Asthma

Audience: Patients and providers
Status: Clinical guide · patient + provider
Last updated: 2026-03-09

1. Clinical overview

Asthma is a chronic inflammatory airway disorder with variable bronchoconstriction, symptom fluctuation, and exacerbation risk that depends heavily on trigger control, adherence, and inhaler technique.

2. Common causes and risk factors

Chronic inflammatory airway disease with variable airflow obstruction.
Triggers include allergens, viral infections, irritants, exercise, reflux, and poor adherence.

3. Typical symptoms

Wheeze, cough, chest tightness, nighttime symptoms, activity limitation.

4. Diagnosis and evaluation

Confirm diagnosis with guideline-based history, exam, and indicated testing.
Screen for severity, complications, and high-risk comorbid conditions.
Identify social or access barriers that could affect treatment success.

5. Treatment (non-pharmacologic)

Trigger reduction and comorbidity management (rhinitis, GERD, obesity).
Written asthma action plan and spacer/technique training.
Vaccination and smoking/vaping cessation support.

6. Treatment (pharmacologic)

ICS-containing therapy is core, with common options including budesonide, fluticasone, or mometasone-based inhalers.
SMART regimens commonly use budesonide/formoterol, while step-up maintenance therapy may include fluticasone/salmeterol or fluticasone/umeclidinium/vilanterol in selected severe disease.
Biologics such as omalizumab, dupilumab, mepolizumab, benralizumab, or tezepelumab are reserved for phenotype-guided severe asthma.

7. Monitoring and follow-up

Control scores, rescue use, exacerbations, lung function, adherence and inhaler technique.

8. Practical counseling points

Give patients a clear “what to do today / when to call / when to seek urgent care” plan.
Use teach-back to confirm understanding of treatment goals and medication instructions.
Simplify regimens when possible to improve adherence and outcomes.

9. Red flags and escalation

Escalate care urgently for severe or rapidly worsening symptoms.
Reassess diagnosis if expected response does not occur within the anticipated timeline.

10. Guideline references

Note: Educational guide only; not a substitute for individualized medical care.