Pharmacy Times

Asthma Inhalers?What You Should Know

Author: Greta M. Pelegrin, PharmD

What Is a Metered-Dose Inhaler?
A metered-dose inhaler (MDI) is a device used to deliver your asthma medication directly to your lungs to treat wheezing, shortness of breath, cough, and tightness of the chest. Most MDIs (such as Proventil HFA) have a pressurized canister, or tube, that holds the medication. After breathing slowly, you press the button on the inhaler, and a propellant "puffs" the drug into your mouth, bringing the medi cine into your lungs.

Unlike drugs that you take by mouth, MDIs deliver a premeasured amount of medication to the lungs, which results in fewer side effects. It can be hard to time your breathing with pressing the button. You must learn proper use of your inhaler, however, for it to work best and to deliver the right amount of drug to your lungs.

Other MDIs include Azmacourt, Ventolina, Combi-vent, Atrovent, and QVar.

Why Is Proper Use of an Inhaler So Important?
Even with good technique, only about 10% of the medicine actually reaches the lungs. When the inhaler is used incorrectly, an even smaller amount may reach the lungs. A demonstration by either a physician or a pharmacist will help, but good technique also requires practice.

Many patients, especially young children and older adults, have trouble using an inhaler correctly. When it is used wrong, some of the medication can remain in your mouth and throat, and this can cause problems. A physician will explain to you the proper place to position the inhaler. It will be one of the following:

What Is a Spacer?
A spacing device can help to deliver the medicine into your airways. Once the inhaler button is pushed, the medication goes into the spacer and is then inhaled directly into the airways. This can help reduce side effects such as hoarseness, sore throat, and thrush?an infection causing creamy, white plaques on the tongue and mouth. You should rinse your mouth after using your inhaler, especially if your medicine contains corticosteroids, such as fluticasone and beclomethasone, to prevent deposits of drug in the mouth.

Proper Inhaler Technique

What Is a Dry-Powder Inhaler?
Dry-powder inhalers have no propellants. These devices (such as Flovent and Pulmicort Turbuhaler) release a fine mist of dry powder when the mouth is closed tightly around the mouthpiece and a breath is taken. Unlike the metered-dose inhaler, you must breathe in very rapidly when you use a dry-powder inhaler. With this type of inhaler. you do not have to coordinate the breathing in with the release of the drug. Patients are encouraged to consult their pharmacists for proper dry-powder inhaler technique.

What Is a Breath-Actuated Inhaler?
Breath-actuated inhalers, such as the Maxair Autohaler, deliver medication automatically when you take a slow, deep breath. There is no need to press anything to release the drug, and a spacer is not necessary. In addition, you do not have to coordinate your breathing with pressing the button for the drug to work.

Other breath-actuated inhalers include the Advair Diskus, Serevent Diskus, and Foradil.

How Can I Take Control?
It is important that you understand the function of the different medicines contained in inhalers. Some inhalers contain bronchodilators, which are prescribed for quick results in opening the airways. Other inhalers have a cor-ticosteroid, a medicine that is prescribed for regular use in reducing inflammation in your airways. Some people use both inhalers. If you do, use the bronchodilator first, followed by the corticosteroid. It is important to keep a log for each inhaler and to make sure that prescriptions are refilled to avoid interrupted therapy. If symptoms are not relieved with the use of your inhaler, consult your physician about proper technique and the possible need for additional medication.

What Else Should I Know about My Inhaler?