I am on advair, spiriva, singulair, (montelukast) and prednisone and my asthma is out of control. Use nebulizer 3 xs day What are other options? Do I need to go ER?

Asthma . Definitely visit your allergist or primary care provider for additional options. It's important to find out if allergies are triggering these symptoms. An allergist might also consider you for Omalizumab injections. You should go to the ER if the symptoms aren't getting better and if you are still experiencing shortness of breath with chest tightness.
Asthma. Your better choice might be to see an allergist so he can determine why your asthma is .out of control.