Lesson 10: All About Asthma Inhalers

There are two major aspects of an asthma inhaler to consider when selecting the one right for you: drug and delivery.

Which drug?

Which drug is best for you will, of course, be decided in consultation with your doctor. There are several to choose from.

Corticosteroids, despite the risks associated with side effects from long-term use, remain a common asthma treatment. They include such brand names as Qvar, Flovent, Pulmicort, and Aerobid. They are intended less to treat short-term symptoms from an attack than lessening the odds of having one in the first place.

Some non-steroidal drugs may be recommended by your doctor, such as Cromolyn or Nedocromil. They help ease the bronchial inflammation that is an intrinsic part of asthma. They’re intended more for long-term treatment than immediate symptom relief.

For more immediate relief of asthma symptoms there are several bronchodilators on the market. Short-acting ones relieve symptoms quicker, but don’t last as long. Long-acting bronchodilators (LABDs) don’t act as fast, but their effects persist longer (up to several hours). SABDs like Ventolin and Proventil are commonly prescribed. LABDs include Serevent and Foradil.

Which Inhaler?

There are three basic types of inhalers, and choosing the one best for you involves a combination of advice from your physician and possibly some experimentation.

The traditional asthma inhaler is a metal cannister inserted into a plastic holder. The cannister contains the drug and the holder has small tabs that keep the can stable and provide small plastic stops called spacers. The design allows you to squeeze the device and deliver the appropriate dosage.

While even young children typically learn to use them correctly, they do require a little bit of coordination between your hand motion and inhaling action. Older asthmatics with hand arthritis may find it difficult to squeeze the tube without discomfort.

By contrast, a newer asthma drug delivery method uses a device called an MDI (Metered Dose Inhaler). Here, a chemical propellant similar to those used in dozens of other consumer products forces a mist into the airways.

The propellant is harmless and the pressure of an MDI presents no danger. But, this type of inhaler does require a bit of skill, as well. Because of the force with which it ejects the drug, it is possible to deposit too much onto the tongue or throat and too little down into the windpipe (trachea). That’s not dangerous, but it can be distasteful and wastes the medicine.

Most users overcome this problem in short order and find MDIs convenient. They are helpful for young children who may have trouble coordinating hand motion and breathing in, and older adults who find it uncomfortable to squeeze the traditional-style inhaler.

A third type is less commonly used but available for those who prefer it. This style uses a dry powder rather than a mist to deliver the drug. They are available in single-dose and multiple-dose varieties. They are much more tolerant of hand-breath coordination, allowing patients to administer the drug and breathe in at leisure. They also make it obvious when the inhaler is empty. However, the powder can clump in conditions of high humidity.

Summary

Discuss your drug and inhaler options with your physician before choosing the asthma treatment that will be right for you.

End of Lesson 10

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