Treatment of asthma. New and time-tested strategies

Early, aggressive therapy in conjunction with good communication with a knowledgeable, caring physician may reverse the trends of increasing morbidity and mortality from asthma. Allergen avoidance and immunotherapy are helpful in some patients. For those who need medication, bronchodilation with a beta 2-adrenergic drug, often in conjunction with an anticholinergic and theophylline, is the current treatment of choice for acute symptoms. For prophylaxis of chronic symptoms, sustained-release theophylline is still an excellent drug. However, an anti-inflammatory agent (eg, cromolyn sodium [Intal]) or, in some cases, an inhaled corticosteroid, may be an effective alternative. Whatever treatment is used, its success depends on effective self-management, which begins with education of the patient and family.