Why are inhalers better than tablets?
Inhaler devices enable the asthma medication to be inhaled,
or breathed in directly to the lungs where it is needed. There are two big
advantages to taking the medication this way:
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Fewer Side-Effects
When you take a tablet, it passes all around the body
as well as to the lungs. Small amounts of the drug are absorbed by
different tissues of the body on its journey. This increases the risk
of side effects. This is particularly important for the steroid based
preventer medications. Using inhalers means that a much smaller amount,
or dose, can be used, as the medication is breathed directly into
the lungs where it works. |
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Rapid Action
The medications work rapidly as they are going straight
where they are needed. This is essential where relievers are concerned
as it means they work almost instantly. |
Why are there so many different inhalers?
Unfortunately, it is not possible to have one inhaler which
everybody can use properly. This is why there are so many different ones.
All aim to deliver the maximum amount of medication to the lungs whilst
being relatively easy to use. In addition, many are colour coded so that
people can easily see which type of medication they contain. Most reliever
inhalers are blue and preventers are brown. Here we will take a look at
the main groups of inhaler device available.
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Metered Dose Inhalers (also
called MDIs or Aerosols)
These are still the most widely used inhaler but they
are also the most difficult to use! Often still referred to as 'puffers',
the medication comes in an aerosol, where it has been mixed into a
liquid then forced under pressure into a canister. When the inhaler
is held upright and the canister is pressed down on top, a measured
amount of the medication is released from the bottom of the inhaler
in mist form at high speed. The big problem for many people is co-ordinating
the release of medication with the breath in. This must be exact or
all the dose will be lost. Even when taken properly, you only get
about 10% of the medication; the rest is deposited in the mouth or
swallowed. |
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Spacers
A spacer is a chamber which fits on to the end of
an aerosol inhaler. The chambers come in different sizes. The aerosol
fits into one end of the spacer and the mouth is placed on the other.
The medication is sprayed into the spacer before it is breathed in.
Using a spacer has many advantages including the following:
(a) Easier to use than an aerosol on its own.
(b) More medication reaches the lungs and less is swallowed. This
can reduce any potential side-effects, particularly at higher doses
of the inhalers containing steroid.
(c) Some spacers come with masks which is ideal for babies and young
children who cannot use other inhalers.
(d) Spacers can be a life saver for giving medication during an asthma
attack when people are too breathless to use an inhaler on its own.
(e) Can help reduce side effects such as thrush in the mouth as less
is deposited here. |
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Autohalers
This is a special kind of aerosol which is 'breath-actuated': that
is, your breath in triggers the release of one dose of the drug. This
means you do not have to co-ordinate breathing in with spraying as
this part happens automatically at the right time. These are much
easier to use and have become quite popular. An example of an autohaler
is the Easi-breathe. |
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Dry Powder Inhalers
(also called DPIs)
This is another type of device which is becoming increasingly popular.
These contain the drug in powder form. Once the device has been primed
or loaded by the user, the drug is breathed in from a mouthpiece.
It is the breath in which draws the powder down into the lungs. This
means you do not need the same degree of co-ordination required when
using the aerosol inhalers.
Examples of DPIs are Turbohaler, Accuhaler and Diskhaler.
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Nebulisers
A nebuliser is a machine which smashes up a liquid form of the medication
into a fine mist which is then breathed in. The doses delivered are
higher than from a standard inhaler device. Nebulisers are usually
used by people with severe asthma and also by doctors to treat an
asthma attack. You should always have very careful instruction on
how and when to use a nebuliser if you have one at home, as they can
be dangerous if used incorrectly. This danger is because people can
over-rely on them and not seek help early enough when their asthma
is getting worse. |
Which is the best one to use?
The best device for you is the one which you use the best
and you prefer. It is essential that the correct type of inhaler is prescribed
for you and that you are shown how to use it. This should include a demonstration
by your doctor or nurse. You should also be able to try different ones using
dummy inhalers. The best device for you depends on a number of things including:
(1) Your Age
(2) Your preference
(3) Your life-style
(4) Which one you use most effectively
(5) Which one(s) contain the medication(s) you need
The device prescribed should be a joint decision between you and your health
professional. Whatever you use, you should have your technique regularly
reviewed. It is easy to slip into bad habits! In addition, you may need
a change of inhaler device as your asthma and/or situation changes. For
example, a 3 year old may only be able to use an aerosol with a spacer.
Once the child is 6, s/he may be able to use a dry powder device which will
also be much easier for use at school. If you are unhappy with your current
inhaler make sure to tell your doctor or asthma nurse. |
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