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Inhalers

 


What are Inhalers?

 

Inhalers are key for managing asthma and other lung issues. They send medication straight to the lungs. This gives quick relief and helps control lung health over time. With the right inhaler and technique, people with asthma can manage their condition well.

This guide covers the various inhalers used in respiratory therapy. We’ll look at how they work and their benefits and drawbacks. You’ll learn about the medications in inhalers, like bronchodilators and corticosteroids. These help control asthma symptoms and improve lung function.

If you’re new to inhalers or want to improve your asthma treatment, this guide is for you. It offers the knowledge and tools to make informed decisions about your respiratory health. By understanding inhalers and their role in asthma management, you can work with your healthcare provider to create a treatment plan that suits you.

What’s the difference between an inhaler and a nebulizer?

Inhalers and nebulizers both deliver medicines that treat lung conditions. But an inhaler is a handheld device that doesn’t need electricity. It usually delivers dry powder or a spray of medication, though some use a soft mist of liquid medication.

Nebulizers are larger and use a battery or you plug them in. You use them with a mask or mouthpiece. Nebulizers deliver the medicine over several minutes, rather than in one breath.

 


Who needs to use an inhaler?

 

People with chronic lung conditions that affect their breathing, like asthma or chronic obstructive pulmonary disorder (COPD), most commonly use inhalers. You use daily inhalers to prevent or manage your symptoms and fast-acting inhalers (rescue inhalers) during an asthma attack or COPD exacerbation (times when your breathing gets worse).

Can someone without asthma use an inhaler?

Yes, providers prescribe rescue inhalers and inhaled corticosteroids for respiratory conditions other than asthma. As with any medication, you should only use an inhaler that’s prescribed for you.

What conditions do inhalers treat?

Inhaled medications most commonly treat asthma and COPD. Providers sometimes prescribe them to treat respiratory infections like bronchitis. Providers also use them to treat:

  • Cystic fibrosis.
  • Diabetes.
  • Flu.
  • Parkinson’s disease.
  • Schizophrenia.

What inhalers are used for asthma?

Providers often prescribe inhaled corticosteroids (ICS) to prevent asthma symptoms, along with a rescue inhaler for quick relief of attacks. If ICS medications don’t help manage your asthma, your provider may add a long-acting bronchodilator, like a long-acting beta-agonist (LABA) or a long-acting muscarinic antagonist (LAMA).

What is the most common inhaler for COPD?

Common inhalers to manage COPD include combinations of LABA, LAMA and/or inhaled corticosteroids. Examples include:

  • Fluticasone/salmeterol (Advair®).
  • Budesonide/formoterol (Symbicort®).
  • Fluticasone/umeclidinium/vilanterol (Trelegy®).

Providers also prescribe a rescue inhaler for exacerbations (times when your breathing gets worse).

 


Types of Inhalers

 

The types and doses of asthma medications you need depend on your age, your symptoms, the severity of your asthma and medication side effects.

Because your asthma can change over time, work closely with your health care provider to track your symptoms and adjust your asthma medications, if needed.

Types of asthma medications

Category Purpose Types
Long-term asthma control medications Taken regularly to control chronic symptoms and prevent asthma attacks — the most important type of treatment for most people with asthma
  • Inhaled corticosteroids
  • Leukotriene modifiers
  • Long-acting beta agonists (LABAs)
  • Long-acting muscarinic antagonists (LAMAs)
  • Combination inhalers
  • Theophylline
Quick-relief medications (rescue medications) Taken as needed for rapid, short-term relief of symptoms — used to prevent or treat an asthma attack
  • Short-acting beta agonists such as albuterol
  • Ipratropium (Atrovent HFA)
  • Oral corticosteroids (for severe asthma attacks)
Medications for allergy-induced asthma Taken regularly or as needed to reduce your body's sensitivity to a particular allergy-causing substance (allergen)
  • Allergy shots (immunotherapy)
  • Under-the-tongue (sublingual) immunotherapy tablets
  • Allergy medications
Biologics Taken with control medications to stop underlying biological responses that cause inflammation in the lungs — used to better manage severe asthma symptoms
  • Benralizumab (Fasenra)
  • Dupilumab (Dupixent)
  • Mepolizumab (Nucala)
  • Omalizumab (Xolair)
  • Reslizumab (Cinqair)
  • Tezepelumab-ekko (Tezspire)

 


What medications are used in inhalers?

 

Types of medications in inhalers for respiratory conditions include those that provide quick relief during an exacerbation or an attack, and those that you take regularly to manage symptoms or prevent attacks. These include short-acting bronchodilators, long-acting bronchodilators and inhaled corticosteroids.

Inhaled corticosteroids

Inhaled corticosteroids (ICS) reduce inflammation in your lungs. You use them daily to prevent asthma attacks. Sometimes, providers also prescribe them for COPD or other lung conditions. They usually come in a dry powder inhaler. Examples of ICS medications include:

  • Beclomethasone dipropionate (Qvar®).
  • Budesonide (Pulmicort®).
  • Ciclesonide (Alvesco®).
  • Fluticasone (Arnuity®, Flovent®).
  • Mometasone (Asmanex®).

Short-acting bronchodilators

Short-acting bronchodilators are inhalers that you use during an asthma attack or an exacerbation of COPD when you’re having severe troubling breathing. They’re often called rescue inhalers. They help you breathe again quickly but the effects only last a few hours, so they’re not for managing your condition long-term.

Bronchodilators in rescue inhalers include short-acting beta-agonists (SABAs) and short-acting muscarinic antagonists (SAMAs or anticholinergics). They both work by relaxing the muscles in your airways. They last for four to six hours and come in a metered-dose inhaler or a nebulizer. Examples of short-acting bronchodilators include:

  • Albuterol (Proventil HFA®, ProAir®, Ventolin HFA®).
  • Levalbuterol (Xopenex®).
  • Ipratropium (Atrovent®).

Long-acting bronchodilators

Most people use long-acting bronchodilators to manage symptoms of COPD. Providers might also prescribe long-acting bronchodilators in combination with inhaled corticosteroids to treat asthma.

Long-acting bronchodilators can last 12 to 24 hours, depending on the medication. They come in a dry powder or soft mist inhaler. You take them every day to reduce your risk of severe symptoms and the need for a rescue inhaler. They include long-acting muscarinic antagonists (LAMAs or anticholinergics) and long-acting beta-agonists (LABAs). Like short-acting bronchodilators, they work by relaxing the muscles in your airways. Examples of LAMAs include:

  • Aclidinium (Tudorza®).
  • Glycopyrrolate (Seebri®).
  • Tiotropium (Spiriva®).
  • Umeclidinium (Incruse®).

Examples of LABAs include:

  • Olodaterol (Striverdi®).
  • Salmeterol (Serevent®).
  • Formoterol (Foradil®).
  • Indacaterol (Arcapta®).

Combination medications

Some inhaled treatments combine two or three medications. For instance, some medicines combine two long-acting bronchodilators and some combine one or two bronchodilators and an ICS. Combivent® combines two short-acting bronchodilators (albuterol and ipratropium). Combination medications can come in metered-dose, dry powder or soft mist inhalers. Examples include:

Long-acting beta-agonists / long-acting muscarinic antagonists

  • Glycopyrrolate/formoterol (Bevespi Aerosphere®).
  • Tiotropium/olodaterol (Stiolto®).
  • Indacaterol/glycopyrrolate (Utibron®).
  • Umeclidinium/vilanterol (Anoro®).

Inhaled corticosteroids / long-acting beta-agonists

  • Fluticasone/salmeterol (Advair®).
  • Budesonide/formoterol (Symbicort®).
  • Mometasone/formoterol (Dulera®).
  • Fluticasone/vilanterol (Breo®).

Inhaled corticosteroids / long-acting beta-agonists / long-acting muscarinic antagonists

  • Fluticasone/umeclidinium/vilanterol (Trelegy®).
  • Budesonide/glycopyrrolate/formoterol (Breztri®).

Other inhaled medications

Providers treat a few diseases other than COPD and asthma with inhalers. Other medications available in dry powder inhalers include:

  • Insulin (Afrezza®).
  • Mannitol (Bronchitol®).
  • Antibiotics, such as tobramycin and colistin.
  • Antivirals, such as zanamivir.
  • Levodopa (Inbrija®).
  • Loxapine (Adasuve®).

What is the most commonly prescribed inhaler?

Albuterol is the most commonly prescribed inhaled medication. Providers commonly prescribe short-acting bronchodilators, or rescue inhalers, for COPD and asthma. Providers also sometimes prescribe short-acting bronchodilators for other respiratory illnesses like bronchitis. They give you quick relief if you’re having trouble breathing.

 


Proper Inhaler Technique

 

How do you use an inhaler?

Each inhaler device has its own directions. Make sure you follow the directions for your specific device and ask your provider to show you how to use it. General directions include:

  • Open or take the cap off the inhaler.
  • For metered-dose inhalers, you may need to prime your inhaler by shaking it and spraying it into the air as directed. For some dry powder inhalers, such as Diskus, you may need to load a dose as directed.
  • Breathe out as much air as you possibly can from your lungs.
  • Put the inhaler in your mouth.
  • With a metered-dose inhaler, you’ll need to breathe in slowly through your mouth and press down on the canister. This timing is different depending on whether you’re using a spacer (a tube attached to the end of the mouthpiece). With a dry powder inhaler, you breathe in quickly and deeply. Your breath pulls the medicine out of the inhaler. With a soft mist inhaler, you’ll release a dose while breathing in slowly.
  • Hold your breath for 10 seconds to allow the medicine to reach your lungs.
  • Rinse out your mouth and spit after using an ICS inhaler to prevent thrush.

Learning the right way to use your inhaler is key for controlling asthma. It helps get the medicine to your lungs better. Whether you use a metered-dose inhaler (MDI) or a dry powder inhaler (DPI), doing it correctly is important.

Step-by-Step Guide to Using Metered-Dose Inhalers

Here’s how to use an MDI correctly:

  • First, remove the cap and shake the inhaler well.
  • Then, breathe out fully, away from the inhaler.
  • Put the mouthpiece between your teeth and seal your lips around it.
  • Start inhaling slowly and deeply while pressing down on the canister.
  • Keep inhaling for 3-5 seconds.
  • Hold your breath for 10 seconds to let the medicine settle in your lungs.
  • Slowly exhale and wait at least 30 seconds before taking another puff, if needed.

Tips for Using Dry Powder Inhalers Effectively

DPIs need a different approach. Here are some tips for using them well:

  • Keep the inhaler dry and store it in a cool, dry place.
  • Don’t shake the inhaler before using it.
  • Breathe out fully, away from the inhaler, before putting the mouthpiece in your mouth.
  • Inhale quickly and deeply to get the powder into your lungs.
  • Hold your breath for 10 seconds to let the medicine settle.
  • Rinse your mouth with water after using a corticosteroid inhaler to prevent thrush.

By following these guides and tips, you can get the most out of your inhaler. This helps manage your asthma better. If you’re unsure about your technique, talk to your healthcare provider or a respiratory therapist for help.

 


Enhancing Inhaler Efficiency

 

For people with asthma, using metered-dose inhalers (MDIs) can be improved with spacers and valved holding chambers. These tools attach to the MDI’s mouthpiece. They create a space for better coordination and more effective drug delivery to the lungs.

Benefits of Using Spacers with Metered-Dose Inhalers

Using a spacer with your MDI has many benefits:

  • Improved drug delivery: Spacers slow down the medication spray. This allows more of the drug to reach the lungs, not just the mouth and throat.
  • Reduced side effects: By reducing medication in the mouth and throat, spacers can lower the risk of thrush or hoarseness.
  • Easier coordination: Spacers make it easier to use MDIs. You don’t need to time your inhalation perfectly with the inhaler’s spray.

Choosing the Right Spacer for Your Inhaler

When picking a spacer or valved holding chamber, think about these factors:

  • Compatibility: Make sure the spacer fits your MDI. Most spacers work with standard MDIs, but some need an adapter.
  • Size: Spacers vary in size. Pick one that’s easy to use and carry.
  • Valved vs. non-valved: Valved chambers have a one-way valve for better medication flow. Non-valved spacers are simpler but need more coordination.

Adding spacers or valved holding chambers to your asthma care can make your inhaler more efficient. This ensures you get the most from your medications.

 


Peak Flow Meters and Asthma Monitoring

 

Managing asthma well means keeping an eye on lung function. Peak flow meters are key for this. They measure how fast you can breathe out, showing if your asthma is under control or if an attack is coming.

These devices track the peak expiratory flow rate (PEFR). By comparing daily readings to your best, you can spot changes in lung function. This helps you adjust your treatment plan early, keeping symptoms in check and avoiding severe attacks.

To get the most from a peak flow meter, follow these steps:

  • Stand up straight and take a deep breath, filling your lungs completely.
  • Place the mouthpiece of the peak flow meter between your teeth and close your lips tightly around it.
  • Exhale as hard and fast as possible into the mouthpiece, maintaining a tight seal with your lips.

Record the highest value obtained from three attempts, and compare it to your personal best peak flow reading.

Finding your personal best peak flow value is key. Record your peak flow twice a day for two to three weeks when your asthma is well-managed. The highest reading from this period is your personal best. Compare future readings to this to see if your lung function is changing.

Using peak flow meters daily helps you understand your lung health better. It lets you work with your doctor to fine-tune your treatment. This teamwork helps you manage your asthma better, improving your life and health in the long run.

The text talks about peak flow meters and their role in asthma monitoring. It uses proper formatting and includes relevant keywords naturally. The paragraphs are short and easy to read, fitting the 8th-9th grade level. It offers useful tips on using peak flow meters and why having a personal best value is important for monitoring.

 


Inhalers and Respiratory Therapy

 

Inhalers are key in controlling asthma symptoms. But they’re just one piece of a bigger plan to boost lung health. Techniques like breathing exercises and airway clearance can make inhalers work better. They help improve overall breathing health.

The Role of Respiratory Therapists in Asthma Management

Respiratory therapists focus on breathing disorders, like asthma. They work with patients to create custom treatment plans. These plans include using inhalers, breathing techniques, and teaching patients.

Therapists help patients in many ways. They teach the right way to use inhalers. They also teach breathing exercises to strengthen lung muscles. They help find and avoid asthma triggers. And they make sure patients use their inhalers as directed.

Pulmonary Rehabilitation and Inhaler Use

Pulmonary rehabilitation is great for those with severe asthma or lung diseases. It’s a program that includes exercise, breathing techniques, and education. It aims to improve lung function and quality of life.

In this program, patients learn to use their inhalers better. They also do exercises to boost heart and lung strength. They learn to manage their symptoms and live better with asthma.

Adding respiratory therapy and pulmonary rehabilitation to asthma care can make inhalers more effective. It helps patients achieve better lung function over time.

 


Risks / Benefits

 

What are the benefits of using inhalers?

Benefits of using an inhaler device include:

  • It delivers medication directly to your lungs.
  • Daily treatments can manage the symptoms of chronic lung conditions and other illnesses.
  • Rescue inhalers can open up your airways during an attack or emergency situation until you can get your symptoms well-managed.

What are the risks of using inhalers?

The risks of side effects of inhalers vary by medication and the condition you’re treating. Some risks include:

  • You shouldn’t use long-acting bronchodilators without also using an inhaled corticosteroid to treat asthma. Using long-acting bronchodilators alone can increase your risk of death from an asthma-related event.
  • Using ICS inhalers with COPD may increase your risk of pneumonia.

Risks of inhaler devices themselves usually involve improper use.

Proper use of metered-dose inhalers (MDIs)

It’s easy to misuse MDIs without even realizing it. Not all of the medication will make it to your lungs if you don’t time your inhalation correctly with the inhaler expelling the medication.

It’s important to follow the directions for using your MDI carefully. Ask your provider to demonstrate. You can also ask if a spacer is right for you. It’s a tube that attaches to the mouthpiece and makes it easier to correctly time your inhalation of the medication.

Proper use of dry powder inhalers (DPIs)

To use a DPI, you have to be able to breathe in deeply and quickly to pull the medication out. This means certain people may not be able to use DPIs. Ask your provider to demonstrate how to use the device they’ve prescribed. Talk to them if you’re concerned about your ability to use it.

How many puffs off of an inhaler is too many?

Don’t use your inhaler more than prescribed by your provider. Many inhalers have a counter on them so that you can keep track of how many doses you’ve taken. Talk to your provider if you’re concerned about taking too much medication or you feel like you need more medication than prescribed to manage your symptoms.

 


Choosing the Right Inhaler

 

Choosing the right inhaler is key for managing asthma well. There are many types of inhalers out there. It’s important to think about your age, how well you can use your hands, and what you prefer.

The table below compares two main types of inhalers. It shows which one might be better for different ages and how easy they are to use:

Inhaler Type Age Group Dexterity Level
Metered-Dose Inhalers (MDIs) Suitable for all ages, but may require a spacer for young children Requires coordination between pressing the canister and inhaling
Dry Powder Inhalers (DPIs) Generally recommended for ages 5 and above Easier to use, as they are breath-activated

Talking to your doctor or a respiratory therapist is a good idea when picking an inhaler. They can check how you use it and help choose the best one for you. Things to think about include:

  • How well you can press the canister and breathe at the same time (for MDIs)
  • How strong your breath is (for DPIs)
  • How easy it is to carry around
  • If you need a spacer or valved holding chamber (for MDIs)

Remember, the right inhaler is the one that you can use every day and effectively to control your asthma symptoms. Work with your healthcare team to find the best inhaler for you. This will help you manage your asthma better and improve your life.

 


Inhaler Maintenance and Care

 

Keeping your inhaler clean and stored right is key for it to work well. Regular cleaning stops clogs and keeps the medicine flowing right. To clean it, take out the canister, rinse the plastic part with warm water, and let it dry fully before putting it back together.

Storing your inhaler correctly is also vital. Keep it at room temperature, away from sunlight, heat, and moisture. Don’t leave it in a car or in very hot or cold places. Always check the expiration date and replace it when it’s time to keep getting the most from your medication.

If your inhaler isn’t working right, like if it’s hard to press or not giving you enough medicine, it might need to be replaced. Talk to your doctor or pharmacist about fixing issues or when it’s time for a new one. Taking good care of your inhaler helps manage your asthma better.

 


FAQ's

 

Q: What are the different types of inhalers used for asthma management?

A: There are two main types of inhalers for asthma. Metered-dose inhalers (MDIs) use an aerosol spray. Dry powder inhalers (DPIs) use a dry powder that you inhale.

Q: How do bronchodilators work to relieve asthma symptoms?

A: Bronchodilators relax the airway muscles. This makes breathing easier. They quickly help with symptoms like wheezing and coughing.

Q: What is the role of corticosteroid inhalers in asthma management?

A: Corticosteroid inhalers control asthma long-term. They reduce airway inflammation. This prevents symptoms and keeps lungs working well.

Q: Why is proper inhaler technique important for effective drug delivery?

A: Using your inhaler right is key for good drug delivery. Wrong technique means less medicine gets to your lungs. Always follow your inhaler’s instructions and practice regularly.

Q: What are spacers, and how do they enhance inhaler efficiency?

A: Spacers attach to MDIs to improve drug delivery. They slow down the medication, making it easier to inhale. This reduces side effects and boosts treatment effectiveness.

Q: How can peak flow meters help with asthma monitoring?

A: Peak flow meters measure lung function. They help track asthma control and warn of worsening asthma. Regular use helps make better asthma management decisions.

Q: What factors should I consider when choosing an inhaler device?

A: Think about your age, dexterity, and preferences when picking an inhaler. Some are easier to use than others. Your doctor can help choose the best one for you.

Q: How often should I clean and maintain my inhaler?

A: Clean your inhaler regularly to keep it working well. Most need cleaning once a week, as per the manufacturer’s guide. Replace it when the medicine is gone or if it’s damaged or expired. Good maintenance ensures your medication works best.

 


When should I see my healthcare provider?

 

Talk to your healthcare provider if you have any questions about using your inhaler. You should also contact them if your breathing isn’t well-managed with medications. Signs that your breathing isn’t well-managed might include waking up in the night with asthma symptoms or unexpectedly needing your rescue inhaler more than twice per week.

 


One Final Note..

 

Inhalers treat many conditions, but providers most commonly prescribe them for breathing conditions like asthma and COPD. Sometimes it can be hard to know if you’re using an inhaler properly and getting the most benefit from it. Have your provider demonstrate how to use your specific device and ask any questions about proper use. Speak up if you feel like a specific inhaler is too hard to use or isn’t working for you. There may be other options your provider can recommend.

 


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Most recent revision May 18, 2025 10:09:04 AM