ICS, OCS, LABA, SABA, SMART, MART. At first glance, they sound less like medicine and more like a Scrabble or Wordle game. But these acronyms are some of the building blocks of asthma care and treatment. The challenge? Figuring out what they mean, how they work together, how to use them correctly and which combination is right for you or your loved one.
Asthma Medicines and Treatment
Taking control and managing asthma effectively goes beyond just treating symptoms. It’s about protecting our well-being so we can live fully and meaningfully. Asthma medicine helps with that. People with asthma are usually treated with a combination of a quick-relief (rescue) and a long-term maintenance (controller) inhaler.
Quick-Relief (also known as rescue) is medicine that you only take when you are feeling symptoms. It is important to take this medicine as soon as your symptoms start. Quick-relief inhalers and nebulizers contain a short-acting bronchodilator (SABA)— usually Albuterol — which will relax the smooth muscles around the airways, making more room for the air to flow and relieve your symptoms quickly to help you breathe easier. “Short” indicates that it works for approximately 4-6 hours and should only be used when symptoms occur. If you use your quick-relief more than twice a week, talk to your doctor to see if your control status is where it should be.
Long-term Maintenance (also known as Controller) is medicine that you take every day. It is important to take this medicine daily, as prescribed and in the correct way, even when you are feeling well. Individuals with asthma always have a little swelling in their airways, so the maintenance medicine helps reduce that swelling and keep symptoms under control. But how does it work? Maintenance-controller medicine contains inhaled corticosteroid (ICS). ICS are anti-inflammatory, so it reduces swelling and mucus production in the airways. Some controllers also combine ICS with a long-acting bronchodilator (LABA) for a dual approach. While ICS addresses the swelling, the LABA relaxes the smooth muscles around the airways, similar to the SABA, but it is long-acting, so this works for up to 12 hours.
Single Maintenance and Reliever Therapy (SMART): On some occasions an individual with asthma may be placed on what is called SMART, which is also known as Maintenance and Reliever Therapy (MART). This treatment plan uses only ONE inhaler for both maintenance and quick-relief. The inhaler used for SMART combines ICS and LABA; so it also reduces the swelling and helps keep the airways open. The LABA in SMART has a quick startup that is like the traditional SABA. It is easier to remember to take or carry with you a single inhaler instead of two.
What about steroid exposure?
But wait, aren’t steroids bad for you? Why would I take something like that, or give it to my child? If those questions come to mind, you are definitely not alone. They are some of the most common concerns people have when they first hear about asthma medicines. So, let’s break it down and put some of those worries at ease.
Often, when you hear the word steroid, you may think about anabolic steroids. These steroids increase muscle mass and are sometimes misused by athletes. Corticosteroids are not the same thing; they are anti-inflammatory medicine that mimic cortisol, which is an anti-inflammatory hormone naturally produced by the body.
There are three forms of corticosteroid, but we’ll focus on two. The inhaled form is found in the ICS and maintenance-controller medicines. There is also an oral form called an oral corticosteroid (OCS).
Although they are both corticosteroids that require a prescription from your doctor, OCS differs from ICS because it is taken by mouth to treat many different conditions beyond just asthma. OCS is anti-inflammatory so it will stop inflammation, but it is systemic, meaning it goes throughout the whole body via the bloodstream versus just straight to the lungs like ICS. So, it can treat symptoms across the body. OCS can also enter other body systems, cause more extreme side effects, and expose your body to more steroids overall, which accumulate over time. Conversely, ICS is inhaled, so it stays localized to the lungs and airways. This means your body is exposed to less steroids, which means a lot fewer side effects than an OCS.
Micro-dose or Mega-dose: Did you know that three years of daily ICS is equivalent to just one burst of OCS? (A burst is a short course of OCS taken for usually 5-7 days). The amount of corticosteroids in an ICS is far less than OCS. But OCS will help when you are having a flare-up or fighting off an illness. They help your body recover from inflammation but not in the same way that SABA or SMART do. ICS can help increase the overall control of your asthma, which can prevent asthma symptoms or flares. This may help you avoid the need for OCS or lengthen the time between bursts. Keep in mind that usually the benefits of taking a daily maintenance-controller medicine outweigh the risks and ICS is considered generally safe.
Furthermore, by using a spacer or valved holding chamber with the Metered Dose Inhalers (MDI), you can make sure the medicine is delivered to your lungs and efficiently used while reducing some of the side effects. Follow your Asthma Action Plan (AAP) and consult with your doctor to determine the best treatment for your asthma.
Your Ticket to the Green Zone
Now that you have a better understanding of asthma medicine, it is important to put that into action. That means learning when to take each medicine, the proper techniques to use and ensuring consistency. If you ever have concerns or questions about your medicines or prescriptions, make sure you talk to your doctor.
The American Lung Association has a number of different resources available to help you take better control of your asthma as well as tips on how to talk to your doctor. Be sure to check out our Asthma Resource Library (also available en español).
Now that we have decoded the acronyms, and debunked some myths, you are taking the right steps to take better control and breathe easier!
Blog last updated: May 20, 2026
