Asthma inhalers
Inhaled asthma medications are generally inhaled through either a metered dose inhaler (MDI), with or without a spacer, or a dry powder device. Many people with asthma refer to their inhalers as ‘puffers’.
There is also another type of inhaler device, the nebuliser, a device that pumps pressurised air through liquid medication to convert it into a fine vapour, which is then breathed in through a mask or mouthpiece. Nebulisers are useful for giving high doses of medication, but are generally prescribed only for people with severe, life-threatening asthma.
Selection of your device
Selection of the type of device is often a personal preference. Some people prefer an MDI to a breath-activated dry powder device and vice versa. However, the individual device you use can depend on the medication you're taking, as medication manufacturers often present their medicine in their own type of device. It is important that you feel comfortable with the inhaler chosen, and that you can use it properly. If you're unsure about your inhaler technique, ask your doctor or pharmacist for advice.
Metered dose inhalers
A common inhaler device is the pressurised metered dose inhaler, also known as an aerosol inhaler.
Aerosol inhalers contain an aerosol canister that dispenses the medication in a fine mist that you can then breathe in.
Some of the CFC-free formulations of asthma medications are stickier than the older formulations. This means that your inhaler could become clogged with medication. Clean your inhaler regularly, as instructed by the manufacturer or your doctor.
Some of the medications available in aerosol inhalers include:
- relievers such as salbutamol (e.g. Airomir, Ventolin) and ipratropium bromide (e.g. Atrovent);
- preventers such as beclomethasone (e.g. Qvar), fluticasone (e.g. Flixotide), sodium cromoglycate (e.g. Intal, Intal Forte) and nedocromil sodium (e.g. Tilade);
- symptom controllers such as salmeterol (e.g. Serevent); and
- combination products such as the combination of fluticasone (a preventer) and salmeterol (a symptom controller) in Seretide.
Aerosol inhalers require co-ordination and good timing between activation (pressing down on the inhaler) and inhalation. Most adults and children older than about 7 years can be taught to use pressurised MDIs correctly, but MDIs can be difficult to co-ordinate. People with arthritis or poor strength in their hands may also have difficulty operating an MDI.
Overcoming co-ordination problems
To aid co-ordination, your doctor might recommend using a spacer with the MDI. A spacer is a large, plastic device which acts as a holding chamber for medication for the few seconds that might elapse between activating your MDI and breathing in the medication. By putting one end of the spacer in your mouth and attaching your MDI to the other end of the spacer, you can inhale your medication effectively without having to press the MDI and breathe at exactly the same time. Most children under 8 years old will probably need to use a spacer to help deliver their medication correctly.
Another type of MDI that can help co-ordination is the Autohaler, a breath-activated metered-dose inhaler that delivers medications such as salbutamol (e.g. Airomir), and beclomethasone (e.g. Qvar). You use it by flicking a switch, and then breathing in through the mouthpiece. However, it is usually not recommended for children under 5 to 7 years old.
Dry powder inhalers
There are a number of different types of dry powder inhalers. The type of dry powder device you receive will depend on the type and brand of medication your doctor prescribes, since medication manufacturers often present their medicine in their own type of device.
Dry powder inhalers require you to take a deep breath to activate the device and get the powder into your lungs. It is important not to exhale into the mouthpiece before inhaling as the moisture from your breath can stop the inhaler from working properly.
Some children aged 5 to 7 years may be able to use dry powder devices effectively. However, often an MDI and spacer are recommended for children under the age of 8 years.
Dry powder inhalers include the Accuhaler, Aerolizer, Rotahaler, Diskhaler and Turbuhaler. There are also other inhalers available so ask your doctor for advice.
The Accuhaler is a breath-activated, multi-dose, dry powder inhaler that delivers the medications salmeterol (Serevent) or fluticasone (Flixotide), or a combination of both (Seretide).
The Aerolizer is a breath-activated, single-dose, dry powder inhaler which comes with capsules of medication that must be loaded into the device before use. The Aerolizer delivers eformoterol (Foradile).
The Rotahaler delivers capsules of medication called Rotacaps, which must be loaded into the device before use. A Rotahaler can be used to administer salbutamol (Ventolin Rotacaps).
The Turbuhaler is a breath-activated inhaler that can deliver terbutaline (Bricanyl), budesonide (Pulmicort) or eformoterol (Oxis), or a combination of both budesonide and eformoterol (Symbicort).
There are many types of asthma medications and different methods of delivery. Your doctor can advise you about the inhaler that's best for you.
Last Reviewed: 09 November 2009
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