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How Do Asthma Inhalers Work

What Else Should I Know

How does asthma work? – Christopher E. Gaw

Using nebulizers or inhalers can be tricky. So ask your doctor to show you how the device works before you first use it. Doctors might ask an older kid or teen to demonstrate using an inhaler and offer advice, if needed.

If you have any questions or if you’re concerned that your child isn’t getting the right dose of medicine, talk to your doctor.

Side Effects Of Using Asthma Inhalers

Asthma inhalers can sometimes have side effects until your body gets used to the medication but this is not likely to last. If you are using your inhalers often, you are more likely to see side effects.

As preventer and reliever inhalers contain different medications, they may have slightly different side effects. Combination inhalers contain both medications, so you may have side effects from either of these medications.

The common side effects of reliever inhalers are:

  • headaches
  • shaking
  • muscle cramps

You do not need to do anything if these side effects go away on their own. If they continue to bother you, speak to your doctor.

Rare side effects of reliever inhalers include:

  • dizziness
  • headaches that are worse than normal
  • allergic reaction

If you get any of these side effects, call your doctor or 111 straight away. If you have a severe allergic reaction, go to A& E.

The common side effects of preventer inhalers are:

  • dry or sore throat
  • a change in voice
  • oral thrush

Keep taking your preventer inhaler but speak to a doctor if these symptoms do not go away. Washing your mouth out with water after taking your inhaler and using a spacer can help with these side effects.

Rare side effects of preventer inhalers include:

  • infection

How Does Asthma Affect The Airways

There is a special kind of muscle in the airways known as the airway smooth muscle. Airway smooth muscle is an important tissue that exists in the trachea and is involved in the regulation of the bronchomotor tone.

Airway smooth muscle of an asthma patient.

The ASM helps to shrink your airways in the event of an irritant or unwanted foreign particle entering the airways. This is a good thing, provided that you have no lung-related conditions, as the ASM shields your lungs from irritants.

However, if you have asthma, the ASM becomes too sensitive. As such, it can constrict the airways, even when it encounters stuff that isnt dangerous, such as cold, dry air. The smooth muscle constricts the airways, which makes it very difficult for one to breathe.

This is where inhalers come in to help.

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Reliever Inhaler Top Tips

  • Keep your reliever inhaler somewhere you can get to it easily and quickly if you need it. And tell friends and family where you keep it in case you have an asthma attack.

  • Always carry your reliever inhaler with you when you go out. Ask your GP to prescribe you an extra reliever inhaler as a spare for work or the car.

  • Check the expiry date. Even if you havent used all the medicine in your inhaler, you should replace your reliever inhaler with a new one if it has passed the expiry date. This is usually six months after opening it. You can find the expiry date on the bottom of the box, or on the side of the canister.

  • Always keep the cap on your reliever inhaler when youre not using it. Small objects could get stuck in the mouthpiece if you dont put the cap on, especially if you carry your inhaler in your bag. This is dangerous because you could end up inhaling them when you next come to use your inhaler.

  • Store your reliever inhaler at the right temperature. Extreme temperatures and high altitudes can affect the medicine in your reliever inhaler. Check the label on your inhaler for storage instructions or speak to your GP or asthma nurse for advice.

  • Check theres enough medicine left in your reliever inhaler, especially when youre going away on holiday, or over Christmas and other holiday periods when your GP surgery is closed. Some inhalers have indicators on the side to tell you how much medicine is left.

  • Or you can send them a WhatsApp message on 07378 606728.

    Types Of Reliever Inhaler

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    Reliever medicine can come in different types of inhaler devices:

    • Metered dose inhalers give the medicine in a spray form . For example, Airomir and Salamol. Its good to use a spacer with these.
    • Breath actuated inhalers automatically release a spray of medicine when you begin to inhale. For example, Easi-breathe, and Autohaler.
    • Dry powder inhalers give the medicine in a dry powder instead of a spray. For example, Accuhaler and Turbohaler.

    Although different inhalers have different benefits, the most important thing is getting the right dose of asthma medicine into the lungs where it can get to work quickly.

    Whatever inhaler you’re prescribed, you need to know how to use it in the best way. Your doctor will work with you to find the inhaler device that suits you best, and one you find easy to use correctly. Some inhalers are easier to use with a spacer.

    Combination inhalers

    If youre on a MART regime, you have one inhaler device combining both a preventer and reliever medicine.

    Make sure your GP or asthma nurse explains how and when to use the reliever part of your MART inhaler if you get symptoms.

    Find out more about combination inhalers, including MART.

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    Do Asthma Medicines Have Side Effects

    Yes. All medicines have side effects. Tell your doctor how you are responding to the treatment and if you have any side effects. Follow up often with your doctor so you can control your asthma with the least amount of medicines and with the fewest side effects.

    Medical Review: June 2021 by S. Allan Bock, MD Maureen George, PhD, RN, AEC, FAAN and Sumita Khatri, MD, MS

    References1. Bonds, R., Asawa, A. and Ghazi, A. . Misuse of medical devices: a persistent problem in self-management of asthma and allergic disease. Annals of Allergy, Asthma & Immunology, 114, pp.74-76.e2.

    Asthma Action Plan

    Things To Know About Advair

    Do not use Advair if you have a severe allergy to milk protein.1-3

    If you have heart problems or high blood pressure, your doctor will evaluate you to decide if Advair is safe for you.1-3

    Advair can affect growth in children. Doctors will regularly monitor the growth of children taking Advair.1-3

    Advair can suppress the immune system since it contains the steroid fluticasone. Tell your doctor if you have a tuberculosis infection or untreated bacterial, viral, or fungal infection before taking Advair.1-3

    When you take Advair, get regular eye exams. Advair can increase the risk for glaucoma and cataracts.1-3

    After using your Advair inhaler, rinse your mouth with water to help prevent a fungal infection of the mouth. Do not swallow the water.1-3

    Tell your doctor if you are pregnant or plan to become pregnant while using Advair. Advair should be used during pregnancy only if your doctor decides that the potential benefit outweighs any possible risks to your unborn baby.1-3

    Advair may interact with certain drugs, including:1-3

    • Beta-blockers
    • MAOI antidepressants or tricyclic antidepressants
    • Clarithromycin

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    How To Use Your Accuhaler

    To get the most benefit, it is important to use the correct technique. Ask your doctor, pharmacist, or nurse to explain how to use your accuhaler. Here is some guidance:

    Using your accuhaler

    • Open: hold the accuhaler in one hand, and with the thumb of the other hand push the thumb grip away from you until you hear a click. This reveals the mouth piece.
    • Load the dose: hold the inhaler in a horizontal position. Slide the lever away from you until you hear a click.
    • Breath out: breathe out, away from the accuhaler. Do not blow directly into your device.
    • Inhale your dose: place the mouth piece in your mouth and form a seal with your lips. Breathe in deeply and forcefully through your mouth. Remove the accuhaler and hold your breath for up to 10 seconds. If you need another dose, wait for 30 seconds and then repeat the process
    • Close: the inhaler by sliding the thumb grip towards you.

    Cleaning and storing your accuhaler: wipe the mouthpiece with a clean dry tissue. Do not wash the mouthpiece or allow it to get wet when cleaning. Close the device when not in use. When to start a new accuhaler: there is a window on the side of the accuhaler called a dose counter. When it turns red it is time to get a new accuhaler.

    How Does A Rescue Inhaler Work

    How Your Asthma Rescue Inhaler Works

    A rescue inhaler works by striking at the core of the problem. Since an asthma crisis involves the sudden constriction of the airways, a rescue inhaler assists in relaxing the airways.

    A typical rescue inhaler.

    Inhalers have different sorts of medications in them, all of which work in relaxing the airways. The most popular inhaler prescribed for quick and short-term relief is the type that contains a drug called albuterol.

    Albuterol binds to receptors on the surface of the smooth muscle cells that line the airways, which, in turn, relaxes the muscle. As a result, the airways become less constricted, allowing the patient to breathe normally again.

    Inhalers can come in two types: sold and aerosol, both of which directly target the airways and lungs. Aerosol inhalers have a liquid that contains gases dissolved under pressure. When the inhaler is squeezed, it releases millions of tiny droplets that are inhaled and subsequently absorbed by the mucous membrane and bloodstream. If the inhaler contains albuterol, it dilates the airways.

    A metered dose inhaler is the most common type of aerosol inhaler. This is the type you have most likely seen asthma patients carrying around on their person.

    A closeup of the release of aerosol particles of an MDI.

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    Solid inhalers contain drugs in powdered form. Dry Powder Inhalers , as they are usually called, release a device-measured or metered dose of powdered medication that is inhaled through a DPI device.

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    What Are The Forms Of Bronchodilators

    There are two forms of bronchodilators:

    • Short-acting bronchodilators relieve or stop asthma symptoms. You use your rescue inhaler to stop an asthma attack.
    • Long-acting bronchodilators help control asthma symptoms by keeping the airways open for 12 hours. You use these inhalers every day to prevent asthma attacks.

    How Do Asthma Inhalers Work

    This video explains how asthma inhalers work:

    Just as a summary really quick I go through it here.

    The main problem with asthma is a narrow airway, that is preventing decent airflow and preventing proper air removal from the lungs. This occurs via two way, 1) the airways are narrowing and 2) the airway are getting inflammed and thicker. Both together, decrease the space needed for proper airflow.

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    Dry Powder Inhaler Quick Tips

    • Do not open the device until you are ready to use it. Never open or swallow the capsule always use it with its matching DPI
    • Do not shake the DPI.
    • Do not use a holding chamber or spacer with a DPI.
    • With most DPIs, the mouthpiece should be pointed up or held horizontal when using in order to not dump the medication after loading.
    • Rinse your mouth after using, if instructed by your physician.
    • Multi-dose devices have an indicator to alert you to the number of doses remaining, or when the device is almost empty.
    • General instructions are that you should not allow your DPI to get wet. The mouthpiece should be wiped regularly with a clean, dry cloth.
    • Inhaling the dry powder may cause some people to cough talk with your doctor if this happens.

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    How To Use An Inhaler With A Spacer And Mouthpiece

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    Learning how to properly use an inhaler with a spacer and mouthpiece for asthma ensures the medicine gets deposited into the lungs. Incorrect technique can leave some of the particles from the medicine on your tongue or throat, where it is useless. Inhalers spray the medicine out so that you can breathe it deep into the lungs. A spacer, or holding chamber, is an attachment that should always be used with your inhaler. The spacer holds the medicine in place so you can breathe it in easier. If you have any further questions about inhalers, spacers or mouthpieces contact your doctors office, asthma care team or pharmacy.

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    Every Day: Control Inhaler

    These inhalers help prevent flares and keep symptoms from getting worse. They’re called control inhalers because they have medicine that controls inflammation.

    Use yours as often as your doctor tells you to, usually once or twice a day:

    • Whether or not you’re having symptoms
    • Even if you feel like you’re doing better

    If you’re supposed to use it two times a day, aim for 12 hours apart.

    When you begin using this kind of inhaler, it may be 2 to 4 weeks before you notice the drugs start to work.

    How To Take And Store

    When using a new inhaler, or one that’s gone unused for a while, you’ll need to prime it to ensure you get the proper dosage:

  • Remove the cap.
  • Spray a short burst away from your face.
  • Repeat once.
  • If you’ve used the inhaler recently, you shouldn’t need to do this. Just follow the steps recommended for use of all bronchodilators, which include ensuring your lungs are empty before you inhale the medication, holding it in for 10 seconds before exhaling, and rinsing your mouth out with water when you’re done.

    Once a week, rinse your inhaler’s plastic case and allow it to dry completely. Don’t submerge the cartridge in water or use cleaning products on your inhaler.

    For safety purposes, keep your inhaler:

    • At room temperature
    • Away from high heat and open flames, as these situations can cause the cartridge to burst
    • Where children and pets can neither see nor reach it

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    How Do Asthma Medicines Work

    People with asthma have what is called a chronic health problem. This means that it’s a problem that’s always there, even when they feel OK.

    Everyday stuff such as exercise, pets, or cigarette smoke can make asthma symptoms worse .

    But medicine can help. Two different kinds of medicines can treat asthma: quick-relief medicines and long-term control medicines.

    Dry Powder Inhaler Step

    World Asthma Day questions: How do inhalers work?
  • Follow your device instructions to load the medication dose. Multi-dose inhalers are preloaded with medication, which you typically prepare with a click of the device. Single-dose inhalers use separately packaged capsules that you drop into the chamber.
  • Stand or sit up straight and breathe out completely. Emptying your lungs is one of the most important steps.
  • Put the mouthpiece into your mouth, close your lips tightly around it and breathe in quickly and forcefully.
  • Take the DPI out of your mouth, hold your breath for 5-10 seconds, then exhale slowly.
  • If your treatment plan calls for a second dose, reload and repeat the steps.
  • When using a capsule device, open the chamber and check to see if the powder has been fully inhaled. If you see remaining powder, close the device, exhale fully, close your mouth around the mouthpiece and inhale again. When the capsule is empty, remove and discard it.
  • Close the device and store in a dry place. Do not wash with water use only a dry cloth to wipe the mouthpiece.
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    Asthma Holding Chamber Or Spacer

    A valved holding chamber is a handheld device that attaches to a metered-dose inhaler and captures the medicated mist as it sprays out. The medication is trapped long enough inside the holding chamber to be inhaled at your own speed. It also pulls out large particles of medication and prevents them from settling in your mouth or throat.

    A spacer is similar to a valved holding chamber, but it does not suspend the medication, so when using it you must coordinate your breath to begin slightly before actuating the MDI.

    Holding chambers are available for use with and without masks. Masks are often essential for children, the elderly or disabled people who cannot close their lips securely around the mouthpiece or who need to take several breaths to inhale the medication fully.

    How to use a spacer or holding chamber

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    During An Asthma Attack

    In a sudden asthma attack you can use your inhaler more and take up to 10 puffs. Wait 30 seconds and always shake the inhaler between doses. You can repeat this dose 10 minutes later.

    Immediate action required: Call 999 or go to A& E now if you or your child:

    • are struggling to breathe
    • have asthma symptoms that are not getting better

    Asthma attacks can get worse very quickly.

    For treating severe asthma attacks, salbutamol can be given through a nebuliser. A nebuliser is a machine that delivers the medicine as a mist inhaled through a face mask. This will probably be given to you by your doctor.

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    Will I Have To Take Medicine All The Time

    Maybe not. Asthma is a chronic condition that is controllable. Unfortunately, there is no cure for asthma. For that reason, you may have asthma symptoms when exposed to triggers. This is the case even if you dont have symptoms very often. Your triggers can change over time, and your treatment will depend on two things: how severe your asthma is, and how often you have symptoms. If your asthma is controlled, your treatment will focus on managing symptoms and treatment of episodes when they happen.

    If your symptoms happen at certain times and you know what caused them, you and your doctor can use this information to determine the best treatment. If, for example, you have seasonal asthma because of a specific pollen allergy, you may take medicines only when that pollen is in the air. But asthma that specific is not common. Many people with asthma take some form of medicine most or all of the time.


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