It’s a frightening time when you or someone you love first experiences asthma symptoms. When your doctor gives you an asthma diagnosis and tells you it is treatable and manageable, you may feel the relief that often comes when you know what you’re dealing with. “Great”, you say. “Just tell me what to do!” Sometime later, you leave their office with a handful of prescriptions and brochures and a headful of new information. What are these medicines for? What’s an asthma action plan? It can be overwhelming,
In this article we'll aim to answer some common questions we’ve received over time in the hope we can make the journey of learning about asthma a little easier.
Spirometry is a test used to diagnose asthma and other lung conditions in adults and in children over the age of 6. It measures how well a person can breathe in and out using a device called a spirometer. Different measurements taken during the test to show how well the lungs are working. It is usually quite a straightforward test that takes around 10-20 minutes.
A study in the US found almost half of parents surveyed didn’t completely understand what type of asthma medication their child was taking or how often they should take it. A little alarming, but understandable. Before asthma affected your life, you probably thought the only asthma medicine that existed was the one that comes in a blue puffer.
The two main types of asthma medicines are relievers and preventers. These are usually delivered using metered dose inhalers (MDIs) and are also known as puffers.
Reliever medicines for asthma are from a group of medicines that are known as bronchodilators. The inhaler devices for these medicines are usually blue or grey. These medicines work by relaxing the muscles that tighten up around the airways (the bronchial tubes) that carry air to the lungs, and opening the tubes up to allow more air into the lungs. Reliever medicines act fast - within about 4 minutes - and keep the airways open for up to 4 hours after use.
They do not, however, treat the underlying inflammation caused by asthma. This is why reliever medicines are only used for short-term relief of asthma symptoms and in an asthma emergency. If your asthma is well-controlled, you should not need to take your reliever medicines more than once or twice per week, not counting before exercise.
Preventer medicines are a part of long term asthma management for most adults and some children. Inhaled corticosteroids are the most commonly used group of preventer medicines. This type of medicine reduces inflammation in the airways which reduces a person’s risk of a severe asthma flare up. The inhaler devices for these medicines are usually brown, orange, rust or yellow.
There are many different medicines and brands used to treat asthma in Australia. One way to break it down is to think about active ingredients vs brand names. The active ingredient is the chemical in a medicine that makes it work. A medicine can have more than one active ingredient, and medicines with the same ingredients are available under different brand names. For example, Ventolin, Asmol and Airomir are different brands that have the same active ingredient of salbutamol.
You may have seen the chart below on the wall of your doctor’s office (if not, they can contact us to get one!). It shows the asthma medicines available in Australia by category.
There are also combination medicines. These are preventer medicines that include a second medicine in addition to the inhaled corticosteroid to help control symptoms better. Your doctors’ recommendation of preventer medicine will depend on the severity of your asthma symptoms and other factors. The most important thing is that if you've been given any sort of preventer, you should take it every day - even when you have no symptoms. But the medicine should be prescribed at the lowest strength that works for you or your child; there’s no extra benefit in taking medicine that is stronger than you need.
Don’t be troubled by the term ‘steroid’. We’re not talking about the bodybuilding kind! The inhaled corticosteroids in asthma preventer medicines have been used for many years, so there is a lot of reliable information available about how well they work. There are also non-steroid preventer medicines available.
Prednisolone (also known as prednisone), is the active ingredient of a group of corticosteroid medicines that are given orally as tablets or syrup. These medicines are only used for a short period of time to treat severe asthma or in the case of a major asthma flare up.
A nebuliser is a machine that changes liquid medication into a vapour. Pressurised air is pumped through the liquid to form a fine mist, which can then be breathed in through a mask or mouthpiece.
The use of spacers over nebulisers for ongoing asthma management has long been a hot topic. A lot of research has been done in this area. There is a strong evidence base that using a puffer with a spacer works just as well as a nebuliser for treating asthma, including during a flare-up. Using a puffer with a spacer is also easier, cheaper, more portable and reduces the potential for side effects.
Nebulisers are still used for treating severe or life-threatening asthma, usually in a hospital when more than one treatment is needed at the same time, or for people in certain circumstances. This may be someone who has other complex conditions besides asthma.
If you’d like some more help in deciphering anything to do with your medicines, ask your doctor or asthma educator or consider visiting your local chemist. Your community pharmacist is often easily accessible and will be able to answer many of the questions you may have about your asthma medicines and your asthma management plan.
In Part 2, we’ll work on demystifying your ongoing asthma management.
