Wheezing, a tight chest and coughing at night are classic asthma symptoms. Common triggers, rescue vs controller inhalers, what to do in an attack and when to call 911.
What is asthma?
Asthma is a long-term condition in which the airways in the lungs are inflamed and extra sensitive. When something triggers them, the muscles around the airways tighten, the lining swells and more mucus is made, so less air gets through. About 25 million people in the US have asthma, and it can start at any age.
Symptoms
- Wheezing – a whistling sound when you breathe
- Shortness of breath
- A tight feeling in the chest
- Coughing, especially at night, early in the morning, during exercise or when laughing
Symptoms often come and go, and can be mild one week and worse the next. In some people, a long-lasting dry cough is the only symptom.
Common triggers
- Colds, flu and other chest infections
- Allergens: pollen, dust mites, mold, pet dander and cockroaches
- Tobacco smoke, wood smoke and air pollution
- Cold, dry air and sudden changes in weather
- Exercise
- Strong smells, perfumes and cleaning products
- Stress and strong emotions
- Some medicines, such as aspirin and ibuprofen in some people, and beta-blockers
- Acid reflux
Rescue and controller inhalers
Rescue (quick-relief) inhalers, such as albuterol, relax the airway muscles within minutes and last 4–6 hours. You use them when symptoms flare. If you need your rescue inhaler on more than 2 days a week (apart from before exercise), your asthma isn't well controlled – talk to your doctor.
Controller (maintenance) inhalers contain an inhaled steroid that calms inflammation over time, often combined with a long-acting bronchodilator – for example budesonide and formoterol or fluticasone and salmeterol. They're used every day, even when you feel well. Some people are prescribed budesonide-formoterol as both their daily and their rescue inhaler.
Our guide to asthma inhalers explains the different types and US brand names. Ask your doctor for a written asthma action plan, and ask a pharmacist to check your inhaler technique – many people don't get the full dose. A spacer helps. PharmacyFarm dispenses inhalers after our pharmacist has verified your prescription.
What to do during an asthma attack
- Sit upright and try to stay calm. Loosen tight clothing.
- Use your rescue inhaler as your asthma action plan tells you, with a spacer if you have one.
- If you don't feel better, or you're getting worse, call 911 – don't wait.
Call 911 straight away if:
- Your lips, face or fingernails are turning blue or gray
- You're too breathless to speak in full sentences or to walk
- The skin between your ribs or at your neck pulls in with each breath
- Your rescue inhaler isn't helping, or the relief wears off quickly
- You feel drowsy or confused
When to see a doctor
See a doctor if you have symptoms that might be asthma – a simple breathing test (spirometry) can confirm it. Also see your doctor if asthma wakes you up more than twice a month, you need your rescue inhaler more than 2 days a week, after any attack that needed urgent care, or if you have side effects from your medicines.