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What Is Maintenance Medication For Asthma

Using Mart When Your Symptoms Get Worse

Asthma Treatment, Symptoms, Pathophysiology, Nursing Interventions NCLEX Review Lecture

You take your MART inhaler every day as prescribed, usually twice a day. But if your symptoms get worse at any point during the day, you can use it as a reliever inhaler too.

This is because it contains a fast-acting medicine called formoterol, which deals with symptoms quickly.

And as well as benefiting from the reliever medicine, each time you take your MART inhaler for relief of symptoms, you also get a dose of steroid preventer medicine. This calms the inflammation in your airways.

If youre using your MART inhaler for rescue reliever medicine

once a day or more – on a regular basis – see your GP or asthma nurse to review your treatment.

Make sure you have a MART action plan

Your personalised MART action plan needs to tell you how many puffs to take morning and evening every day, and how many to take if you have symptoms.

There is usually a maximum dose of day, including your maintenance doses. Always talk to your GP or asthma nurse if youre not sure how to use your MART inhaler, or if youre regularly using extra doses.

Rescue Inhalers For Asthma Attacks

Rescue medicines do just what the name says: Work quickly enough to rescue you during an asthma attack. These drugs should be used for short periods of time for symptoms of asthma such as wheezing and cough. You may also hear these drugs called SABAs, which stands for short-acting beta-agonist.

Rescue inhalers work by relaxing the airway muscles. Used early, this can help keep an asthma attack from getting worse. These drugs begin to work in minutes, and the effects last for 4 to 6 hours. Examples of rescue inhalers include:1,2

  • Albuterol
  • Levalbuterol

How Are Inhalers Used To Treat Asthma

Many asthma medicines are delivered using an inhaler or a nebulizer. Inhalers and nebulizers are devices that allow the asthma medications to be inhaled. This means you breathe them in, and they go straight to the airways. There are four types of delivery devices:

  • metered-dose inhaler : a pressurized device that releases medication in a fine spray for you to inhale
  • slow-moving mist inhaler: like an MDI, with a slower-moving mist
  • dry powder inhaler : releases medication as a fine powder for inhaling

Visit our online store to download our free respiratory treatment poster or purchase print copies. The respiratory treatment poster is an asthma medication chart. It lists asthma inhalers by brand name as well as biologic medications used to treat asthma.

How to Use a Metered Dose Inhaler

How to Use a Slow-Moving Mist Inhaler

How to Use a Dry Powder Inhaler

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What Should You Do If These Medicines Trigger Your Asthma

  • Take your preventer medication every day.
  • If your symptoms get worse, use your reliever and your asthma action plan.
  • If it’s triggered by medicine or herbal supplements that you’ve bought from your pharmacy or supermarket, avoid these in the future.
  • If it’s triggered by medicine that has been prescribed, such as a beta blocker, let your doctor know. They may be able to prescribe a different medicine or increase the dose of your preventer medication.
  • Do not suddenly stop taking your beta blocker without talking to your doctor first. This can be dangerous and make you feel unwell.
  • Patient Attitudes To Asthma Management

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    A total of 2992 patients stated that they were very or quite confident that they could self-manage their asthma worsenings without physician visits. Many patients were concerned about taking too much medication when they felt well or during periods with no symptoms . The majority of patients reported that they used their medication as and when necessary and were much more likely to try to manage their asthma themselves, rather than consulting their physician, when symptoms become bothersome . Nearly 70% of patients also agreed that they preferred to adjust their maintenance ICS/combination medication to the changes in their asthma, i.e. taking less medication when well and more when their asthma worsens . Ninety per cent of patients stated that they wanted immediate relief from symptoms and 85% felt confident that they knew their asthma well enough to intervene early to try to prevent a worsening of symptoms.

    Table 2 Patients’ attitudes to asthma management

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    Adherence To Maintenance Medication In Asthma In Patients Admitted With Acute Asthma

    Tho Chi Nguyen,1 Hanne Madsen,1

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    1Department of Respiratory Medicine, Odense University Hospital, Denmark2Department of Clinical Pharmacology, University of Southern Denmark, Denmark

    Correspondence: Hanne Madsen, Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark, Tel 40580041

    Received: August 09, 2014 | Published: August 21, 2014

    Citation: Nguyen TC, Madsen H, Pottegard A, et al. Adherence to maintenance medication in asthma in patients admitted with acute asthma. J Lung Pulm Respir Res. 2014 1:1520. DOI: 10.15406/jlprr.2014.01.00004

    When To Use One Inhaler Type Over The Other

    Since asthma can vary from person to person, not everyone will need to have or take both rescue and maintenance inhalers. However, for us asthmatics who need a daily, long-term maintenance plan to make sure our lungs stay open and fully functional, its important to remember which inhaler to take at what time.

    • Rescue inhalers. Also called quick-relief inhalers, rescue inhalers are sometimes taken before exercise and/or during the onset of asthma symptoms, depending on the person. The fast-acting medication in rescue inhalers begins working within minutes and can be effective for four to six hours.2
    • Maintenance inhalers. Long-term control inhalers are usually taken every day, even when there are no symptoms present. This inhaler type sometimes needs to be taken for several months before the maximum benefit is felt.2

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    Asthma Holding Chamber Or Spacer

    A valved holding chamber is a handheld device that attaches to a metered-dose inhaler . It 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 like 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 some disabled people. Anyone who cannot close their lips securely around the mouthpiece should use a mask. Anyone who needs to take several breaths to inhale the medication fully should use a mask.

    How to use a spacer or holding chamber

    What Is The Best Maintenance Inhaler

    Inhalers (Asthma Treatment & COPD Treatment) Explained!

    Advair is one of the most commonly used inhalers for the maintenance treatment of COPD. It is a combination of fluticasone, a corticosteroid, and salmeterol, a long-acting bronchodilator. Advair is used on a regular basis for the maintenance treatment of COPD and it is typically taken twice per day.

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    What Do Rescue And Maintenance Inhalers Do

    While we get to know rescue vs maintenance inhalers, heres a short introduction to the function of each type of inhaler:

    • Rescue inhalers. This inhaler type is also called a quick-relief medication or rescue medication. As the name suggests, rescue inhaler medication opens the lungs and relaxes the airways. However, they are not meant to be used on a daily basis.
    • Maintenance inhalers. These long-term control medications can help reduce asthma-related swelling and tightening in the airways and some medications also block the immune system chemicals that can trigger asthma symptoms. These are typically prescribed for more frequent use.

    Each type of inhaler serves the important purpose of managing asthma symptoms before they lead to severe health issues including an asthma attack, and in my experience, both types of inhalers are important for long-term management of chronic asthma. But when do you take them?

    Choosing The Right Asthma Delivery Device

    Have you ever wondered how your doctor decides which is the best way for you to take your asthma medicine?

    Options include syrups, granules, tablets, or capsules that you swallow. Or they are aerosols and powders that you inhale from a metered-dose inhaler, dry powder inhaler or nebulizer. Attaching a valved holding chamber to an MDI allows patients to direct the medicine into the airways by holding it and inhaling at their own speed.

    Healthcare providers prescribe treatments effective in disease control. They also want treatments that are convenient for patients needs and lifestyles. You should be part of the decision process. Discuss with your healthcare provider your needs and lifestyle.

    Here are 5 patient-focused factors that are part of the decision process:

  • Age. This is always an important consideration, but especially with infants. Infants have smaller airways and lungs and breathe faster. National asthma guidelines say children should use a holding chamber when using an MDI. This is because the aerosolized spray comes out faster than most kids can inhale.
  • Ability to follow directions. This consideration crosses all age groups. It includes when and how to take a particular medication. Even adults may confuse the directions for using MDIs and DPIs.
  • If your asthma symptoms persist, talk with your doctor about the need to adjust your medications. Talk with your doctor about concerns over cost. Any barrier to using your medication can affect your asthma control.

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    My Asthma Treatment Plan

    For my asthma treatment plan, I take a long-term inhaler every day and keep a rescue inhaler on hand for sudden symptoms. Even though this manages my asthma effectively enough that I rarely feel symptoms, I still keep both types of inhalers refilled because thats what works for me. It did take a few tries with multiple types of maintenance inhalers to find what worked best with my chronic asthma, but finding the right balance with both inhaler types has helped me fully experience life and has been well worth the journey.

    What about you? How do you have a maintenance inhaler and a rescue inhaler? Share in the comments below!

    Do I Need An Inhaler Every Day

    Everything about Asthma  Information so Good itll Take your Breath ...

    According to updated guidance from the National Institutes of Health, the daily use of long-acting inhalers is no longer necessary for people with mild to moderate persistent asthma. If you use an inhaler daily, ask your healthcare provider if the new guidelines might affect your treatment.

    There are three types of long-acting inhalers commonly used for people with asthma:

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    How Do Asthma Treatments Work

    Asthma treatments work in these ways:

  • They relax the muscles that tighten around the airways. They relieve the squeeze. They can be short- or long-acting. By opening the airways, they help remove and reduce mucus. These medicines are bronchodilators or beta agonists.
  • They reduce the swelling and mucus inside the airways. These medicines are anti-inflammatories .
  • Bronchodilators

    Bronchodilators can be short- or long-acting. If you use short-acting bronchodilators more than two days a week, talk with your doctor about your asthma control. You may need to make changes to your treatment plan to better control your asthma.

    Anti-Inflammatories

    Anti-inflammatories come in many different forms. They are also called controllers because they help to control or prevent asthma symptoms. They reduce swelling and extra mucus inside the airways. They will not relieve sudden symptoms.

    Other Types of Medicines and Treatments

    Single Maintenance and Reliever Therapy

    The 2020 Focused Updates to the Asthma Management Guidelines recommends single maintenance and reliever therapy, also known as SMART. SMART uses one inhaler that has two medicines as a quick-relief and controller medicine. When on SMART, you can either take your medicine only as needed to relieve sudden symptoms, or you can take it daily as a controller and as needed for quick relief. This is based on your age and the severity of your asthma.

    What Are Different Ways To Take Asthma Medications

    The different ways in which asthma medication is administered include:

    • Inhalers: the most common and effective way to deliver asthma medication. They are a medical device that delivers medicine straight to your lungs. This medication is mostly in the form of a mist or spray that the person breathes in. Unlike a tablet or syrup, inhalers deliver the medicine straight to the lungs. Devices come in the following three forms:
    • Metered-dose inhalers
    • Dry powder inhalers
    • Soft mist inhalers
  • Nebulizers: prescribed for patients having difficulty using small inhalers. Nebulizers are an ideal option for infants, young children and older adults as it has a mouthpiece and masks.
  • Injectables: Biologics are usually given via shots or infusions every few weeks. Shots are given via an auto-injector device and may be administered at the doctors office or at home, while infusions are only given at the doctors office.
  • Oral: some drugs may need to be administered orally for better control of the condition.
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    Common Inhaler Medications And Uses

    Quick-Relief Inhalers

    Asthma medications can also come in tablet or liquid form.

    Leukotriene modifiers

    A long-term control medicine that blocks chemicals called leukotrienes, which can increase swelling in your airways.

    Theophylline

    A long-term bronchodilator that relaxes the muscles around the airways of the lungs and opens your airways. It can be taken as a tablet, capsule, solution, or syrup.

    Oral Corticosteroids

    While oral corticosteroids are generally used as a short-term treatment for severe asthma attacks, they may be used as maintenance treatment in some patients. However, with extended use comes an increased risk of side effects.

    Why Access And Buy Treatments For Asthma With Thesocialmedwork

    Module 3: Asthma Medications

    TheSocialMedwork is registered in The Hague with the Dutch Ministry of Health as an independent medicines intermediary and as an international pharmacy . We have helped patients from over 85 countries to access thousands of medicines that are not yet approved in their home country, including patients suffering from Psoriatic Arthritis. With a prescription from your treating doctor, you can count on our expert team to safely and legally guide you to access Psoriatic Arthritis medicines in your country. If you or someone you know are looking to access a medicine that is not yet approved where you live, we will support you. Contact us for more information.

    References:

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    What Are New Asthma Treatments

    There are several approved new asthma drugs. Here are some of them:

    Trelegy Ellipta

    Trelegy Ellipta is a combination medication used for the long-term, once-daily, maintenance treatment of:

    • Asthma in patients aged 18 years and older
    • Patients with chronic obstructive pulmonary disease .

    Trelegy Ellipta is a combination therapy that consists of 3 active ingredients:

    • The inhaled corticosteroid Fluticasone furoate, which reduces inflammation
    • The anticholinergic agent Umeclidium, which works as a bronchodilator.
    • The long-acting beta2-adrenergic agonist Vilanterol, which works as a bronchodilator.

    Trelegy Ellipta was approved for the treatment of asthma in adults by:

    • The Food and Drug Administration , USA on September 10, 2020.

    Dupixent

    Dupixent is a medicine given by self-injection under the skin used to treat:

    • Patients aged 12 year and older with moderate-to-severe asthma with an eosinophilic phenotype, or with OCSdependent asthma regardless of phenotype. It is indicated as add-on maintenance treatment.
    • Patients aged 6 year and older with moderate-to-severe atopic dermatitis
    • Adult patients with chronic rhinosinusitis with nasal polyposis .

    Dupixent was approved for the treatment of people with asthma by:

    • The Food and Drug Administration , USA on October 19, 2018
    • The European Medicines Agency on May 7, 2019

    Ketas

    Ketas is a treatment for bronchial asthma,

    Ketas was approved for the treatment of patients with bronchial asthma and cerebrovascular disorders by:

    Will Medicine Help Me Sleep Better

    Yes, if you have nighttime asthma symptoms. Many people wake up with asthma symptoms such as coughing or wheezing. You can control nighttime symptoms by taking asthma medicines as directed by your doctor.

    Removing triggers where you sleep may help you sleep better. Many people are allergic to dust mites and mold found in bedding materials. Using mattress or pillow encasements can help contain those allergens. Dehumidifiers can also be helpful to reduce the humidity in your home that dust mites and mold need to exist. Using air cleaners in your bedroom may also help reduce your exposure to allergens and irritants .

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    Common Rescue And Maintenance Asthma Meds

    Within these two types of asthma management inhalers, there are multiple types of medications that each work a little bit differently. Although learning about all the different types of asthma medications can be overwhelming, its good news because that means more options to find the right medication balance.

    Rescue inhaler medications:

    • Combinations of multiple medication types

    What Is An Inhaler

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    An inhaler is a device used to send medicine to your airways. By getting medicine directly to your lungs, smaller doses of medicine are needed and it can start working more quickly. The main types of inhaler devices are metered dose inhalers and dry powder inhalers such as Turbuhalers, Accuhalers and Handihalers.

    Read more about the different inhaler devices and the points to consider when deciding on the right inhaler for you.

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    Asthma Variability And Patient Response

    The majority of patients recognised that they had experienced variation in their asthma during the past year. When asked whether they perceived any signs or warnings that they were about to experience a worsening of asthma, 68% of patients said that they were able to identify such signs. When described, these signs or warnings were found to correspond to asthma symptoms, the most common being “shortness of breath/getting breathless”. Of the patients who reported recognising signs of an impending worsening, the mean length of time from the appearance of the first signs to the peak symptoms of the worsening was 5.1 days . The mean length of time from peak symptoms to recovery was 6.2 days.

    Patients responded to the signs of an impending worsening by increasing their medication. Regardless of the type of maintenance therapy they were prescribed, patients reported using their SABA at the onset of symptoms, with the ICS being increased later and to a lesser extent when symptoms were at their worst . A 4-fold increase in the number of SABA inhalations was reported when symptoms were at their peak compared with when patients were well. When symptoms started to decrease, patients reduced their intake of both SABA and ICS.

    Figure 3Figure 4

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