What are asthma inhalers?

To begin with, asthma inhalers are devices holding a medicine that you take by breathing in (inhaling).

Firstly, inhalers are the main treatment for asthma.

Then, there are many different types of inhaler, which can be confusing.

This leaflet gives information on the medicines inside inhalers, and the types of inhaler device, and some general information about inhalers.

Secondly, this leaflet is about inhalers for asthma.

Types of asthma inhalers

Third and most importantly, 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 asthma inhalers.

Inhalers can have generic names and be produced by different drug companies too.

For some medicines there are different inhaler devices that deliver the same medicine.

This means that there are many types of inhaler available on prescription, all of which are produced in different colors.

This can be confusing.

Because there are lots of different-colored inhalers available, it is helpful to remember their names, as well as the color of the device.

This might be important if you need to see a doctor who does not have your medical records – for example:

  • In A&E.
  • If you are on holiday.
  • Outside the normal opening hours of your GP surgery.

It might be helpful to keep a list of the names of your medicines and inhalers in your wallet or purse.

This information will prevent mistakes and confusion.

In the treatment of asthma, the medicine inside inhalers can be grouped into relievers (short-acting bronchodilators), preventers (steroid inhalers) and long-acting bronchodilators.

Reliever inhalers – contain bronchodilator medicines

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 (dilate) the airways (bronchi).

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. Salbutamol brands include;

  1. Airomir®
  2. Asmasal®
  3. Salamol®
  4. Salbulin®
  5. Pulvinal Salbutamol®
  6. Ventolin®
  7. Terbutaline often goes by the brand name Bricanyl®.

These inhalers are often (but not always) blue in color.

For instance, other inhalers containing different medicines can be blue too.

Always read the label.

If you only have symptoms every now and then, the occasional use of a reliever asthma inhalers 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 – usually contain a steroid medicine

The type of medicine commonly useful in preventer inhalers as 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 (flare-up) of your asthma symptoms, you may be advise to take the preventer asthma inhalers 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.

So, 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.

Asthma inhalers that contain medicines called sodium cromoglicate (brand name Intal®) or nedocromil (brand name Tilade®) are sometimes used as preventers.

However, they do not usually work as well as steroids.

The main inhaled steroid preventer medications are:
  • Beclometasone. Brands include Asmabec®, Clenil Modulite®, and Qvar®. These inhalers are usually brown and sometimes red in colour.
  • Budesonide. Brands include Easyhaler Budesonide®, Novolizer Budesonide® and Pulmicort®.
  • Ciclesonide. Brand name Alvesco®.
  • Fluticasone. Brand name Flixotide®. This is a yellow-coloured or orange-coloured inhaler.
  • Mometasone. Brand name Asmanex Twisthaler®.

Therefore people who use steroid inhalers for asthma need to make sure they have a good supply of calcium in their diet.

Milk is a good source of calcium but dairy products may need to be avoided for some people with asthma inhalers.

Other good dietary sources of calcium include:

  • Bread.
  • Some vegetables (curly kale, okra, spinach and watercress).
  • Some fruits (eg, dried apricots).

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