The principal goals of asthma management are: 1) To prevent the occurrence of symptoms that are chronic or troublesome (such as coughing or breathlessness after exercise) in the nighttime or in the early morning; 2) To maintain near normal pulmonary function; 3) To sustain normal levels of physical activity, including exercise; 4) To prevent the recurrence of asthma exacerbations and to reduce visits to the ER or hospital; 5) To provide optimal pharmacotherapy with minimal adverse effects; and 6) To provide asthma care that meets the needs and expectations of patients and their families. Care of these patients by clinicians well versed in the underlying pathophysiology of asthma as well as currently available comprehensive pharmacotherapeutic agents, can achieve these goals.
Optimal asthma management must include objective monitoring of lung function to determine whether the goals of therapy are being met; environmental control measures such as allergen avoidance; patient education; and appropriate use of pharmacotherapy. Pharmacologic therapies for asthma are grouped into one of two classes according to the duration of their effects: quick-relief medications and long-term control medications. The goals of pharmacologic therapy are to prevent and control asthma symptoms, to lessen the frequency and severity of exacerbations, and to counteract airflow obstruction. Patients with persistent asthma require both quick-relief and long-term control medications to alleviate their symptoms and deter the ongoing disease process.