Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Controllers and Relievers


  • A reliever should be used on an as needed basis for relief of symptoms
  • Best represented by short-acting ß2-agonists
  • Act by relaxing the smooth muscle surrounding the airways
  • Provide quick relief (within 1-2 minutes)
  • Using 4 or more doses (2 puffs/dose) per week (excluding pre-exercise) is an indicator of poor control


  • Inhaled corticosteroids are the main treatment for control of asthma.
  • Other medications are used as adjuncts when control is not achieved with an adequate dose of inhaled corticosteroids.
  • Controllers must be taken regularly long-term to prevent or decrease inflammation and edema of the airways.
  • Slow onset of action.
  • The management goal for children should always be the lowest dose of inhaled corticosteroids necessary to control symptoms, therefore medication dose needs to be assessed regularly and reduced or discontinued when appropriate.