Inhalers for Asthma Relief

The Magic of Inhalers

The right inhaler can transform the life of an asthmatic - but used with poor technique, it will be useless. Understand your inhaler and improve your quality of life.

Inhalers can prevent as well as treat asthma, including allergies
Inhalers can prevent as well as treat asthma, including allergies | Source

With a well-prescribed preventative inhaler, even severe asthmatics need never have an attack again! And if you have mild asthma, an emergency inhaler (like Ventolin) can stop the occasional wheeze in its tracks, so you'll never have to worry about disturbed sleep or miss out on activities.

The great thing is that these benefits come with very few, if any, downsides. Most emergency inhalers (called "relievers", or "bronchodilators" because they relax the airways) are so safe, it's actually impossible to overdose! Preventative inhalers do have some side effects, but the dose is so tiny, they are much less serious than most other medications.

Some asthmatics are reluctant to use their inhalers because they don't like the idea of taking drugs. It's important to understand that every time you wheeze, damage is being done to your airways.

Isn't it better to take a minuscule dose of medication in an inhaler, than risk that damage?

Preventive Inhalers

Preventative inhalers have to be taken daily - usually two or three times a day. The protection builds up over time, so if you don't take it religiously every day, you may as well throw it away - occasional use has no effect whatsoever, so you're wasting your money!

The payoff for being conscientious is that, with the right dose, you'll feel as if you don't have asthma at all. No wheezing, no coughing, no shortness of breath when you exercise. Every day, all the time. Isn't that worth making an effort for?

Preventive inhalers usually contain some kind of steroid. In large doses, they can cause osteoporosis, so even with the tiny amount in inhalers, it's best to play it safe and get the dosage just right. Newer inhalers like Seretide or Advair use a combination of preventative and bronchodilator to help get the balance right.

You may need extra asthma preventer puffs in summer if you're allergic to pollen
You may need extra asthma preventer puffs in summer if you're allergic to pollen

Your Asthma Treatment Plan

If your doctor or specialist knows their stuff, they won't just give you a prescription for a preventative inhaler, they'll also give you an Asthma Treatment Plan.

We talk about asthma "attacks" because they seem to hit with little or no warning. In reality, the asthma has often been lurking in the background, building up gradually, until something tips it over the edge.

A Treatment Plan enables you to identify that early build-up. if you take a little extra preventer at that point, you can stop an attack before it has a chance to get started.

And if you miss the signs and have a full-blown attack, the Treatment Plan gives you benchmarks so you can judge how severe it is, and tells you what to do to get your asthma back under control.

To follow the Plan, you must be able to identify when your breathing is normal and when it’s not. That's why a Peak Flow Meter is an essential weapon in your war against asthma!

Peak Flow Meters

Microlife, PF 100 Peak Flow Meter for Spirometry with FEV1, White/Blue
Microlife, PF 100 Peak Flow Meter for Spirometry with FEV1, White/Blue

This peak flow meter has optional software and a USB connection so you can keep track of your readings on your PC - very useful to take to your doctor.

 

If your readings aren’t consistent, or if your morning reading is much worse than the evening one (or vice versa), see your doctor.

Unpredictable readings mean your asthma is very “twitchy”, making you vulnerable to sudden, possibly dangerous, attacks. Readings that deteriorate overnight suggest you need a combined preventer / bronchodilator, or a long-acting night-time medication, to keep you on an even keel.

Benefits of a Peak Flow Meter

By using your Peak Flow Meter every day and recording the readings, you can learn what your normal breathing pattern is. Then you’ll know instantly, the moment your breathing starts to deteriorate.

If your doctor hasn’t given you a treatment plan, here’s how to build one yourself. You’ll need a Peak Flow Meter and a notebook to record your daily readings

Use the Peak Flow Meter every morning when you get up, and again when you go to bed, and record the readings. After a week, check your readings - you should find the readings are fairly consistent. If they are, you now have a reading that you can regard as “normal”.

From now on, make your Peak Flow Meter part of your regular morning routine, like brushing your teeth. If your reading takes a sudden dip, take one extra puff of your preventer for a few days until your reading returns to normal. If it shows no sign of improving, don’t increase the dose again – see your physician first.

Emergency Inhalers

Emergency inhalers - bronchodilators - are inhalers you carry around and use when you have a wheeze. You can also take a puff or two before you start exercising, to prevent you having an attack. Common brand names are Ventolin and Proventil. For these inhalers, there is no such thing as an overdose limit, and the only known side effect is a tremor.

If there's no overdose limit, you may wonder why the packet sets a limit on the number of puffs you should take. It's not because the drug is dangerous - it's because if you have an asthma attack and it doesn't respond to two or three puffs, it's so bad that you may be in danger.

In theory, almost all asthma attacks can be relieved by just one puff of one of these inhalers. The problem is, it has to get deep into your lungs to do so - and it can't, if your asthma is bad. That's why you need to take two puffs - but there's no point in taking them in quick succession.

The first puff is meant to ease the congestion enough so the second puff can get deep into your lungs. Therefore it's very important to wait a minute or so for the first puff to work before taking the second one. If you're still feeling tight after another minute or so, you can take a third puff.

It's also vital to use the correct inhaler technique, which may not be as obvious as you think.  Watch this video to make sure you're getting it exactly right:

A severe asthma attack needs hospital treatment
A severe asthma attack needs hospital treatment

Danger Signs of Asthma

If you've taken three puffs (with the correct technique and leaving gaps between, as described above), and you still don't feel better - you're in trouble.

I mean it!

Take a fourth puff, but get yourself straight to a doctor or a hospital. Lungs that don't respond to an inhaler are so badly congested that you're in grave danger - you could suffocate to death.

Deaths from asthma are more common than you may think, and many of them occur because people keep on taking puffs on their inhaler and hoping it will work, rather than seeking help. Don't be a statistic!

*

pollen pic by zenobia_joy, child in hospital by Daryl Davis.

Comments 36 comments

Marisa Wright profile image

Marisa Wright 4 years ago from Sydney Author

Good luck with the complementary therapies, Ariel, but be sure you are using your Peak Flow Meter to check your progress - NEVER just rely on how you feel. It can be very dangerous to give up using inhalers.


Marisa Wright profile image

Marisa Wright 4 years ago from Sydney Author

Good luck with the complementary therapies, Ariel, but be sure you are using your Peak Flow Meter to check your progress - NEVER just rely on how you feel. It can be very dangerous to give up using inhalers.


devlinsteel profile image

devlinsteel 4 years ago

Hi Marisa. Yes. Have a look at the video - I believe we can safely reduce asthma by reducing the level of hidden "over-breathing", and as (and if) symptoms reduce and it is safe - then to reduce medications under medical supervision.

Buteyko is one method of safely doing this. I know that it worked for me, my mother, and about 4,000 people I have taught over the last 16 years. I am really surprised that it has not been taken up by physiotherapists and nurses. There is nothing that alternative about it - just consider a different theory, safely test it and consider the results.

And as you say - keep safe by using resources like peak flows and medical advice - any lost life lost is a tragedy. There is no rush - providing we do what is safe. Eventually the reality of things like over breathing as a component of asthma will with either be proven or dismissed. Obviously I am convinced that it is real, and that reducing it works to reduce symptoms because I have seen it.

It is sort of bizarre that something as simple as just learning some breathing drills can reduce asthma symptoms very dramatically - and it will be interesting to see what is in place for asthma in 20 years from now. Hopefully we will see a condition that is on the decline rather than the current increase.

Cheers

James Hooper


Marisa Wright profile image

Marisa Wright 4 years ago from Sydney Author

James, it sounds like you're talking about something similar to the Buteyko method. It's a fascinating theory and worth looking into. The only thing I would caution is - always check the effectiveness of any treatment, natural or otherwise, with a peak flow meter. Don't rely on how you feel, because that's very unreliable.


devlinsteel profile image

devlinsteel 4 years ago

Wow - great hub. If there is one thing I would like to make people more aware of - especially if you are pregnant and have asthma - is the impact of changed (hidden) over breathing levels on need for relief drugs.

There is a great video about how hidden hyperventilation is a factor in asthma - that shows clinical trials that reduce drug relief need by about 90% average. Just google 'grow out of asthma' for videos. I am new to hubs and do not know if a link will work? http://www.youtube.com/watch?v=LZM5L1WVVBg&feature...

It will make you consider things like how being pregnant does change your breathing levels - even if only because it changes your posture. Eg slouching actually increases your breathing levels, as do the obvious things like breathing through your mouth.

To me - anything that potentially reduces the need for meds while pregnant is worth checking out. And the comments above are supported by good studies - asthma meds are safe and are better than risking a severe asthma attack.

Great work.

James Hooper


Marisa Wright profile image

Marisa Wright 4 years ago from Sydney Author

@Choccat, I had asthma at that age so I feel for your daughter.

I live in Australia, which has the highest rate of asthma in the world. You'll find the "three puffs and hospital" directive posted on the wall in primary schools here, because so many kids have it. Of course, schools are going to err on the safe side, so perhaps the advice is a little extreme - but it is official!

Does she have a peak flow meter to check her airways daily? If she keeps a record for a month or so, and works out what her "personal best" is, you can use it during the attack to decide when she must go to hospital. The rule is that if she drops below 50% of her personal best, it's definitely time to go.

I wonder if the reliever is part of the problem. Long lasting relievers are excellent at enhancing the effect of preventers, but they're not all good for quick relief of a bad attack. Maybe that's why your asthma plan allows such a high number of puffs. The problem is, for an asthmatic having a severe attack, 30 puffs would be absolutely exhausting, and it's unlikely most of them would get to the lungs. It might be worth getting an ordinary reliever like Ventolin to keep for severe attacks - you may find it's more effective, because that's what it's designed for.

Another thing to ask your doctor about is Salbutamol tablets (basically Ventolin in tablet form). They're considered old-fashioned, but in a severe attack where nothing is getting into her lungs, a tablet makes sense. They do have a distressing side effect because they make you tremble - but when I had asthma as a child, I was so grateful to be able to breathe, I was willing to put up with the shakes!

The peak flow meter is also a useful habit to get into, because severe attacks rarely come completely "out of the blue" - if she uses a peak flow meter first thing in the morning and in late afternoon, she'll start to recognize the subtle changes in airflow that indicate there's a big one on the way. Then she can increase her medication in advance, which will reduce the severity.


Choccat 4 years ago

Hi, just came across this and am quite concerned that you seem to think a hospital visit is necessary after just three puffs of an inhaler. My daughter, almost 11, was diagnosed with asthma at 2, she currently uses a preventer and a long lasting reliever, both of which she takes twice a day. She does still occasionally suffer from attacks, these usually come out of the blue and can be quite severe, with her struggling for breath, leaving her exhausted for days afterwards. She does have an asthma plan which we follow and that says that she can take 3 lots of 10 puffs of her reliever before we seek emergency help. But she often feels so stressed and panicy that we go long before that point and end up being told it was unnecessary and we should have stayed at home where she would have recovered in due course. She always uses a spacer with her inhalers and has her technique reviewed regularly. Are we being given the wrong information and should I get her the GP/hospital sooner than I do?


LucidDreams profile image

LucidDreams 4 years ago from St Petersburg, Florida

I never thought about that. That's a great idea.....Thanks Marisa, I hope that might work! Certainly an elitist healthcare system. It's really all abot profit. Unfortunately there will be many suffering because of this. I wonder if the news will pick that up or be hushed....


Marisa Wright profile image

Marisa Wright 4 years ago from Sydney Author

I'm so sorry to hear that. I've lived in Europe and Australia all my life, and I'm still amazed that a "developed" country like America has such an elitist health system,with no safety net for those who can't afford it.

I can still see Primatene on sale on Amazon.com, have you tried ordering there?


LucidDreams profile image

LucidDreams 4 years ago from St Petersburg, Florida

Now we who suffer from asthma cannot even get an inhaler over the counter. I have has asthma all of my life and recently have had to depend on Primatene mist. Now it has been banned and I cannot afford a doctor or the prescription which is now the only way to get an inhaler. Guess I will eather die or pay for the doctor and prescription.

This make me so upset. They had plenty of time to fix this problem. What happens if someone is out of state or abroad and has an attack without the inhaler. Could they buy one, I guess it would depend where they were at but I think not. Just lettem die right?


Marisa Wright profile image

Marisa Wright 5 years ago from Sydney Author

Haf Sha, doctors are very cautious about prescribing any medication to pregnant women. Tests on animals suggest that Seretide is safe in pregnancy, but there haven't been any human tests so no one can be 100% sure.

I suggest you go back to your doctor and ask his opinion. If your allergy is mild, there may be other more suitable alternatives.


Haf Sha 5 years ago

i have problem of elergy.due to that now i got problem of short breathing sometimes..doctor recommendede me SERETIDE 250..just i started using it i came to know in a week i m pregnant...so i m in 1st trimester now..can any1 suggest me should i continue using it or not..just 2,3 times a week.wil it effect my pregnency or the fetous?


Marisa Wright profile image

Marisa Wright 5 years ago from Sydney Author

Babyj, a Ventolin inhaler should give you relief for 3 to 4 hours, not 10 to 15 minutes. If you find it's only working for 15 minutes, you didn't use it properly.

You must always take two puffs of a Ventolin inhaler, not just one. More important, you MUST wait a minute or two between puffs. The first puff prepares your airways for the second dose, so you must give it time to work.


Babyj 5 years ago

Asthma is a kind of disease that can kill and some people can over come asthma by beliefs or EVEN MARTIAL ARTS OR EXERCISE, there is a kind of inhaler that is called ventolin inhaler it only last up to at least 10-15 min but another type of inhaler calledAlbuterol inhaler can last up to 4-6 hours, i am asthmatic and i would like to have that inhaler cus i want to start doing marshial art but i am not sure if i can.


Marisa Wright profile image

Marisa Wright 5 years ago from Sydney Author

Viacic, I am not sure how much Ventolin costs in your country, but it sounds like you're using the inhaler a lot.

If you need to use a Ventolin inhaler more than once or twice a week, you should be on a preventive inhaler instead, which you would need smaller doses of, so it might be cheaper.


viaclc 5 years ago

The makers of ventolin do not care about people, I have been taking ventolin for a long time and know I have little insurance and does not cover any inhaler. Can not affordit any more lost my good health insurance but I tried to get help from the maker glaxosmithkline they said I was not eligible because I have insurance even though it covers no inhalers whatsoever $6 without insurance it is almost $60.00 a month which most older people can not afford because they take other medications. Maybe if someone dies from not being able to afford there medication then they might help. please pray for me that I find a way to get help because without I will die.


Marisa Wright profile image

Marisa Wright 5 years ago from Sydney Author

Carol, if you have a sulfa allergy, you're allergic to sulfonamides. That's not the same thing as sulfate OR sulfites. I know the names sound similar so that's why people assume they're all connected - but they're not.

So the first thing to check, before you worry about the new inhalers, is whether you genuinely have those three separate allergies.

If you do, I believe it used to be possible to get CFC inhalers from Mexico. Otherwise, your best option is to seek better treatment for your asthma so you don't need to use emergency inhalers.


carolholiver 5 years ago

Formerly the delivery system for emergency albuturol inhalers was flurocarbons. They have banned them now, and they use albuturol sulfates I am dangerously allergic to sulfa, sulfates, and sulfites. Does anyone know of an emergency inhaler that does not use these ingredients?


Marisa Wright profile image

Marisa Wright 6 years ago from Sydney Author

@Lynne, I suspect you and I disagree about the fundamental causes of asthma.

Many people blame contaminants, but the research is pointing much more to over-protection as the cause. Allergic asthma is basically a faulty immune system that identifies harmless substances as dangerous. You can give pigs asthma by keeping them in a sterile environment for their early life, so their immune systems don't 'learn'.


OxygenLynne profile image

OxygenLynne 6 years ago from Florida

Bless you all who dealing with this modern-day scourge called asthma. From everything I have read asthma is becoming more and more common much as diabetes and arthritis because of the contaminants that we eat, breathe and drink everyday.

I read a report from CNN 2 weeks ago about "Airborne Diabetes" and it showed auto exhaust as the primary culprit. That was a real shocker!

Obviously there is a root cause of all these 'new' diseases and many doctors earlier in this century had some pretty novel ideas about them.

Their work has mostly been relegated to the trash bin, though, because they do not contribute to the bottom line profit of those who name the disease then, in short order, produce a pill to 'manage' it.

Read what Dr. Virchow had to say about disease. What the Mayo brothers believed was the root cause of disease. And what many other famous doctors and surgeons had to say decades ago that is still pertinent today.


Marisa Wright profile image

Marisa Wright 6 years ago from Sydney Author

Newzolt, you are right and I hope I emphasized that sufficiently in the section on preventative inhalers.


newzolt profile image

newzolt 6 years ago

Remember asthma treatment is taking regular and lifelong inhalers. You cannot skip or ignore this by any means.


2besure profile image

2besure 6 years ago from Charlotte, North Carolina

When I first got asthma, I didn't realize I was having asthma symptoms. I did not use my inhaler when I needed to and always found myself in the emergency room and on steroids. I am smarter now and have had less problems.


Marisa Wright profile image

Marisa Wright 7 years ago from Sydney Author

Becky, I'm not sure I understand why you can't take preventative meds if you can take Prednisone? Most preventative inhalers are just microdoses of Prednisone - if you can tolerate a big hit to your whole system from the tablets, then why wouldn't you tolerate a tiny amount targeted solely in your lungs? Or maybe your doctor is prescribing the wrong inhaler?


BeckyC profile image

BeckyC 7 years ago

I wish it were always that simple. Unfortunately I can't tolerate the side effects of most medications--it makes another health condition worse--and asthma meds are some of the worst. If my asthma starts to flare though I can tolerate some of the preventative meds in small doses short term, and if that's not enough Prednisone always comes to the rescue :-)

Fiona, if your son isn't using his inhaler correctly, there are different attachments you can get to make it easier for him. Spacers are great for anyone with asthma, and can be of a lot of help to a child. I've also seen an attachment that looks like a face mask, which covers the mouth and nose, but I don't know anything about it. A lot of times doctors will prescribe nebulizers for young children as well.


Marisa Wright profile image

Marisa Wright 7 years ago from Sydney Author

Dragonpoet, I understand how scary that can be. The vital thing is to get yourself a peak flow meter. By checking your peak flow when you wake up in the morning and before you go to bed, you can learn what your "normal" range is.

Asthma attacks rarely come on without any warning - it's just that we're not good at recognizing the signs! If you're heading for an asthma attack, you will usually see the peak flow starting to drop slightly - don't wait for it to drop any more, jump on it immediately by increasing your medication.

Speaking of medication - if you've had a near fatal attack, then you should be on a preventer inhaler at all times.


dragonpoet12000 7 years ago

I have just recently been diagnosised with asthma and I am still learning stages what is best for me, and what i can do to keep attacks at bay, since I just suffered a near fatal asthma a few weeks ago, any possibly suggestions would be helpful.


jenblacksheep profile image

jenblacksheep 7 years ago from England

I've had inhalers all my life. Sometimes I go through phases where I don't take them and I don't need them. But then it gets a bit worse and I have to go back on them. At the moment I am taking my preventative and usually need the reliever when I am trying to sleep. It makes me shake really badly though!!


Marisa Wright profile image

Marisa Wright 7 years ago from Sydney Author

No, absolutely not Fiona! If he has to take his inhaler every half hour, he's either so ill he should be in hospital, or he's using the inhaler wrongly and most of the medicine isn't reaching his lungs.

You need to fix this. I hate to scare you, but the fact is that children can die of asthma, so you need to take this very seriously.

Watch him when he uses the inhaler. Make sure he doesn't rush it - he needs to try to breathe out as much as possible before he takes a puff, then he needs to breathe in at EXACTLY the same time as he presses the inhaler. If you see any vapour escaping up the "chimney", he's done it wrong.

He should never, ever take just one puff. He should take one puff, then wait a few minutes until he feels his chest easing a little, then take another one. If he still feels wheezy, he can wait again and take a third one.

If he's used the inhaler correctly and three puffs doesn't work, he needs to go to the ER.


Fiona 7 years ago

My 5 year old son has asthma only when he has a cold but it can come on quite quickly and be quite severe - Is it ok for him to take his inhaler every half hour or hour if he needs it?


Marisa Wright profile image

Marisa Wright 7 years ago from Sydney Author

No Jo, there is no evidence of any link between inhalers and leukemia.  In fact there have been several very long-term studies on children using albuterol inhalers daily throughout their childhood. These studies followed large numbers of children from infancy until their 20's or 30's.  Albuterol inhalers are so safe, there's no documented toxic dose and there is no evidence of dangerous side effects.

Preventer inhalers do have side effects, but there is no evidence they cause cancer.  In fact, there is some evidence they may lower the risk of lung cancer.


jo 7 years ago

are inhalers linked to leukemia in children


kcr101 profile image

kcr101 7 years ago from Philippines

I've been dependent on my nebulizer and inhalers for almost 6 years, and man I've had really bad attacks! My friend recommended me switching to a certain diet and now I've been asthma - free for almost 2 years now! Please view my hub. Thanks!


Eileen Hughes profile image

Eileen Hughes 7 years ago from Northam Western Australia

Marissa, my granddaughter has an attack of asthma occasional, but it was only by accident that we found out she wasn't using her inhaler correctly therefore it was a hit and miss effect. not good at all, I believe it wasn't explained to her correctly.

Good hub as normal. thanks for sharing


tjmum profile image

tjmum 8 years ago from Isle of Wight

Asthma seems to be all too common in this modern era with pollution and household cleaners and air fresheners playing a big part. But I find too that doctors are too quick to jump on the asthma band wagon. My son had a cough and weezy chest and my doctor immediately put him on an inhaler as he has eczema. It turned out he had a chest infection and after antibiotics (and much love and attention) it cleared up and has not returned. Inhalers are great for treating those with asthma (as my niece has) but are often abused.


Zsuzsy Bee profile image

Zsuzsy Bee 8 years ago from Ontario/Canada

Great HUB Marisa! It is hard to imagine that breathing, something we take for granted is a problem to so many.

regards Zsuzsy

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