Adult asthma treatment: action plan, controller medicines and refills
Adult asthma treatment combines controller medicines, used every day to prevent attacks, with a quick-relief inhaler for sudden symptoms, and a written action plan. By video, the doctor can check how well your asthma is controlled, review your plan and, if appropriate, renew your prescriptions. An attack that does not improve with your rescue inhaler is an emergency: call 911.
Can we help by telehealth? Yes, we can help by telehealth.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Your rescue inhaler does not help, or breathing is still very hard
- Trouble talking or walking because you are short of breath
- A blue tint to your lips, nails or skin
- Drowsiness, confusion or distress
- A very fast heartbeat
Help lines:
- 911 — Emergencies
- 1-800-981-0023 — Línea PAS (mental-health crisis line)
- 988 — Suicide & Crisis Lifeline
- 1-800-222-1222 — Poison Help
Asthma symptoms
Asthma causes wheezing, breathlessness, chest tightness and coughing, especially at night or early in the morning. Symptoms can come and go, and suddenly get worse during an attack.
Controller vs. quick-relief medicines
Controller medicines are used every day, even when you feel well, so you have fewer and milder attacks. The most common is an inhaled corticosteroid; it can cause a hoarse voice or a mouth yeast infection (thrush), which rinsing your mouth after use helps prevent. Others include long-acting bronchodilators, leukotriene modifiers and biologic medicines.
Quick-relief (rescue) medicines ease symptoms during an attack. If you need your rescue inhaler often, your asthma is not well controlled and your treatment should be reviewed.
Your asthma action plan
An action plan is a written document that tells you:
- Which triggers to avoid.
- How to recognize an asthma attack and what to do.
- Which medicines to take and when.
- When to call the doctor and when to go to the emergency room.
- Whom to contact in an emergency.
Common triggers
Avoiding what sets off your symptoms is part of treatment. The CDC lists these common triggers:
- Tobacco smoke, including secondhand smoke
- Dust mites
- Air pollution, including smoke from fires
- Cockroaches and other pests
- Furry pets
- Mold, which grows in damp places such as kitchens and bathrooms
- Infections such as flu, colds and RSV
- Sinus infections, allergies and pollen
- Strong chemicals and fragrances
- Acid reflux
- Bad weather, exercise and strong emotions
Asthma in Puerto Rico
The Puerto Rico Department of Health's BRFSS trends report (2011 to 2021) found that adult asthma stayed steady over those years and was about twice as common in women as in men.
In a warm, humid climate, mold and dust mites are triggers worth controlling at home. And because storms can cut off access to a pharmacy, keep a supply of your inhalers: see medications and hurricanes.
Adult asthma treatment by telehealth
If you are physically in Puerto Rico and your asthma has already been diagnosed, in an online doctor visit the doctor can:
- Ask about your symptoms, how often you use your rescue inhaler and whether you wake up at night.
- Check your inhaler technique on camera.
- Review your action plan or help you put one together.
- Renew your inhalers if appropriate. If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances.
What needs to be done in person
Telehealth does not replace these:
- Spirometry: the lung function test that measures how much air you breathe out and how fast. It is done in person, at a pulmonary function lab or a lung specialist's office, and helps confirm the diagnosis.
- A new asthma diagnosis, or shortness of breath that has not been evaluated.
- Asthma that stays uncontrolled despite treatment: the doctor may refer you to a lung specialist or allergist.
- Any asthma attack that does not improve with your rescue medicine: go to the emergency room or call 911.
Asthma in children
This page is about adults. We see children from 6 months old, but the doctor is not a pediatrician: routine management of childhood asthma should be handled by their pediatric specialist. If a child is breathing fast, the skin pulls in between the ribs, their lips look blue or they cannot talk, call 911. See cough and cold in children.
Video visit: US$79 · Pay by card · See the price and what is included
Before you book
- You must be physically in Puerto Rico during the visit (visitors and tourists are welcome).
- We see patients from 6 months old. Patients under 21: a parent or legal guardian must be on camera for the whole visit.
- Real-time video only; we do not do phone-call visits.
- We do not prescribe controlled substances.
Frequently asked questions
- Can you refill my inhaler by telehealth?
- Yes, if your asthma has been diagnosed, is stable and the doctor judges it appropriate after the visit. Have your inhalers at hand to show on camera.
- What is the difference between a controller and a rescue inhaler?
- A controller is used every day to prevent attacks, even when you feel well. A rescue inhaler is used when you have symptoms. If you use your rescue inhaler a lot, your treatment needs a review.
- When is an asthma attack an emergency?
- If your rescue inhaler does not help, breathing is still very hard, you cannot talk, or your lips or skin look blue, call 911.
- Do I need spirometry?
- Spirometry helps confirm asthma and shows how well your lungs are working. It is done in person; the doctor will tell you whether you need it.
Sources
- CDC: About asthma (accessed 2026-09-30)
- CDC: Asthma triggers (accessed 2026-09-30)
- NHLBI (NIH): Asthma treatment and action plan (accessed 2026-09-30)
- NHLBI (NIH): Asthma attacks (accessed 2026-09-30)
- NHLBI (NIH): Asthma diagnosis (accessed 2026-09-30)
- Puerto Rico Department of Health: BRFSS Trends Report 2011–2021 (accessed 2026-09-30)