Types of Asthma Inhalers: All you need to know about it

Types of Asthma Inhalers: All you need to know about it

Asthma inhalers are handheld, portable devices that administer medication to your lungs. To assist and control asthma symptoms, a range of asthma inhalers are available. Finding the proper one and utilizing it correctly might assist you in preventing or resolving asthma symptoms and episodes

To select the ideal inhaler for you, you must strike a balance between the right medicine and the right type of inhaler for your needs, as well as your ability to use the inhaler appropriately. Training from your doctor or another health care practitioner is required to learn how to operate the inhaler appropriately.

Based on the Type of Medication Delivered, there are Two Primary Classifications for Inhalers: Controller and Rescue Inhalers.

Inhalers are classified into two categories: controller inhalers and rescue inhalers. Controller inhalers are used for delivering controller medications on long-term basis. These inhalers are used regularly and help in the long-term control of asthma symptoms, while rescue inhalers are used for delivering rescue medications for quick relief. They are used intermittently to relieve asthma symptoms [breathlessness]. They help in the delivery of inhaled medications and provide great help in relieving life-threatening asthma attack.

Medications in rescue inhalers are quick-acting; they relieve breathlessness on a primary basis. These medications are also referred to as short-acting bronchodilators as they help open up the constricted airway brought on by an asthma attack. These devices are, therefore, used for emergency and rescue treatment. These devices are effective within minutes of use and the effects of its use last for 2 to 4 hours. Rescue inhalers can also be used preventatively in selective conditions, such as before exercise, in order to avoid exercise-induced asthma attacks or episodes.

Recently, the concept of using 2 different inhalers has been updated to using one single inhaler. This form of therapy is called SMART therapy. SMART therapy for asthma means needing only one inhaler for both “daily” and “rescue” asthma treatment. A SMART treatment inhaler contains two medications: a corticosteroid and a long-acting beta-2 agonist (LABA) called formoterol.

Depending on the mechanism of medication delivery, Inhalers are classified in two types: Metered Dose Inhalers and Dry Powder Inhalers.

Metered dose inhalers

Metered dose inhalers comprise of a pressurized canister whose function is to hold the medication. When the canister is pushed/actuated into the boot, medication is released through the opening into your mouth cavity, which is then available for inhalation to enter lungs.

Some metered dose inhalers facilitate automatic release of medication when you inhale [breath-actuated metered dose inhalers]. A few metered dose inhalers include dose counters so you can see how many doses are remaining for inhalation. Some newer models employ technology to assist you in counting dosages through a mobile application installed onto your phone.

Spacers are used to overcome the co-ordination errors associated with metered dose inhalers. Spacer serves as a holding chamber. They have a mouthpiece at one end and on the other end, you can fit your metered dose inhaler. When metered dose inhaler is actuated, it delivers the medication in the spacer which retains it in a tube between the inhaler and your mouth. By releasing the medication into the spacer, you may inhale more slowly, increasing the quantity of medication that enters your lungs and increase its effectiveness. A spacer might help some patient population, such as children or older adults, to inhale a sufficient quantity of dose. A prescription is required for spacers [holding chambers with valve] and holding chambers [holding chambers without valve].

Technique for inhalation with metered dose inhalers

A metered dose inhaler use has 12 steps in total. Following the correct usage can help in depositing the right amount of medication in the lungs.

  • Remove the cap
  • Shake the inhaler before use
  • Attach the inhaler to a spacer if needed
  • Hold the inhaler in an upright position
  • Exhale completely before putting the inhaler to your mouth
  • Place the inhaler mouthpiece between teeth and seal your lips around it.
  • Actuate once during inhalation
  • Inhale slowly and deeply
  • Hold your breath for 5-10 seconds
  • Remove the inhaler from your mouth
  • Exhale and breathe normally
  • Wait for 30 seconds or 1 minute before taking the second puff
  • Repeat steps 1- 11 for the second puff.
  • Post inhalation, gargle with water and spit it out.

How to clean a metered dose inhaler:

  • Take out the metal canister from the outer covering of the inhaler and take off the cap from the mouthpiece.
  • Place the outer plastic covering under running warm water
  • Let the inhaler dry overnight, making sure you have a back-up in case needed.
  • Insert the canister back into the plastic covering and check the workability of the inhaler by releasing a puff in the air.
  • Replace the cap on the mouthpiece.

Dry powder inhaler

Dry powder inhalers [DPIs] are another popular type of inhaler used in India to deliver asthma medication. As the name suggests, medication is present in the form of dry powder in this inhaler. Patients have to inhale fast and deep to inhale the powdered medication present in DPI. A multiple dose DPI may hold up to 200 doses while some devices [Single dose DPI] may require you to insert a pill right before every use.

STEPS TO USE A DPI

STEPS TO USE A DPI

How to clean a dry powder inhaler:

  • A dry powder inhaler must never come in contact with water and dampness should be avoided.
  • To keep your inhaler clean, you may wipe the mouthpiece with a dry, clean cloth.

Soft mist inhaler

Soft mist inhalers are propellant-free devices and are a little larger in size than your average metered dose inhalers. Unlike meter dose inhalers and DPIs, soft mist inhalers release a low-velocity aerosol mist that can be gradually inhaled over a short period of time. A face mask may be required in order to use a soft mist inhaler, especially in case of children.

How to clean soft mist inhaler:

The mouthpiece can be wiped by a damp, clean cloth on a weekly basis.

Other devices

For those unable to use either a meter dose inhaler or a DPI, other types of asthma inhalers include:

  • Nebuliser: A nebuliser turns medication into mist which is inhaled through a mask that fits over the mouth and nose. For those who are very ill and unable to use an inhaler, such as children and infants, and for those who require a large dose of medication, a nebulizer may be necessary to administer asthma treatment

Cleaning instructions may be mentioned on product packaging for the above

Finding the right inhaler

Contact your general physician to understand which inhaler might be best suited for you. To make best use of your inhaler, ensure the following:

  • Make sure the cap is on the mouthpiece in order to prevent dust and debris accumulation.
  • Ensure that your inhaler is stored at a neutral temperature.
  • Avoid contact of the inhaler with dampness and water.
  • Keep medicines safely, away from moisture, pets, and children.
  • Replace your inhaler when it is past its expiration.
  • Ensure that your inhaler has adequate doses.