Other Treatments and ‘Add-on Therapies’
If your asthma is not well controlled by using your preventer/controller medicine regularly, you should go and see your doctor. Before increasing the dose of your preventer/controller, your doctor may suggest other treatments or 'add-on therapies' to help you.
The first 'add-on therapy' to be tried is usually a leukotriene receptor antagonist (LRA) which blocks the action of naturally occurring chemicals in the lungs, called leukotrienes, which lead to inflammation in both upper and lower airways. If asthma treatment remains suboptimal after the addition of an LRA, a long acting reliever may be prescribed, in addition to your steroid preventer/controller. Long acting reliever should always be taken with an inhaled steroid. Your doctor may prescribe these separately or in a combined inhaler.
Long-acting relievers go on working for a longer time than normal relievers and are usually taken twice a day to have an effect. Another treatment which may be prescribed by your doctor is a slow-releasing theophylline.
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Before changing any medicines or offering you new ones, your doctor or nurse should speak to you about how you take your medicines, if you are taking them regularly and whether you are taking the prescribed dose
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If you are taking an 'add-on therapy' that is not helping to control your asthma symptoms, your doctor may stop it before you start a different treatment.
When are steroid tablets used in asthma?
If your asthma gets really bad, your doctor may give you a short course of steroid tablets. They work quickly and powerfully to help calm down your inflamed airways. Short courses of tablets, anything from 3-14 days, will not give any long-term side effects. Steroid tablets can lower the body's resistance to chickenpox, so you should contact your doctor if you are taking steroids and come into contact with chickenpox. A small minority of people with severe asthma need to take steroid tablets for a longer period. These people are more at risk of experiencing side effects. Always talk to your doctor or practice nurse about any concerns you have about the side effects of your asthma treatment.
Concerns About Steroids
Many people are anxious about the side effects of steroids used in preventer treatment.
Here are some points to remember:
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The steroids used to treat asthma are called corticosteroids
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Corticosteroids are a copy of those produced naturally in our bodies
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They are completely different to the anabolic steroids used by body builders and athletes. Most people with asthma use low dose inhaled steroids, which go straight down to the airways, so very little is absorbed into the rest of the body.
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Your doctor will prescribe the lowest possible dose to get your asthma under control
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There is a small risk of a mouth infection called thrush and hoarseness of the voice. You can avoid this by using your inhaler before brushing your teeth, and by rinsing out your mouth well afterwards. Using a spacer will also help reduce the possibility of thrush.
Top Tip: Leave your preventer inhaler beside your toothbrush to remind you to take it morning and evening before you brush your teeth.
