Asthma and Stepwise Management

Subject: Pulmonology
Pages: 4
Words: 881
Reading time:
4 min
Study level: College

Asthma is a chronic condition that affects one’s airways and lungs. Treatment options for this condition have two purposes – to alleviate symptoms when they arise and to prevent new exacerbations from occurring in the future. Following the first approach to asthma, individuals can utilize quick-relief drugs during an asthma attack. The second variety of medications is long-term control drugs, which need to be taken by a person daily or regularly. Both types can have a significant impact on patients’ well-being and everyday life – their side effects and dosage requirements are important to consider.

As asthma can develop in persons of any age, its treatment strategies should be flexible to address the changing needs of every age and individual characteristics (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). The GINA (Global Initiative for Asthma) guidelines present a stepwise management approach that is focused on stabilizing and controlling symptoms with adjustable drug therapy (Reddel et al., 2016). This plan allows health care providers to assess patients’ conditions and gives patients the tools to control their disease effectively.

Long-Acting and Quick Relief Treatment Options and Their Impact

The use of long-term medications, also called controllers, is essential for reducing the possibility of exacerbations such as asthma attacks. These include a variety of drugs such as inhaled corticosteroids, beta-2 agonists, their combinations, theophylline, and leukotriene receptor agonists (LTRA) (Horak et al., 2016). The primary function of corticosteroids is to reduce inflammation in the airways, making the breathing process easier. Beta-2 agonists can be long- and short-acting, the first type being a component of control medications. It opens the airways and is used in combination with inhaled corticosteroids to decrease possible adverse effects. Furthermore, theophylline and LTRA are also utilized as bronchodilators which relax the muscles and keep airways open.

As can be observed, long-term medications function as bronchodilators, giving people with asthma the ability to breathe easily. However, their use can also lead to some negative health-related outcomes, especially if they are taken incorrectly. For example, in children, inhaled corticosteroids may cause growth suppression (Castro-Rodriguez, Custovic, & Ducharme, 2016). Other side-effects of long-acting treatment options include severe asthma attacks, depression, and mood changes (Ban et al., 2015). Thus, patients should always consult their health care providers about negative outcomes and adjust their treatment.

Patients can use quick-relief medications during asthma attacks or before engaging in physical activity. They should be taken as per the physician’s instructions and should not replace long-term solutions for some symptoms. These drugs include short-acting beta-2 agonists, short-acting anticholinergics, and oral corticosteroids which are not recommended due to their severe side effects (Horak et al., 2016). Their main purpose is similar to that of long-acting solutions – they serve as bronchodilators. Nonetheless, their impact is much more rapid while their time of action is short. A person whose dosage of long-acting drugs is correct should not need quick-relief solutions regularly. Their side effects include anxiety, restlessness, and irregular heartbeat (Horak et al., 2016). While their influence on the body is short, the strength of these medications should be taken into consideration.

The Stepwise Approach to Asthma

Persistent asthma is a chronic disease that is managed effectively with long-acting medicine. However, each person’s body responds differently to drugs, thus requiring health care providers to create a system for determining which types and doses of medication work efficiently. A recognized strategy for treating asthma is the stepwise approach (Reddel et al., 2016). It presents several steps with recommendations and a set of actions to move between these steps. Each level is designed for different ages to address the needs of children and adults. The movement between the multiple phases is based on regular assessments by a health care provider. Thus, the first step is the starting point for a person who shows symptoms of asthma – it includes short-acting beta-2 agonists (Horak et al., 2016). If a person’s asthma is intermittent, he/she can continue this line of treatment. However, if the symptoms reveal the presence of persistent asthma, other steps need to be taken. The following phases engage increasing doses of inhaled corticosteroids, LTRA, and long-acting beta-2 agonists (Horak et al., 2016).

The benefits of this system lie in its flexibility and adjustability to individual needs. Regular reassessments allow health care providers to determine whether the current dose is necessary or it can be lowered to decrease the impact of drugs on the patient’s body. Moreover, this system is focused on stability, as movements up the steps are initiated only if a person cannot control their asthma (Reddel et al., 2016). Moreover, children’s guidelines differ from that of adult ones, which assures that their response to the drugs is evaluated accordingly to their age (Castro-Rodriguez et al., 2016). Moreover, patients also gain more control over their disease, understanding how long- and short-acting medications impact their health.


The treatment of asthma is a systematic process that needs frequent adjustments and reassessments. The use of quick-relief medications may be unnecessary for patients, whose long-acting treatment is effective. To help individuals manage asthma, health care providers should engage the stepwise management approach which uses various solutions and adjusts doses regularly to lower the use of drugs as much as possible. The focus of this system is stability, allowing patients to assume control over their health.


Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Ban, G. Y., Ye, Y. M., Lee, Y., Kim, J. E., Nam, Y. H., Lee, S. K.,… & Premier Researchers Aiming New Era in Asthma and Allergic Diseases (PRANA) Study Group. (2015). Predictors of asthma control by stepwise treatment in elderly asthmatic patients. Journal of Korean Medical Science, 30(8), 1042-1047.

Castro-Rodriguez, J. A., Custovic, A., & Ducharme, F. M. (2016). Treatment of asthma in young children: Evidence-based recommendations. Asthma Research and Practice, 2(5), 1-11.

Horak, F., Doberer, D., Eber, E., Horak, E., Pohl, W., Riedler, J.,… Studnicka, M. (2016). Diagnosis and management of asthma – Statement on the 2015 GINA Guidelines. Wiener Klinische Wochenschrift – The Central European Journal of Medicine, 128(15-16), 541-554.

Reddel, H. K., Bateman, E. D., Becker, A., Boulet, L. P., Cruz, A. A., Drazen, J. M.,… FitzGerald, J. M. (2015). A summary of the new GINA strategy: A roadmap to asthma control. European Respiratory Journal, 46(3), 622-639.