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)
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:
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:
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.
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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.