Inhalers deliver medicine you need straight to your lungs. It goes without saying then, that they’re used for conditions which affect your lungs, of which by far the most common are asthma and chronic obstructive pulmonary disease (COPD). Because the medicine goes straight to where it’s needed, you only need tiny amounts compared to the dose you’d need to take of the same medicine in tablet form. That means fewer side effects and more effective treatment – as long as you take them properly.
The wheeze and cough of asthma affect one in 20 adults and one in 10 children. Which inhalers you’ll get depends on how severe, and how frequent, your symptoms are – but the aim is to keep you pretty much wheeze-free, so you only need to take a dose of ‘reliever’ medicine every few days at most and live a completely normal life.
In the early stages, you may only need an occasional dose of reliever medicine. As time goes on – especially if you keep smoking – you may find your ability to exercise becomes more limited. Once this happens you’ll need to start taking regular inhalers. However, inhaled medicine will still help, even if your lungs aren’t as young as they were.
Reliever inhalers open up the airways in asthma and COPD . This means air can flow more freely into your lungs, relieving wheeze and breathlessness. They start to work within minutes but their effect usually only lasts a few hours. If your asthma is well controlled, you should only need your reliever inhaler occasionally – perhaps when you’re exercising or when you have a cold. The inhalers are often blue and common ones includeVentolin® (salbutamol) and Bricanyl® (terbutaline).
Preventer inhalers don’t work as fast as relievers, but they’re just as important. If your symptoms aren’t controlled by using occasional puffs of your reliever medicine, you’ll be advised to take a preventer inhaler to stop symptoms happening in the first place. Different ones work in different ways, but their roles include reducing inflammation in the airways and opening the airways up. They need to be taken every day for full effect, and can both prevent wheeze and improve your ability to get around and exercise. They can also reduce your risk of a severe attack needing hospital admission. In asthma, the most common preventer inhalers contain small doses of steroid. You may also get a long-acting version of a reliever medicine to take to relieve your symptoms over 12 or even 24 hours.
Inhalers – more to them than what’s in them!
As if treatment with relievers and preventers weren’t complicated enough, there are different devices to deliver the medicine into your lungs, and sometimes the same drug comes in several different devices. Some devices involve pressing down and breathing in at the same time. These are called ‘metered dose inhalers’ and are among the most common type of inhaler used to deliver reliever medication in particular. Sometimes with these metered dose inhalers, your doctor or nurse will recommend that you pump a dose of medicine into a plastic bubble and breathe it in from here. Others still are ‘breath-actuated’ – as you breathe in, the medicine is delivered automatically into your lungs. Fortunately your practice nurse or GP can help you find the right one for you. You can find out more about all the options available, and their pros and cons, athttp://patient.info/doctor/which-device-in-asthma. Even if you’ve had asthma or COPD for a long time and have used the same inhaler for years, it’s still worth reminding yourself regularly how they work. You might be surprised how different the ‘optimal’ inhaler technique is from your own!
Inhaler technique – getting it right
If your inhaler technique isn’t good, you may not be getting much of the medicine into your lungs at all. Problems often arise with the metered dose inhalers, where you have to co-ordinate pressing down to get the dose at the same time as you breathe it in. If you press before you breathe, most of the dose ends up on the back of your throat rather than in your lungs. Press after you breathe in and you’ll leave it all in your mouth where it will promptly get breathed out again! If you’ve been given a spacer to use with your metered dose inhaler and don’t use it, you’ll get up to 30% less medicine going into your lungs but more going into your body because it’s deposited in your mouth and throat. That makes you more prone to side effects, such as trembling and palpitations from large doses of reliever medication. If you’re in any doubt, take your inhaler with you when you get your next check-up with the doctor or nurse and get them to look at how you take it. Alternatively, many pharmacists now have training in checking inhaler technique – for instance, all Boots pharmacists can check not just by looking but also have machines to work out if you’re getting the right amount of medicine to where it’s needed.
Nebulisers – a better option?
Although nebulisers are sometimes used in hospital to get high doses of inhaled medicine into your lungs in severe asthma attacks, the British Thoracic Society (BTS) says there’s not enough evidence to recommend them for routine use. What’s more, the BTS now recommends using a metered dose inhaler with a spacer rather than a nebuliser in mild to moderate asthma attacks. That means that for children in particular, you may find the doctor gives them a spacer and not a nebuliser when they’re acutely wheezy. Don’t worry – there is good evidence the spacer will work just as well in these cases.
WHY SHOULD I TAKE INHALERS WHEN THERE ARE TABLETS AND SYRUPS AVAILABLE?
You should take inhalers even though there are tablets and syrups available. In most countries like the USA and UK, inhalation therapy has succeeded in replacing oral therapy as it is the most effective, the safest and also the most cost efficient way to control asthma.
Most patients in India still believe that taking a medicine orally, i.e. through the mouth, is the right way to treat any disease. However studies show that the best way to take asthma medication is by inhalation. Oral therapy, i.e. tablets and syrups which have to be swallowed, takes time to act as they have to pass from the stomach to the bloodstream and finally to the lungs. Whereas inhalation therapy is quicker because the drug is delivered directly to the place where it is required, i.e. the lungs.
If you have an eye infection, would you rather take tablets for it or put eye drops which go straight to the problem?
If you have a cut on your hand, wouldn’t you rather put some medicine on it directly, than take a tablet to cure it?
In the same way, inhalation therapy is the short cut that reaches your lungs directly and takes care of the problem.
Besides, in oral therapy, you need a larger dose in milligrams (up to 40 times more than in inhalation therapy) which means greater side effects. In inhalation therapy, the drug is in micrograms – and since very little medicine is allowed to reach any other part of the body, you have few side effects. Clinical studies and medical research by reputed scientific institutes and medical centres prove that inhalers are much safer than tablets and syrups.
ARE INHALERS SAFE? WHAT ABOUT SIDE EFFECTS?
Yes, inhalers are safe. All medicines carry a risk of side effects in some people. But there are enough scientific studies to prove that the medicines in inhalers are safe, and have no serious side effects.
Most Controller treatments contain steroids and taking them by inhaler means that a much lower dose of the steroid can be used and because the inhaled medicine goes straight down to the airways where it is needed, very little is absorbed into the rest of the body. In oral therapy (tablets and syrups) you need a larger dose which is up to 40 times more than in inhalation therapy. The larger the dose, the more the side effects.
Your Controller will usually contain a corticosteroid, but it’s safe. Corticosteroids are a copy of the steroids that are produced naturally in our bodies. Thus it is a very safe and effective treatment for asthma. Rest assured that these are not the same steroids that are misused by some athletes and body builders. However, not all inhalers contain steroid, some contain a quick relief drug.
Sometimes, there is a small risk of developing a sore throat or a husky voice. To avoid this, use your inhaler before brushing your teeth and rinse your mouth afterwards. Using a spacer device also helps reduce the chances of side effects.
WHY ARE INHALERS BETTER?
The advantages of taking medicines through inhalers have been understood by the world not just in our modern age. Over 2000 years ago, in ancient Egypt, Greece and in India, people had realized the benefits of inhaling medicinal herbs and leaves to relieve their breathlessness and asthma. Over the centuries, inhalers developed and now it is much more advanced and effective.
Today asthmatics across the world use inhalers which enable them to go about their normal, daily activities. Asthma inhalers have given people the freedom to lead fulfilling lives, even with asthma.
The world over, asthma inhalers are proven to be better than other forms of treatment like pills or syrups. Why? When you have a problem with your eye, you put drops in your eye. When you have a problem with your skin you rub an ointment or cream on your skin. You don’t swallow a tablet or some syrup. You put the medicine exactly where it is needed. The same way, for asthma, you inhale or breathe in the medicine through an inhaler which you place in your mouth.
This is more effective because the inhaled medicine is delivered directly and quickly exactly where it is required, which is the airways in your lungs.
Compare this with tablets and syrups for asthma. As you know they have to be swallowed. But what you may not know is that it takes time for the tablet or syrup to act as it has to pass from the stomach to the blood and finally to the lungs. This is slower and it takes longer for the patient to get relief.
Besides, in the case of tablets or syrups, you need a larger dose because everything does not reach the lungs. This means greater side effects. When you take your medicines with an inhaler, the dosage entering your lungs is up to 40 times less and it never goes to the stomach, so there are minimum side effects. It is important for you to ask yourself this question: “Why should I use medicine that goes to other parts of my body when I just need it for my lungs?”
In most developed countries like the USA and UK, inhalers have replaced tablets and syrups as the primary therapy for asthma. It is an effective and safe way to control asthma.
Clinical studies and research by reputed scientific and medical institutes prove that Inhalers are safe. The side effects, if at all, are mild and can be easily minimized. Keep your doctor informed if you experience the slightest discomfort or any side effect.
Asthma inhalers are also affordable. For just a few rupees every day you get relief. You decrease the chance of an attack and the payment of hospital bills. Studies have even revealed that asthma patients on inhalers have regular attendance at work and in schools and colleges.
The 2 types of medicines that can be taken through Inhalers are called Controllers and Relievers. Read on for more information on the inhaled medicines. And consult your doctor for the best treatment for your asthma.