Asthma cannot be cured; however treatment is aimed at reducing the frequency, severity and length of attacks. Treatment plans would vary from individual to individual since a lot of different factors are involved in asthma. A large number of patients are treated with inhalers, which could be reliever inhalers or preventer inhalers.
1. Reliever inhalers
These are prescribed to help treat symptoms when they occur, that is, during an asthma attack, when peak flow readings are low and before exercise or activity. They help relax and open the airways, making it easier to breath and reducing the risk of an attack. Relievers are medically known as bronchodilators as they widen the bronchi or airways.
Some relievers alleviate symptoms almost instantly (rescue relievers). Others have a longer lasting action (long-lasting relievers). Long-lasting relievers may be prescribed if wheezing, breathing difficulties and coughing persist despite using a preventer and a rescue reliever, or if the sufferer has nocturnal asthma. Common rescue relievers are salbutamol and terbutaline. Another type of reliever is ipratropium bromide, which is often prescribed for babies under two and for older people. Long-lasting relievers include oxitropium, salmeterol, and eformoterol, all of which are inhaled. Side effects are usually mild and pass away quickly. The main ones are a slightly increased heartbeat, and muscle trembling, especially in the hands.
Occasional use of a reliever inhaler may be all that is required where symptoms occur every now and again; however, where a reliever inhaler is required at least 3 times a week to ease symptoms, a preventer inhaler is usually advised.
2. Preventer inhalers
These are prescribed to help prevent asthma symptoms. These are typically used everyday, even when patients do not have symptoms. Preventers are designed to quell swelling and inflammation in the airways and reduce mucus; as such, the sensitivity of the airways is reduced, thereby minimising potential damage. Most preventers are based on corticosteroids, which are steroids but completely different from the anabolic steroids sometimes used by bodybuilders and athletes. The most common types of preventer inhalers include beclomethasone, budesonide, and fluticasone. There are also non-steroid preventers, which are usually used for children; these include sodium cromoglycate and nedocromil sodium. These are usually taken three to four times a day and are not generally as effective as steroids.
It usually takes about 7-14 days for the steroid in a preventer inhaler to build up its effect. As such, it will not give any immediate relief of symptoms. However, after a week or so of treatment, the symptoms will often disappear, or are much reduced. It can take up to six weeks for maximum benefit, after which patients should not need to use a reliever inhaler very often, if at all.
Side-effects of preventer inhalers are unusual at normal doses. These may include hoarseness or loss of voice, oral yeast infections (thrush), and cough. Long-term use may slightly increase the risk of skin thinning, bruising, osteoporosis, eye pressure and cataracts. In children, inhaled corticosteroids may slow growth.
1. Reliever inhalers
2. 2. Preventer inhalers
Types of inhaler devices
- Pressured Metered Dose Inhalers (MDI's)
- Dry powder inhalers
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