Asthma Medicines
Asthma can be well controlled by using asthma medicines and avoiding trigger factors (see Asthma Fact Card). The main types of asthma medicines are relievers, preventers and symptom controllers.
Asthma medicines are mostly inhaled directly into the lungs with inhalers, on their own or via a spacer. They can also be inhaled using a nebuliser or taken as tablets, capsules or syrups. The main types of asthma medicines are: relievers, preventers, symptom controllers and combination medications.
Relievers
(e.g. Airomir, Asmol, Epaq, Bricanyl, Ventolin) Relievers relax the muscles in the airways, opening the airways up. This helps patients to breathe more easily when they are short of breath. Asthma may not be adequately controlled if a patient needs to use a reliever most days (in this case the patient should see a doctor).
Relievers:
* Will help when asthma symptoms get worse
* Do not treat the inflammation (see Asthma Fact Card)
* May be used before exercise if exercise triggers asthma.
* Can cause a rapid heartbeat and shakiness - this is a common side effect for some people. Talk to a doctor, pharmacist or asthma educator if this happens.
Ipratropium (e.g. Atrovent, Ipratrin) is also called a reliever medicine. Ipratropium takes longer than the other relievers to work and therefore cannot be used to relieve symptoms quickly.
Theophylline (e.g. Nuelin) is another reliever medicine, usually taken as a tablet. Theophylline is not used to relieve asthma symptoms as it takes longer than other relievers to work.
Preventers
These medicines prevent asthma symptoms. They reduce inflammation in the airways and make them less sensitive to trigger factors.
Preventers are usually inhaled (e.g. Flixotide, Intal, Pulmicort, Tilade, Qvar).
There is a new preventer medicine (e.g. Singulair, Accolate) which is a tablet. This may be taken instead of, or with, an inhaled preventer and is suitable for some patients with asthma.
Preventers:
* Need to be used every day, even when symptoms are absent.
* Will not stop an attack once it has started.
* Take time to work, when first started. The patient may not notice an improvement in the asthma for two weeks or more.
* Should not be stopped, unless a doctor advises.
Prednisone, or prednisolone, tablets (or syrup) are preventers mainly used to treat severe asthma symptoms. They are usually only taken until symptoms improve and can be controlled by regular asthma medicines.
Symptom controllers
(e.g. Foradile, Oxis, Serevent) Symptom controllers can be used in conjunction with preventers to improve control of asthma symptoms.
Symptom controllers:
* Work well for people who get a lot of asthma symptoms, even when using a preventer
* Are particularly used for night-time and exercise-induced asthma
* Work for 12 hours
* Are used regularly
* Can not be used in an asthma attack.
Combination medications
(e.g. Symbicort, Seretide) Combination medications contain a preventer and symptom controller together in one inhaler.
Combination medications:
* Save having to use two different inhalers
* Are used regularly
* Do not provide quick relief of asthma symptoms.
Taking asthma medicines
Inhalers
Inhalers allow the medicine to get directly into the lungs where it needs to work. Inhalers include aerosol inhalers (’puffers’), autohalers, turbuhalers, accuhalers and aerolizers.
Using inhalers properly is important for good asthma control. The patient should ask a pharmacist, doctor or asthma educator to check inhaler technique, and show the proper use of an inhaler and devices that can help (e.g. spacers).
Spacers
A spacer is a plastic chamber that fits onto an aerosol inhaler. The medicine is sprayed into the spacer at one end, and then the medicine is breathed in from the other end.
Spacers help get the best amount of medicine into the lungs. They can also help people who find it hard to press down on their aerosol inhalers and breathe in at the same time.
Nebulisers
A nebuliser is a pump that turns liquid asthma medicine into a fine mist. The mist is then inhaled through a facemask or mouthpiece. For most people, a puffer and spacer are easier and more effective to use than a nebuliser. Nebulisers are not used as often in acute asthma attacks as they were in the past.
Monitoring asthma
A doctor may measure how well the lungs are working using a special test called spirometry.
Another method is to use a peak-flow meter. This checks how open the airways are using a simple blow test. Measuring peak flow and keeping a check on symptoms helps the patient see how well the asthma is controlled.
Self care
* Do not ignore asthma symptoms. Always carry a reliever (blue inhaler).
* Controlling asthma with a preventer (and possibly a symptom controller) will mean the need for less or no reliever.
* Develop an action plan with a doctor (see Asthma Fact Card).
* After using Flixotide, Pulmicort, Qvar, Seretide or Symbicort, rinse the mouth out with water, gargle and spit out (do not swallow). This reduces the risk of possible mouth and throat problems, such as thrush and hoarseness.
* Check with a pharmacist and/or doctor before stopping or starting any medicine.
* If using a spacer, wash it regularly in warm water with kitchen detergent and leave it to drain and drip dry (without wiping).
* Smokers should quit. A pharmacist can help.
Contact
A doctor - listed under ‘Medical Practitioners’ in the yellow pages of the phone book.
A Self Care pharmacy - to locate telephone 1300 369 772 and ask for the Pharmacy Self Care Field Officer
Asthma Australia or the Asthma Foundation in each state or territory. Links to state websites can be found at www.asthmaaustralia.org.au or freecall 1800 645 130 for the Advice Line.
In case of poisoning, phone the Poisons Information Centre on 131 126 from anywhere in Australia.
Pharmacists are medicines experts. Ask your pharmacist for advice when choosing a medicine.
