Asthma Inhalers and More

This section will familiarize you with ASTHMA INHALERS and MEDICINE available to you, their advantages, disadvantages, and how best to use them.

The Asthma Inhaler or Metered Dose Inhaler

The purpose of inhalers is to send chemical messages to narrowed airways to reopen. These chemical medicines can be packaged in two ways - as a liquid or as a powder. Liquid inhalers use gas compressed so tightly that it forms a liquid which when released turns back into a gas and carries medicine into your lungs. Dry powder inhalers use your inhalation breath to pull them up as a dust cloud into your lungs. Either method can be used to get medicine into your lung.

	The design to your left is the gas propelled type. The gas and medicine are stored in the canister (1) which is held in your hand by the housing (2). After removing the dust cap, and shaking the canister, it is pressed down opening a valve at its base and releasing a jet of air and medicine (3) as you inhale.
	This is a dry powder design. It does not need to be shaken. Its base is twisted (1) to load your next dose, the shaft is placed into your mouth (2) and the medicine sucked up as you breathe in.

One bad thing about the dry powder inhaler is that it's difficult to tell if you've actually breathed in anything - there's nothing to taste, feel, or smell while you can immediately tell if a gas inhaler is empty: it feels light, if you spray it in the air you see no spray, and if you put the canister in a bowl of water it will float like a log while it sinks when full.

Conversely, gas inhalers need to be used with special care to effectively get their medicine into your lungs or it ends up at the back of your throat. The inhaler should not be placed into the mouth.
It is to be placed a few finger breaths away from your open mouth and triggered after shaking as you breathe deeply in. Then hold your breath about 5 s if you can. Repeat.
Spacers Children can't coordinate the above well but they have to breathe. The spacer (1) makes use of this by blowing medication into a confined space over the child's face. As the child breathes, it sucks in the medicated vapor. This can't be done with the dry powder inhaler. Spacers can also be used in adults.

There are three other methods of getting medication to your lungs: tablets; syrups; and injection. The first two make use of your digestion passing the active ingredients into the blood through the stomach, which then carries it to the lungs i.e. it's slower than an inhaler but the drug will linger around the lung for a longer time as it's stored in the blood. The injections used in asthma are straight into veins usually through a drip. This way is used in hospitals because in a severe asthmatic you can get a large dose of medication to his/her lungs fast, and hopefully save their life. The big disadvantage of all these methods is that instead of medication reaching only the lungs as with inhalers, the entire body is exposed making side effects likely. Syrups have a special place in very young children - when inhalers are difficult to use - and in adults who don't like, or can't swallow tablets but need more than an inhaler to control their asthma.

One final note is the nebulizer. This device uses a continuous air pump attached to a mask that you fill with liquid bronchodilator and/or steroid and hold over your mouth. It delivers a continuous medicated vapor to your lungs and is very effective for moderate to severe asthmatics in which inhalers alone are not enough. Of course the machine is costly but a worthwhile investment and a lifesaver in bad asthmatics or asthmatics who live far from a hospital.

One big advantage of inhalers / puffers, is that the medication you need is delivered only to your lungs so widespread side effects are uncommon.

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