampsia, diabetes, preterm birth, low birth weight baby, stillbirth.

– Untreated asthma attacks can deprive the baby of sufficient oxygen. This can result in infant death.

– Controlled asthma improves oxygen supply to the developing baby for proper growth.

– Most asthma medicines like inhaled steroids and quick-relief bronchodilators are low risk in pregnancy. Your doctor may adjust doses for optimal control.

– Oral steroids may be used for severe attacks during pregnancy if needed. The risks of uncontrolled asthma outweigh potential steroid side effects.

– Medications like ACE inhibitors, aspirin, ibuprofen might need to be changed during pregnancy.

Make sure to monitor your asthma diligently during pregnancy. See your doctor immediately if your asthma worsens or becomes difficult to control. Your medications may need adjustment to keep your asthma under tight control for a healthy pregnancy.

Do Not Underestimate Asthma

When asthma seems well controlled, it is easy to become complacent and underestimate your condition. But asthma requires lifelong care and attention. Failing to take asthma seriously can have grave consequences.

Reasons to take your asthma seriously:

– Asthma symptoms can flare up any time if you underestimate your triggers or skip medications

– Chronic untreated asthma can cause permanent lung damage over time, with symptoms getting progressively worse

– Poorly controlled asthma is linked to other health problems like respiratory infections, sinusitis, COPD, reduced immunity

– Uncontrolled asthma causes poorer quality of life with lower activity tolerance and more sick days

– Asthma attacks can quickly spiral out of control and become life-threatening emergencies when not managed properly

– Effective asthma treatment enables normal activity levels and good quality of life

Regardless of whether your asthma seems mild or severe, taking it seriously and adhering to your treatment plan is key. Follow your doctor’s instructions, avoid triggers, and stick to your medication regimen. Recognize worsening symptoms early and make adjustments. Well managed asthma lets you live fully and thrive.


Asthma control takes a joint team effort between you and your doctor. While your doctor prescribes appropriate treatment, you need to take medications regularly, avoid triggers, monitor symptoms, and follow up as scheduled. Failing to do so risks poor asthma control, reduced quality of life, permanent lung damage, and dangerous attacks. Make sure to take your asthma seriously and take responsibility for managing it properly. Doing so will enable you to breathe easy and stay healthy.

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