Telehealth Treatment

Asthma Treatment

Same-day evaluation for mild to moderate asthma exacerbations. Rescue inhaler prescriptions, step-up therapy, and personalized action plans — from home.

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What Is Asthma?

Asthma is a long-term lung condition where the airways become inflamed and narrowed. This makes it harder to breathe. It affects about 25 million Americans — roughly 1 in 13 people — and leads to nearly 2 million ER visits each year, according to the CDC.

Person using inhaler for asthma relief and management

In asthma, ongoing airway inflammation causes:

Excess mucus production
Thickening of airway muscles
Increased sensitivity to triggers like allergens, cold air, respiratory viruses, exercise, smoke, and air pollution

National guidelines (NAEPP EPR-3) classify asthma by severity and how well it is controlled. This guides the step-by-step treatment approach.

Asthma flare-ups — episodes where breathing suddenly gets worse — range from mild to severe:

Mild: Slight increase in symptoms with small changes in peak flow readings
Moderate: Noticeable shortness of breath, reduced activity, and peak flow at 40–69% of your best
Severe: A medical emergency with major breathing difficulty and possible low oxygen levels

Telehealth works well for mild-to-moderate flare-ups. You should be a known asthma patient, able to speak in full sentences, and not showing signs of low oxygen. Severe flare-ups need immediate emergency care.

At Innocre Telehealth, our board-certified provider evaluates asthma patients in Maryland, Washington, and Delaware. During your visit, your provider will review:

What triggered your flare-up
Your current medications and how often you use your rescue inhaler
How severe your symptoms are, plus home peak flow readings if available

Based on this, your provider may adjust your therapy, prescribe rescue medications, start a short course of oral steroids, or update your asthma action plan. Patients with poorly controlled or severe asthma are referred to a lung or allergy specialist for further testing and possible advanced treatments.

Common Symptoms

Wheezing

High-pitched whistling sound during exhalation due to airway narrowing

Shortness of breath (dyspnea)

Exertional initially; at rest in more severe episodes

Chest tightness

A feeling of constriction or squeezing in the chest

Chronic or nocturnal cough

Often worse at night or early morning; can be the only symptom

Increased rescue inhaler use

Needing albuterol more than twice per week suggests poor control

Decreased exercise tolerance

Avoiding activities due to breathing difficulties

Drop in peak expiratory flow (PEF)

Below 80% of personal best indicates worsening control

Worsening symptoms at night or with triggers

Allergens, cold air, exercise, smoke, or viral URI exposure

How Innocre Treats Asthma Online

For mild-to-moderate flare-ups, the first step is a quick-relief rescue inhaler. Albuterol (ProAir, Ventolin) — 2 puffs every 4 to 6 hours using a spacer — is the standard rescue treatment. Your provider can prescribe albuterol inhalers and spacers for patients in Maryland, Washington, and Delaware. Levalbuterol (Xopenex) is an option if albuterol causes a fast heartbeat or other side effects.

For moderate flare-ups, a short course of oral steroids (prednisone, 40–60 mg/day for 5 days) can shorten the episode and lower the risk of it coming back. Your provider prescribes these when needed.

Optimizing daily controller therapy is a key focus at Innocre Telehealth. Depending on your current step, your provider may recommend:

Low-dose inhaled steroids (fluticasone/Flovent, budesonide/Pulmicort) for patients with frequent symptoms
Combination inhalers (Advair, Symbicort, Breo Ellipta) that pair a steroid with a long-acting bronchodilator for better control

Your provider also checks your inhaler technique — a commonly overlooked issue — and reminds you to rinse your mouth after using steroid inhalers to prevent oral yeast infections.

A written asthma action plan helps you manage your asthma day to day. Your provider creates or updates this plan during your visit. It uses a simple color-coded system:

Green zone: Asthma is well-controlled — continue daily medications
Yellow zone: Symptoms are worsening — take specific steps to get back on track
Red zone: This is an emergency — follow your emergency plan and seek care immediately

If you use your rescue inhaler more than twice a week, need oral steroids more than twice a year, or wake up with symptoms more than twice a month, your asthma may need stronger treatment. Your provider may refer you to a lung or allergy specialist for breathing tests and advanced options.

⚠️ When to Go to the Emergency Room

Telehealth is appropriate for mild-to-moderate asthma flare-ups. Seek emergency care immediately if you experience:

• Severe shortness of breath that is not responding to 2–4 puffs of albuterol within 20 minutes
• Inability to speak in full sentences, or having to pause mid-sentence to breathe
• Oxygen saturation (SpO2) below 92% on a home pulse oximeter, or any reading below 90%
• Use of accessory muscles (neck muscles, intercostal or subcostal retractions) or paradoxical abdominal movement with breathing
• Bluish discoloration of lips or fingertips (cyanosis), altered mental status, or extreme agitation — signs of severe hypoxia

Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice. A licensed provider evaluation is required for diagnosis and treatment.

Asthma — Frequently Asked Questions

Yes, for mild to moderate exacerbations in established asthma patients. Telehealth is appropriate when you can speak in full sentences, your symptoms are not rapidly worsening, and your oxygen saturation (if you have a pulse oximeter) is above 93%. Your provider will assess symptom severity, current medication use, peak flow readings, and trigger exposure to determine the best course of action — whether that is optimizing your current regimen, prescribing a short course of oral steroids, or directing you to emergency care if symptoms are severe.

Rescue inhaler use more than twice per week (not counting pre-exercise use) or more than twice per month for nighttime awakenings indicates that your asthma is not well-controlled and that your controller therapy may need to be stepped up. NAEPP EPR-3 guidelines are clear: over-reliance on rescue bronchodilators is associated with increased risk of severe exacerbations and asthma death. If you are using albuterol more than recommended, a telehealth visit with your provider to review your asthma action plan and controller regimen is strongly encouraged.

Rescue inhalers (short-acting beta-2 agonists, or SABAs, like albuterol) provide rapid bronchodilation within minutes and are used for acute symptoms or before exercise. They do not treat the underlying airway inflammation. Controller inhalers (inhaled corticosteroids such as fluticasone, or ICS/LABA combinations such as Advair or Symbicort) are taken daily to reduce airway inflammation and prevent exacerbations. They require consistent use to be effective — typically 2–4 weeks for full anti-inflammatory benefit — and should never be stopped abruptly without provider guidance.

Yes — viral respiratory infections, particularly rhinovirus (the common cold), are the most common trigger of asthma exacerbations in both children and adults, accounting for up to 80% of exacerbations in some studies. The viral-induced inflammation of the airways amplifies existing airway hyperresponsiveness. During cold and flu season, patients with persistent asthma should ensure their controller medications are optimized, avoid known allergen triggers, and have a clear written action plan. If you have asthma and develop cold symptoms with worsening breathing, an early telehealth visit can help prevent escalation to a severe attack.

Biologic therapies (dupilumab/Dupixent, mepolizumab/Nucala, benralizumab/Fasenra, tezepelumab/Tezspire) are approved for severe eosinophilic asthma and are highly effective at reducing exacerbations. At Innocre Telehealth, your provider can evaluate patients for biologic eligibility and facilitate referral to a pulmonologist or allergist for formal workup including blood eosinophil counts and FeNO testing. Initiation of biologic therapy typically requires in-person subspecialty involvement, but ongoing asthma management and coordination can continue via telehealth.

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