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Asthma Inhalers - The Complete Guide to Asthma Treatments

Most Popular - Ventolin
  • 1 inhaler for £19.99
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  • Evoholer and Accuhaler
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There are a wide variety of asthma inhalers in the UK with the ability to prevent a host of symptoms connected to respiratory conditions. Inhalers can be split into two categories; reliever inhalers used as fast relief only when needed and preventer inhalers used everyday to stop symptoms from occurring in the first place. Inhalers also come in various forms, from breath-activated Accuhalers to standard pump Evohalers. You can begin your consultation now or continue below to find out more.

What are the types of inhaler?

Inhalers (which can also be referred to as "puffers") can come in a variety of forms depending on the level of your condition and how you would prefer to take the medication. They can initially be split into two categories:

  • Preventer – taken daily to avoid symptoms from materialising
  • Reliever – taken only when symptoms appear or in anticipation

All asthmatics should have a reliever inhaler (blue inhaler) on their person just in case symptoms erupt. A smaller number of asthmatics will also need a preventer inhaler (brown or dark red typically) to combat asthma triggers.

Types of inhaler devices

In addition, the style of the inhaler can also vary. The most common inhaler device is the standard pump format known as an Evohaler or Metered-Dose Inhalers; a metal canister containing the medication, which you press down to release the formula. Some are breath-activated, otherwise called Accuhalers. This is handy for individuals with arthritis, for example, who struggle using an aerosol pump that needs to be physically pressed down. The styles of inhaler include:

Evohaler

Metered-Dose Inhalers (MDIs)

Also known as Evohalers, these are the most common type of inhalers that have been used for decades. It consists of a pressurised canister that is pressed down to release a "puff" of medication.

Accuhaler

Breath-Activated Inhalers (BAIs)

Most commonly known as Accuhalers, the medication is activated by breathing in the mouthpiece. They may also be called Easi-Breathe, Turbohaler or Dry Powder Inhalers, and can look different to the standard Accuhaler shown.

Inhaler Spacer

Spacer

Used with Metered-Dose Inhalers, it is a hollow plastic device that you can attached your Evohaler to, which helps you to breathe in the medication more effectively. May also be referred to as a 'Bubble' or 'Chamber'.

Nebuliser

Nebulisers

A machine with a mouthpiece or facemask that presents the medication as a fine mist. Generally found in hospitals. May also be referred to as a Short-Acting Bronchodilator.

What conditions can I use an inhaler for?

The most common reason for using an inhaler is asthma, but inhalers can also be used for bronchitis, cystic fibrosis, COPD and other conditions affecting the airways. This includes temporary conditions such as allergies (some hay fever sufferers may be prescribed an inhaler during the spring and summer) or if you have a particularly nasty cough.

Regardless of the type of inhaler, all treatment for respiratory conditions require a prescription approved by a doctor. Whilst this is typically available through GP appointment, it is possible to order your preferred inhaler online from HealthExpress. Our doctor will review your consultation and when approved, the prescription is sent straight to the pharmacy. Your asthma medication will be sent straight to your door.

Reliever Inhalers

As briefly mentioned, reliever inhalers (blue inhalers) are the most common type of inhaler and are only used when symptoms appear, or in anticipation of experiencing symptoms (aka around 20 minutes before strenuous activity such as exercising). They may also be called short-acting reliever inhalers and any asthmatic can use them (as per recommendation by a medical professional). It is also common to use a reliever inhaler alongside a prevent inhaler.

Types of Reliever Inhaler
Metered-Dose Inhalers (MDIs or Evohalers) Breath-Actuated Inhalers (BAIs or Accuhalers) Dry Powder Inhalers (DPIs, Accuhalers or Turbohalers)

Reliever inhaler in blue with cannister

If you are experiencing any symptoms linked to asthma, a reliever inhaler can be taken to prevent the symptoms from worsening, and eventually subdue them completely.

Reliever inhalers can also be taken in anticipation of breathing difficulties. For example, relievers such as Ventolin are commonly used before exercising to help open the airways.

The most common asthma treatment available in the UK is Ventolin, coming in the form of a light blue plastic casing. It is also available in its generic form Salbutamol (the active ingredient in Ventolin). Other reliever inhalers available include:

Reliever inhalers can be used by all asthmatics, and occasionally for non-asthmatics who are experiencing a cough, hay fever and any other condition that causes breathing problems . They should be used if you have symptoms rarely and/or you have well-controlled asthma/COPD/bronchitis/etc.

Short-acting reliever inhalers should be carried AT ALL TIMES by asthmatics and sufferers of other respiratory conditions.

Long-acting reliever inhalers (LARI)

Long-acting reliever inhalers are used alongside preventers and should be prescribed by your doctor to complement steroid preventer inhaler treatment. These are for asthmatics and other related respiratory sufferers who have trouble controlling their symptoms with a short-acting reliever and/or a preventer.

There are two types of long-acting reliever inhalers:

  • Long-acting beta agonist (LABA) – Serevent, Vertine Metered-Dose Inhaler, Formoterol Easyhaler.
  • Long-acting muscarinic receptor antagonists (LAMA) – Spiriva Respimat

You must NOT use this type of inhaler without clarification from your doctor and without using a specific steroid preventer inhaler, also recommended by your doctor. In fact, using a long-acting reliever inhaler without a steroid preventer inhaler can be dangerous to your health. If you don't use a preventer recommended by your doctor, a long-acting reliever inhaler can cause further irritation and inflame the airways leading to further, more serious, breathing issues.

This type of inhaler is also NOT appropriate during an asthma attack, the blue inhaler is the ideal treatment in an emergency.

These long-acting reliever inhalers are seldom the first port of call, but their need is established after a period of time where you have struggle using just a preventer and/or short-acting reliever. Your doctor or asthma nurse will be able to find you the perfect combination of inhalers, and show you how to correctly use them.

Preventer Inhalers

Preventer inhalers tend to be a brown or dark red colour and must be used on a daily basis, whether you are experiencing symptoms or not. Preventers are for asthmatics that have trouble controlling their asthma symptoms (mild-moderate asthma) and can be prone to asthma attacks. They can help to prevent triggers and the medication builds up every day you use it.

Types of Preventer Inhaler
Metered-Dose Inhalers (MDIs or Evohalers) Breath-Actuated Inhalers (BAIs or Accuhalers) Dry Powder Inhalers (DPIs, Accuhalers or Turbohalers)

Preventer inhaler in a brown and orange colour with the cannister

There are a number of preventer inhalers on offer in the UK depending on the compatibility with your lifestyle and respiratory symptoms:

Preventer inhalers can be used alongside reliever inhalers, and your doctor will often advise which ones you can take. You can also use a spacer with preventer inhalers.

Combination Inhalers (Preventer and Long-Acting Reliever)

Combination inhalers are for individuals with moderate asthma who are finding that symptoms are difficult to control with a separate preventer and reliever. They can be used by children as well as adults and help to subdue symptoms caused by a range of triggers.

Types of combination inhaler (containing Long-Acting Relievers (LABA) and corticosteroid) should be used every day similar to a preventer inhaler and include:

You will also need to keep your blue inhaler on you in case of emergencies.

Accuhalers (dry-powder inhalers or breath-activated inhalers)

Inhalers that are activated by your own breathing are known as Accuhalers. These are suitable for those who find the coordination of MDIs difficult, such as children and those with arthritis. Accuhalers tend to be a circular plastic device.

Accuhaler device for asthma tha tis orange in colour

You should always read the instructions and take your doctor's advice when using inhalers to ensure you're inhaling the medication correctly. The basic rules of Accuhalers are as follows:

  • Give the Accuhaler a good shake.
  • Slide the opening across, revealing the mouthpiece for inhalation.
  • Exhale slowly and fully.
  • Place the opening to your mouth.
  • Inhale slowly and fully – the Accuhaler will automatically release a measured dosage.
  • Try to hold your breath for at least 10 seconds so the medication can be absorbed.
  • Wait at least 10 seconds in-between each puff.

Some Accuhalers are refillable whilst others can be binned responsibly once finished. Within an Accuhaler are measured inhaler dosages also known as "blisters packets" that are broken, and therefore ready to use, every time you slide open the device. Accuhalers also have a useful number system along the side, which tells you how many puffs you have left.

Due to the correct dosage already being measured, it is far less likely to use an Accuhaler incorrectly than it is the other inhaler devices.

Metered-Dose Inhaler (MDIs or Evohalers)

Metered-Dose Inhalers (MDIs) are the stereotypical inhalers you think of when it comes to asthma treatment; a metal canister in a plastic casing and mouthpiece. The most common MDI is the "blue inhaler", which is often Ventolin although there are other types available.

A rang eof three evohalers in different colours

Asthma UK claims that up to 33% of asthmatics use their inhaler incorrectly. Here is the protocol for using your blue inhaler:

  • With an Evohaler, it must be given a firm shake before use.
  • Take off the cap and place the mouthpiece around your mouth.
  • Each puff is a measured dosage of medication.
  • Exhale slowly and fully.
  • Inhale slowly and fully.
  • Try to hold your breath for at least 10 seconds so the medication can be absorbed.
  • Wait around 10 seconds in-between each puff.
  • Depending on your doctor's instruction, take between 1-3 puffs.

If you have trouble holding your breath, or you're prone to getting a sore throat, you can use a spacer (bubble). See our paragraph below for further information.

Using a spacer (bubble/chamber)

A spacer is used alongside an inhaler to make inhaling the medication easier. It is simply a plastic container/hollow tube with two holes on either end; one to insert the inhaler and the other is a mouthpiece.

This means that the complete dosage of medication is inhaled correctly without the need for coordination. It can also be absorbed more slowly, without the need to inhale all the dosage in one go.

Detailed photograph of a spacer used for asthmatics

This is particularly handy for children, the elderly or disabled who may have trouble using inhalers correctly. In reality, a spacer can be used by anyone if it helps the medication to be ingested correctly, rather than the dosage hitting the back of your throat, which can cause side effects.

  • A spacer should be cleaned regularly with warm water and left to dry fully before the next use.
  • Spacers can come in different shapes and sizes; some can be split in half and others have a rubber mouthpiece that can be removed.
  • A spacer should NOT be kept in a plastic bag as this creates an electric charge which affects the medication.

Spacers are a great option if you're prone to side effects of inhalers such as a sore or dry throat from inhaling the medication directly.

Nebulisers

It is a device with either a mouthpiece or facemask that offers a high dosage of reliever medication to combat asthmatic symptoms during an emergency. Nebulisers are often used in a hospital setting for asthmatics that have been admitted with severe asthma symptoms. If your condition is particularly bad, your doctor can arrange for you to have a nebuliser at your home.

Photograph of a nebuliser used in hospitals

This particular medication begins as a liquid medicine before changing into a fine mist to be inhaled easily with help from a trained professional in hospital, or after practice if at home.

Nebulisers can be used for asthmatics but also other respiratory conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis and bronchitis. Cystic fibrosis sufferers are the most likely group to require nebulisers.

Which device is right for me?

If you have light to moderate asthma, you may be prescribed a reliever inhaler such as Ventolin, which should be carried on your person at all times. It's quite likely that this is the only medication you need to help control your symptoms.

For mild to moderate asthmatics, an additional inhaler can be supplied that should be taken every day; the preventer inhaler (brown or red in colour). If you take a preventer inhaler, you are still advised to have a reliever inhaler on you in case of emergencies.

Asthma UK states that if you're ordering and using over 12 reliever inhalers every year then your symptoms aren't well managed. From here, you could be prescribed a long-acting reliever inhaler for additional help, a higher dosage option, or a preventer inhaler as well as you're current choice.

Anyone can ask for additional help in how to ingest the medication correctly and request a spacer device if they require further assistance.

In terms of the style of the inhaler, this is very much down to you. If you're elderly, have issues with your joints (rheumatism or arthritis for example) or simply have trouble coordinating to inhale the medication correctly, an Accuhaler or Turbohaler (both breath-activated) can be the perfect option. Most asthmatics find the standard canister (MDIs) device to be effective.

For asthmatics with severe symptoms of asthma, a high level of control is required. Not only must you carry an inhaler on you at all times, and often use a preventer on a daily basis, but if you experience an attack, you may need to go to hospital to use a nebulizer to stabilised your breathing, or in some cases, the NHS will give you a device for your home.

With all types and styles of inhaler, it's important to:

Asthma Checklist
1. Check the expiry date.
2. Keep a reliever inhaler on you AT ALL TIMES.
3. Renew your prescription in plenty of time.
4. Use correctly by inhaling fully.
5. Ask for a demonstration anytime you need clarification.
6. Request a spacer device if you have trouble.
7. Keep your inhaler stored correctly – usually at room temperature.

As studies have shown, many asthmatics are using their medication incorrectly. You can ask your doctor at any time to repeat the process for you to ensure your managing any respiratory conditions effectively. In addition, if you feel like your inhaler plan is not working for you, you can mention this to your doctor or asthma nurse at any time. Asthma is continually evolving – it may get better or worse with age, and varies massively depending on the individual – so reviewing your current asthma plan will always be encouraged.

Last updated: 31.01.2018

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