Asthma Inhalers - A guide

When you breathe in, the drug in an asthma inhaler gets straight into your airways. This means you'll only require a fraction of the dose you'd get if you took the medicine as a tablet or drink. The airways and lungs are treated, but only a small amount of the medication is absorbed by the rest of the body.

The generic name refers to the full name of the drug. The generic pharmaceutical can be used by multiple drug companies to create different brands, or proprietary medicine names. Inhalers are available in a variety of brands. Inhalers can have generic names and be manufactured by a variety of pharmaceutical businesses. There are different inhaler devices that administer the same drug for some medicines. This implies that a variety of inhalers are accessible on prescription, all of which come in a variety of colours. This can be perplexing.

Because there are so many various coloured inhalers, it's helpful to remember both their names and the colour of the device. This is useful if you need to consult a doctor who does not have access to your medical records, such as:

• In the A&E department
• If you're on vacation
• ⦁ Outside of your doctor's office's regular business hours
• Keeping a list of the names of your medicines and inhalers in your wallet or purse may be useful. This information will help you avoid mistakes and misunderstandings
• Inhalers contain relievers (short-acting bronchodilators), preventers (steroid inhalers), and long-acting bronchodilators, which are used to treat asthma

When you're feeling short of breath, wheezy, or tight in the chest, a relief inhaler can help. A relief inhaler works by relaxing the muscles in the airways. This widens the airways, and symptoms normally subside fast. Because they enlarge (dilate) the airways, these drugs are called bronchodilators (bronchi).

Salbutamol and terbutaline are the two most common pain relievers. These are available in a variety of brands and from a variety of manufacturers. Different inhaler devices administer the same pain reliever medication. Airomir®, Asmasal®, Salamol®, Salbulin®, Pulvinal Salbutamol®, and Ventolin® are all salbutamol brands. Bricanyl® is a common brand name for terbutaline. Blue inhalers are common (though not always) on the market. Other inhalers carrying various drugs may also be blue.

Always read the label.

If you only get symptoms once in a while, a relief inhaler may be all you need.

A preventer inhaler is usually recommended if you need a reliever three times a week or more to treat symptoms.

These are taken on a daily basis to prevent the onset of symptoms. A steroid is a type of medication typically seen in preventer inhalers. Steroids help to clear the airways by lowering inflammation. The airways are considerably less likely to become restricted and generate symptoms like wheezing once the inflammation has subsided.
Inhalers containing steroids are normally used twice a day. If you suffer an asthma exacerbation (flare-up), you may be encouraged to use the preventer inhaler more frequently.

The steroid in a preventer inhaler takes 7-14 days to become effective. This implies that it will not provide instant relief from symptoms (like a reliever does). Symptoms are frequently gone or greatly diminished after a week or so of treatment with a preventer. However, for best benefit, it may take up to six weeks.
If your asthma symptoms are adequately controlled with a daily preventer, you may not need to use a reliever inhaler as frequently, if at all.

As a preventative, inhalers containing sodium cromoglicate (brand name Intal®) or nedocromil (brand name Tilade®) are sometimes used. They do not, however, always work as well as steroids.
The following are the most common inhaled steroid preventer medications:

• Beclometasone. Asmabec®, Clenil Modulite®, and Qvar® are some of the brands available. These inhalers are usually brown in colour, but they can also be red
• Budesonide. Easyhaler Budesonide®, Novolizer Budesonide®, and Pulmicort® are some of the brands available
• Ciclesonide. Alvesco® is the brand name for this product
• Fluticasone. Flixotide® is the brand name for this drug. This inhaler is either yellow or orange in colour
• Mometasone. Asmanex Twisthaler® is the brand name for this product.

Long-term usage of large dosages of inhaled corticosteroids may impair bone strength (density). As a result, those who use steroid inhalers for asthma should ensure that they get enough calcium in their diet. Although milk is a good source of calcium, some persons with asthma may need to avoid dairy products. Calcium can also be found in the following foods:

• Bread
• Some fruits and veggies (curly kale, okra, spinach and watercress)
• a few fruits (eg, dried apricots).

The drugs in these inhalers work similarly to pain relievers, but they last for up to 12 hours after each dose. Formoterol (brand names Atimos®, Foradil®, and Oxis®) and salmeterol (brand names Serevent® and Neovent®) are two of them.

If a steroid inhaler alone is not enough to treat symptoms, a long-acting bronchodilator may be used in addition to the steroid inhaler.

For patients who need both a steroid and a long-acting bronchodilator to control their symptoms, certain inhaler brands provide both. Combination inhalers include the following:

• Fostair® is a trademark of Fostair, Inc. (formoterol and beclometasone)
• Seretide® is a trademark of Seretide, Inc. (salmeterol and fluticasone). This inhaler is purple in colour
• Symbicort® is a brand name for a drug that is used (formoterol and budesonide).

Different types of inhaler devices are appropriate for different persons. Inhaler devices are classified into four categories:

• Inhalers with a pressurised metered dose (MDIs)
• MDIs and dry powder inhalers are examples of breath-activated inhalers
• Inhalers with spacers are available
• Nebulisers

Above is an example of a normal MDI. The MDI has been used to distribute numerous types and brands of medicines for over 40 years. Each 'puff' comprises a pressurised inert gas that propels a dose of medication. The top of the inhaler is pressed to release each dose. This sort of inhaler is simple to use, compact, and portable. To press the canister and breathe in deeply at the same time, you'll need superb coordination. These are also called as evohalers (depending upon the manufacturer).

The most often used inhaler is the conventional MDI. However, many people do not take advantage of it to its full potential. The following are examples of common mistakes:.

• Before using the inhaler, it is not shaken
• Inhaling too quickly or at an inopportune time
• After inhaling the contents, you didn't hold your breath long enough.

The propellant gas in MDI inhalers has been a chlorofluorocarbon until recently (CFC). CFCs, on the other hand, deplete the ozone layer and are being phased out. The newer CFC-free inhalers are equally effective, but they employ a different propellant gas that does not harm the ozone layer.

These are different types of MDIs than the regular MDI. Some MDIs are still pressurised, but you don't have to squeeze a canister on top of them. An example is the autohaler illustrated above. The easi-breathe inhaler is another example of a breath-activated MDI.

Dry powder inhalers are another type of breath-activated inhaler. The drug is not propelled by a pressurised inactive gas in these inhalers. To discharge a dose, you don't have to press the canister. Instead, you inhale via the mouthpiece to initiate a dose. Breath-activated dry powder inhalers include accuhalers, clickhalers, easyhalers, novolizers, turbohalers, and twisthalers. To get the powder into your lungs, you must take a deep breath in. The types are listed below.

With pressurised MDIs, spacer devices are used. There are several sorts, as seen in the example above. When the inhaler is pressed, the spacer between the inhaler and the mouth acts as a reservoir, holding the medicine. The drug is held within the spacer by a valve at the mouth end until you breathe in. The valve closes when you breathe out. To utilise a spacer device, you don't require good coordination.

Instead of a mouthpiece, some types of spacers can be fitted with a face mask. This is sometimes done for little toddlers and babies, who can then use the inhaler by simply breathing in and out through the mask as normal.
Spacers come in a variety of shapes and sizes. Able Spacer®, Aerochamber Plus®, Nebuchamber®, Optichamber®, Pocket Chamber®, Volumatic®, and Vortex® are just a few examples. Some spacers work with all MDIs, while others are exclusively compatible with certain inhaler brands.

Useful hints for utilising a spacer device. If you've been prescribed a holding spacer, here are some suggestions.

The spacer in the picture above is an example of one with a valve at the mouth end:

• If your dose calls for more than one puff, take one at a time
• Before each puff, give the inhaler a good shake
• As soon as the puff is fired, begin inhaling in through the mouthpiece
• After you've breathed in, try holding your breath for a few moments
• Before firing the following puff, take a few deep breaths in and out. Each time you breathe in, try to hold your breath for a few moments
• Make sure the valve closes and opens with each breath
• For babies and small children, a face mask can be attached to the valve end. With their face against the mask, they simply breathe normally. With each breath in and out, the valve opens and shuts. To make the valve open and close more readily, slant the spacer slightly with the inhaler end on top
• On the inside of the plastic chamber, a static charge can accumulate. When the spacer is employed, this can attract drug particles and reduce production.

Nebulisers are machines that transform your liquid short-acting bronchodilator drugs into a fine mist, similar to an aerosol. This is inhaled through a face mask or a mouthpiece. Normal inhalers are no more effective than nebulisers. They are, nevertheless, highly helpful in persons who are really tired (fatigued) with their breathing or who are severely short of breath. Nebulisers are mostly used in hospitals for severe asthma attacks requiring large dosages of inhaled medications. Modern spacer devices are usually just as useful as nebulisers for providing large dosages of inhaled medicines, thus they are used less frequently than in the past.