Inhaled bronchodilators are medications that are used for daily monitoring of asthma symptoms or rapid bronchospasm arrest. Two different types of inhaled medications are used for supportive treatment and management of acute asthma episodes.
- Inhaled corticosteroids are used for daily prophylaxis of bronchospasms and long-term maintenance therapy for asthma.
- Long-acting beta-agonist bronchodilators (LABAs) are used in emergency situations for a rapid relief of acute bronchospasm.
Sometimes, inhalers are used in combination with oral asthma therapy. Though, the inhalation therapy usually allows controlling the symptoms of asthma. Therefore, patients, who use inhalers, should not require additional oral asthma therapy.
Inhaled corticosteroids, which are recommended for daily maintenance treatment of asthma, have a powerful anti-inflammatory effect on the respiratory tract. Due to the powerful anti-inflammatory activity, inhaled corticosteroids:
- Reduce edema in the bronchial ways
- Reduce bronchial hyperactivity
- Improve the daily function of the lungs
- Reduce the frequency and severity of bronchospasms
Asmanex (Mometasone) and Pulmicort Respules (Budesonide) are some of the best inhalers for daily asthma therapy in children and adults. The choice of an inhaled corticosteroid for maintenance asthma treatment depends largely on the age of the patient and his adherence to treatment.
- For example, Pulmicort inhaler is prescribed to children older than 6 years and adults. For an effective prevention of bronchospasm, it should be taken 2 times a day.
- If the patient periodically skips a dose of Pulmicort, doctor may recommend Asmanex inhaler, which should be used only once a day.
A one-time dosage regimen of Asmanex reduces the likelihood of missed doses, yet it is recommended only for patients, who have not previously taken oral corticosteroids. Patients with asthma, who previously used oral steroids, should use Asmanex inhaler twice daily.
It should be noted that Asmanex can be used to prevent asthma symptoms in children aged 4 and more. Therefore, it is more often prescribed to small children, than Pulmicort inhaler, which is contraindicated in children under the age of 6 years.
Regardless of which corticosteroid inhaler was chosen to control asthma symptoms, patient should be warned that steroid medications are not capable of quickly relieving bronchospasms.
If a patient develops acute bronchospasm during the maintenance therapy of asthma, he should use non-steroidal inhalers from the group of long-acting beta2-adrenergic agonists (LABAs) to relieve it.
Some of the best non-steroidal inhalers for the treatment of acute asthmatic episodes are:
- Foradil (Formoterol) - is prescribed for patients aged 5 years and older.
- Ventolin (Albuterol) - is prescribed for patients aged 4 years and older.
- Serevent Diskus (Salmeterol) - is prescribed for patients aged 4 years and older.
Each of these inhaled medications effectively reduces bronchospasm and helps to quickly calm the breathing. Yet, when choosing one of the listed inhalers, patient should take into account the frequency of bronchospasms.
- If bronchospasms occur very often, patient may be recommended Foradil inhaler, which can be used every 2 hours.
- If patient has 5-6 severe asthma attacks during a day, physician can prescribe Ventolin inhaler, which can be taken every 4-6 hours to relieve them.
- To arrest rare bronchospasms, people usually resort to Serevent Diskus inhaler, which is recommended to be used not more than 2 times a day.
Inhalers from the LABAs group (Ventolin, Foradil, Serevent) stop bronchospasm quickly, but do not prevent their reappearance. Therefore, they should be considered as part of a combined therapy for asthma, in which the main role is played by oral or inhaled corticosteroids.
It should be noted that inhaled aerosols that contain just two active ingredients, corticosteroid + LABA, can be used for a maintenance treatment.
- Dulera aerosol inhaler contains Formoterol and Mometasone.
- Advair Diskus aerosol inhaler contains Salmeterol and Fluticasone.
Combined inhalers are only used for preventive, maintenance treatment of asthma, and should not be administered to relieve acute bronchospasms.
Combined inhaled asthma medications may be useful for patients, who do not manage to control asthma symptoms only with oral or aerosol corticosteroid medications.
The presence of a large number of different types of inhalers for asthma therapy allows choosing an optimal treatment regimen for each patient, taking into account the severity of asthma symptoms, the recurrence frequency of acute asthma episodes and the income level of the patient.
If a patient buys inhalers for asthma without insurance, doctor always has the opportunity to give patient advice and recommendations that will help optimize the costs of emergency treatment or preventive inhalation therapy.