While being diagnosed with asthma certainly is uncomfortable and in some people somewhat dangerous, depending on the exact sub-type and the severity of their condition, the good news is that today it’s relatively easy to manage asthma with the proper medication. Two broadest categories of asthma drugs include reliever and preventer inhalers. In addition to those, long-acting combination of non-steroidal inhalers might be prescribed if the condition requires that kind of approach.
Here we created a brief guide, an overview of different asthma treatments available in the UK in order to help you gain a better and more in-depth understanding of the specifics and differences of these drugs.
What’s on this page?
What are reliever inhalers?
The most common type of asthma treatment, reliever inhalers are prescribed to every asthmatic in order to be used to rapidly ease acute symptoms, especially in the case of an asthma attack. Conventionally blue in colour, they relax the airway muscles almost immediately, allowing the users to return their breathing to normal rather fast and avoid potentially serious consequences of an asthma attack. Usually, these medicines are based either on salbutamol or terbutaline. These substances are collectively called bronchodilators.
Reliever inhalers are sold only with prescription from a certified medical professional and can be purchased under numerous brand names, with most common ones being:
This type of medicine should always be handy in case of an emergency. However, using your reliever inhaler more than three times in one week is not recommended since this is a sign that your condition isn’t properly managed. If this is the case, consult with your doctor immediately about the potential change of treatment and possible introduction of preventer inhaler.
What are preventer inhalers?
As opposed to relievers, preventer inhalers are conventionally brown in colour and are used on a regular basis, not just in case of an emergency. Commonly, they are to be taken twice a day in order to prevent asthma attack from happening at the first place. Not all asthmatics will require preventer inhaler, but only those with more severe types of the condition.
Preventer inhalers release a dose of corticosteroid medication that is breathed in directly through the airways and into the lungs, thus reducing inflammatory processes there. The preventive qualities of this type of medicine will build up over time and it might take as long as two weeks before the full benefit of the drug is directly noticed. As opposed to reliever medicines which are administered only when needed, preventers must be taken regularly, precisely following the doctor’s instruction, even when you’re feeling perfectly fine.
The doctors usually advise patients to use preventer inhalers roughly at the same time every day. While there are no medical benefits to this practice, this way, taking your medication will become a part of your daily routine, making you less likely to forget it.
What are long-acting reliever inhalers?
Long-acting reliever inhalers are commonly prescribed as a complementary treatment to a daily preventer inhaler. The active ingredients of this type of asthma medicines are long-acting beta agonists (LABA) and long-acting muscarinic receptor antagonists (LAMA for short). However, their mechanism of action is rather similar to other medicines mentioned here, as they work by relaxing the muscles surrounding the airways and opening them up to allow for more air to reach the lungs. Medicines based on LAMA can also be beneficial in reducing the amount of mucus in the airways.
At the same time, it is worth mentioning that using long-acting reliever inhalers without a steroid preventer inhaler can be somewhat dangerous, so it’s important to follow the doctor’s instructions exactly and not change your treatment plan without prior consultations.
What are combination inhalers?
Another somewhat less common type of inhaler, called combination inhaler, contains a combination of long-acting reliever medication (usually based on LABAs) and a corticosteroid preventer medication. The most commonly prescribed medicines include brand names such as Seretide and Symbicort. These inhalers both ease the acute symptoms of an asthma attack, while also having a long-term preventive function when it comes to inflammation of the airways.
Somewhat rarer than other types, combination inhalers are usually prescribed to asthmatics who don’t have their asthma under control and are still reacting harshly to their asthma triggers. In addition to this treatment, a classic reliever inhaler is usually prescribed for rapid relief in case of an emergency situation.
What are non-steroidal inhalers?
While many dislike the conventional asthma medicines because they often rely on steroids, non-steroidal inhalers successfully solved this problem by offering a steroid-free solution to asthmatics. At this moment, there are only two non-steroidal inhalers available on the market – Intal, based on sodium cromoglicate and Tilade, based on nedocromil sodium. While Intal is usually prescribed for the treatment of exercise induced asthma, both of the medicines mentioned here work by opening up the airways and reducing the symptoms of the inflammation.
This type of medicine is especially suitable for people who experience an allergic reaction to steroids, but also to sportsmen who might get disqualified from competitions for testing positive on doping test because of their steroid-based asthma medicines.
What is maintenance and reliever therapy (MART)?
Medicines belonging to this category are prescribed only to adults who have very bad asthma control and who experience regular asthma attacks. MARTs are useful in these patients since they can both reduce airway inflammation and relieve acute and sudden symptoms of an asthma attack. Being effective both as instant relievers in emergency situations and long-term treatments, MARTs don’t need an accompanying reliever inhaler, as opposed to other long-term medicines.
Currently, there are two brands available on the market – Symbicort SMART and Fostair MART Regime.
What different inhaler devices are there?
Asthma inhalers come in a variety of different types. These devices are always manufactured in such a way to ensure the proper dose is administered during each use. Of course, not everybody is suitable for every type of device, so it’s important to maintain regular contact with your doctor so that he can assess if everything is alright and if you maybe need to change the medicine you’re currently using.
Metered dose inhaler (MDI)
The most commonly prescribed type of asthma inhalers is so-called metered dose inhaler or MDI for short, also known among the users as “the puffer”. MDIs provide a single dose of medication in the form of a spray or aerosol which is propelled into the airways by a safe pressurised gas.
Metered dose inhalers are very easy to use – the medication is expelled from the aerosol chamber by pressing down on the top of the inhaler device. The only thing you need to keep in mind is coordinating your breathing and the pressing of the canister.
Breath-actuated inhaler (BAI)
An alternative type of device available to people who have difficulties using MDIs is called breath-actuated inhaler (or BDI for short). As the name implies, this type of inhaler uses breath of the user to automatically release the aerosol. Breath-activated inhalers can also be obtained in metered dose form and dry powder (DPI).
Used in parallel to metered dose inhalers, spacer devices help user to successfully receive the correct dose. For people who find MDIs difficult to use, spacers are a true game-changer. This simple device is just an empty plastic container which is attached to the MDI at one end and to the mouthpiece on the other. A spacer will gather the medicine in the empty space, from where it can be inhaled by the user at a rate that is comfortable.
As the timing and speed of user’s breathing aren’t as important when using a spacer device, this approach is particularly useful to children.
Finally, another type of asthma medicine is a nebuliser – this device is specialized for turning the liquid medication into a breathable mist. Nebulisers are most often used in hospital setting to deliver a high dose of medicine to a patient experiencing an asthma attack. They can also be attached to the facemask so they can be applied even during the most severe asthma attacks. They are rarely used in other circumstances since they provide no other benefits aside from this.