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Is There More You Can Do to Help Manage Your Asthma?

If you are 12 years or older, this short quiz will provide a score that you should share with your healthcare provider to help assess your treatment plan.

For children 4 to 11 years old, there is a different quiz called the Childhood Asthma Control Test. This 7-question quiz is answered by the child and caregiver.


Answer each question by choosing from one of the five options. A number score will appear in the column to the right. When you're finished, click "Submit" to view your score. Clicking on the "Start Over" button clears the form.

The results of the questionnaire are not intended to diagnose a condition or disease state and do not replace the advice of a qualified healthcare professional.

  1. 1. In the past 4 weeks, how often did your asthma keep you from getting as much done at work, school, or home?

  1. 2. During the past 4 weeks, how often have you had shortness of breath?

  1. 3. During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath,
    chest tightness, or pain) wake you up at night or earlier than usual in the morning?

  1. 4. During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)?

  1. 5. How would you rate your asthma control during the past 4 weeks?

Copyright 2002 by QualityMetric Incorporated.

*ASTHMA CONTROL TEST is a trademark of QualityMetric Incorporated.
The Childhood Asthma Control Test was developed by GlaxoSmithKline.


VENTOLIN HFA is a prescription medicine used to treat or prevent bronchospasm in people 4 years of age and older with reversible obstructive airway disease. VENTOLIN HFA is also used to prevent exercise-induced bronchospasm (EIB) in patients 4 years of age and older. It is not known if VENTOLIN HFA is safe and effective in children under 4 years of age.


  • Do not use VENTOLIN HFA if you are allergic to albuterol sulfate or any of the ingredients in VENTOLIN HFA. If you have any questions or are not sure, you should ask your healthcare provider.
  • Tell your healthcare provider about the medicines you take and about all of your medical conditions.
  • Use VENTOLIN HFA exactly as your healthcare provider tells you to use it.
  • Do not increase your dose or take extra doses of VENTOLIN HFA without first talking to your healthcare provider.
  • Get medical help right away if VENTOLIN HFA no longer helps your symptoms (like wheezing and trouble breathing), if your symptoms get worse, or if you need to use your inhaler more often.
  • While you are using VENTOLIN HFA, use other inhaled medicines and asthma medicines only as directed by your healthcare provider.
  • VENTOLIN HFA may cause serious side effects, including:
    • worsening trouble breathing, coughing, and wheezing (paradoxical bronchospasm). If this happens, stop using VENTOLIN HFA and call your healthcare provider or get emergency help right away. This is more likely to happen with your first use of a new canister of medicine.
    • heart problems, including faster heart rate and higher blood pressure.
    • possible death in people with asthma who use too much VENTOLIN HFA.
    • allergic reactions. Call your healthcare provider right away if you have any of the following symptoms of an allergic reaction:
      • itchy skin
      • swelling beneath your skin or in your throat
      • rash
      • worsening trouble breathing
    • low potassium levels in your blood.
    • worsening of other medical problems in people who also use VENTOLIN HFA, including increases in blood sugar.
  • Common side effects of VENTOLIN HFA include:
    • your heart feels like it is pounding or racing (palpitations)
    • chest pain
    • fast heart rate
    • shakiness
    • nervousness
    • headache
    • pain
    • dizziness
    • sore throat
    • runny nose

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

This website is funded and developed by GlaxoSmithKline.
This site is intended for US residents only.
©2015 GlaxoSmithKline group of companies. All rights reserved.

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