Working with your doctor to treat other conditions that can interfere with asthma management.
Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.
Working with your doctor and other health care providers to create and follow an asthma action plan.
An asthma action plan gives guidance on taking your medicines properly, avoiding asthma triggers (except physical activity), tracking your level of asthma control, responding to worsening symptoms, and seeking consultation from your doctor when needed regularly.
The widespread use of inhaled corticosteroids (ICS) for the treatment of persistent asthma, although highly effective, may be associated with both systemic and local side effects. Systemic side effects of ICS have been extensively studied. In contrast, relatively few studies have been performed to specifically evaluate local side effects of ICS. These local side effects – including oropharyngeal candidiasis, dysphonia, pharyngitis, and cough – are generally viewed as minor complications of therapy. However, they can be clinically significant, affect patient quality of life, hinder compliance with therapy, and mask symptoms of more serious disease. Local side effects result from deposition of an active ICS in the oropharynx during administration of the drug. Numerous factors can influence the proportion of an inhaled dose that is deposited in the oropharyngeal cavity, including the ICS formulation, type of delivery system, and patient compliance with administration instructions. Therefore, the incidence of local side effects can vary widely. The goal in developing a new ICS is to include key pharmacologic characteristics that reduce oropharyngeal exposure to active drug while maintaining efficacy comparable with currently available ICS.
Measurement of drugs in plasma following inhalation often poses
difficulties because of low concentrations. Systemic exposure following
inhalation is inherently variable and although the delivery device will be
a major determinant, the contribution of other factors should not be
underestimated. Other factors include the particle size distribution of
the aerosol, regional aerosol deposition, the physicochemical properties
of the drug, formulation excipients, mucus secretion, mucociliary
clearance and presystemic drug metabolism. In turn these factors will be
determined by variables such as the pharmaceutics of the aerosol,
respiratory physiology and disease, environmental pollution and infection.
In conclusion, side effect profiles cannot be reliably interpreted without
accurate measurement of systemic corticosteroid exposure.