Asthma and Allergy Inhalers

Different inhaler devices suit different people. Inhaler devices can be divided into four main groups:

• Pressurised metered dose inhalers (MDIs).
• Dry powder inhalers.
• Inhalers with spacer devices.
• Nebulisers.

The standard MDI inhaler

Standard MDI has been used for over 40 years and is used to deliver various types and brands of medicines. It contains a pressurised inactive gas that propels a dose of medicine in each puff. Each dose is released by pressing the top of the inhaler. This type of inhaler is quick to use, small, and convenient to carry. It needs good co-ordination to press the canister, and breathe in fully at the same time. The standard MDI is the most widely used inhaler.

Dry powder inhalers

Other breath-activated inhalers are also called dry powder inhalers. These inhalers do not contain the pressurised inactive gas to propel the medicine. You don't have to push the canister to release a dose. Instead, you trigger a dose by breathing in at the mouthpiece. You need to breathe in fairly hard to get the powder into your lungs.

Spacer devices

Spacer devices are used with pressurised MDIs. There are various types. The spacer between the inhaler and the mouth holds the medicine like a reservoir when the inhaler is pressed. A valve at the mouth end ensures that the medicine is kept within the spacer until you breathe in. When you breathe out, the valve closes. You don't need to have good co-ordination to use a spacer device.

A face mask can be fitted on to some types of spacers, instead of a mouthpiece. This is sometimes done for young children and babies who can then use the inhaler simply by breathing in and out normally through the mask.

Nebulisers

Nebulisers are machines that turn the liquid form of your short-acting bronchodilator medicines into a fine mist, like an aerosol. You breathe this in with a face mask or a mouthpiece. Nebulisers are no more effective than normal inhalers. However, they are extremely useful in people who are very tired (fatigued) with their breathing, or in people who are very breathless. Nebulisers are used mainly in hospital for severe attacks of asthma when large doses of inhaled medicines are needed. They are used less commonly than in the past, as modern spacer devices are usually just as good as nebulisers for giving large doses of inhaled medicines. You do not need any co-ordination to use a nebuliser - you just breathe in and out, and you will breathe in the medicine.

What is Inhaler

An inhaler is a device holding a medicine that you take by breathing in (inhaling). Inhalers are the main treatment for asthma. There are many different types of inhalers. This article gives information about inhalers for asthma and allergy, about the medicines inside inhalers, the types of inhaler device, and some general information about inhalers.

The medicine inside an inhaler goes straight into the airways when you breathe in. This means that you need a much smaller dose than if you were to take the medicine as a tablet or liquid by mouth. The airways and lungs are treated, but little of the medicine gets into the rest of the body.

The proper medicine name is called the generic name. Different drug companies can use the generic medicine and produce different brands - the proprietary medicine names. There are many different brands of inhalers. Inhalers can have generic names and be produced by different drug companies too.

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Reliever inhalers

You can take a reliever inhaler as required to ease symptoms when you are breathless, wheezy or tight-chested. The medicine in a reliever inhaler relaxes the muscle in the airways. This opens the airways wider, and symptoms usually quickly ease. These medicines are called bronchodilators as they widen the airways.

The two main reliever medicines are salbutamol and terbutaline. These come in various brands made by different companies. There are different inhaler devices that deliver the same reliever medicine. These inhalers are often blue in colour. Other inhalers containing different medicines can be blue too.

If you only have symptoms every now and then, the occasional use of a reliever inhaler may be all that you need. If you need a reliever three times a week or more to ease symptoms, a preventer inhaler is usually advised.

Preventer inhalers

These are taken every day to prevent symptoms from developing. The type of medicine commonly used in preventer inhalers is a steroid. Steroids work by reducing the inflammation in the airways. When the inflammation has gone, the airways are much less likely to become narrow and cause symptoms such as wheezing.

Steroid inhalers are usually taken twice per day. If you have an exacerbation of your asthma symptoms, you may be advised to take the preventer inhaler more often.

It takes 7-14 days for the steroid in a preventer inhaler to build up its effect. This means it will not give any immediate relief of symptoms like a reliever does. After a week or so of treatment with a preventer, the symptoms have often gone, or are much reduced. It can, however, take up to six weeks for maximum benefit. If your asthma symptoms are well controlled with a regular preventer you may then not need to use a reliever inhaler very often, if at all.

Long-acting bronchodilator inhalers

The medicines in these inhalers function in a similar way to relievers, but work for up to 12 hours after taking each dose. A long-acting bronchodilator may be advised in addition to a steroid inhaler if symptoms are not fully controlled by the steroid inhaler alone.

Some brands of inhaler contain a steroid plus a long-acting bronchodilator for people who need both to control their symptoms. Example of combination inhaler is: Symbicort.