Asthma Inhalers 101: A Quick Guide on Asthma Inhaler Types, Ingredients, and How To Use Them

Author: Dr. Andrea Pinto, M.D.

An asthma inhaler is a type of medical device that delivers medications directly into the airways and lungs. Inhalers are portable, small, and easy to use, allowing asthma patients to manage their symptoms and take their treatment anytime, anywhere. Certain types of asthma inhalers can even provide life-saving treatment during an asthma crisis.

However, it is essential to learn how to use inhalers properly to maximize their benefits. When misused, inhalers may not be as effective, and its medicinal efficacy reduced.

You should always seek medical advice when it comes to choosing the right type of inhaler for you. There are many different types and brands of inhalers available in the market, and your healthcare provider should be able to prescribe an inhaler that will work for you.

Read on to learn more about the different types of asthma inhalers, their ingredients, and how to use them correctly.

Types of Asthma Inhalers

Asthma inhalers are categorized according to the mechanisms used to deliver the medication to your airways.

Metered-Dose Inhalers (MDI)

MDIs have been used to treat asthma and other respiratory ailments for decades; they contain pressurized inactive gas that releases the medication into aerosol form every time the inhaler is activated. To activate the inhaler, the patient needs to push down on the canister.

MDIs are the most widely used inhalers. Some MDIs feature a counter that allows you to know exactly how many doses are left inside the canister.

Breath-Activated Inhalers or Dry Powder Inhalers

These inhalers work similarly to MDIs; however, they don’t require you to push down on the inhaler to fire it. Instead, the patient needs to place the mouthpiece into their mouth and take a deep, sharp inhale to release the medication.

Breath-activated inhalers require less coordination than MDIs to use it effectively. There are multi-dose breath-activated inhalers, which can contain up to 200 doses of medication, and single-dose inhalers that are filled with single-use capsules before each application.

Inhalers Spacer Devices

Spacer devices are used in combination with MDIs. They act as chambers that hold the medication after the inhaler is activated. Spacer devices can be fitted with face masks or mouthpieces. They feature valves which ensure that the drug is maintained inside the spacer until the patient inhales it.

Spacer devices are particularly useful for babies, young children, and older adults who need to use inhalers but are unable to use MDIs properly. Spacers allow for a slower inhalation, which can maximize their effectiveness in these patients.

Inhalers can also be classified depending on the type of active ingredient that they contain and whether these medications are used to provide relief for acute symptoms, or for long-term asthma management.

Quick-Relief Inhalers or “Relievers.”

Rescue or reliever inhalers typically contain short-acting bronchodilators. These asthma medicines can relieve symptoms very quickly. Reliever inhalers can be very helpful when a

patient is experiencing acute symptoms, such as difficulty breathing, wheezing, chest pressure, or coughing.

Short-acting bronchodilators work by quickly relaxing the muscles in your airways. By doing so, they open up the airways that become constricted during an asthma attack and improve the airflow to your lungs. Short-acting bronchodilators act within seconds or minutes of using them.

Some patients who only experience mild, occasional asthma symptoms may be able to manage their asthma using quick-relief inhalers only. However, needing to use rescue inhalers too often may signal uncontrolled or poorly controlled asthma.

Short-acting bronchodilators that we commonly used in quick-relief inhalers include:

Albuterol
Salbutamol
Terbutaline
Metaproterenol
Levalbuterol
Pirbuterol

Long-Term Control Inhalers or “Preventers”

“Preventer” inhalers contain steroids, and sometimes, long-acting bronchodilators. We use these inhalers every day to prevent asthma symptoms from flaring up and causing an asthma crisis. These inhalers are typically used twice each day, and patients must use them anywhere between 7 to 14 days for their effects to become apparent.

Long-term control inhalers aren’t very useful when it comes to managing acute asthma symptoms; instead, their ingredients work by reducing inflammation in your airways. As inflammation levels decrease, you will be much less likely to develop symptoms of asthma.

It can take up to 6 weeks of using a preventer inhaler to reach maximum efficiency. If you have been using your preventer inhaler correctly and still experience asthma symptoms frequently, your doctor could advise you to use this inhaler more often. Ideally, patients who use long-term control inhalers should be able to manage their symptoms without using reliever inhalers or other medications too often.

Medications that we commonly find in long-term control inhalers include:

Beclometasone
Budesonide
Ciclesonide
Fluticasone
Formoterol
Mometasone
Salmeterol
Tiotropium bromide

Long-term use of long-acting bronchodilators and high-dose corticosteroids can carry certain risks, which is why a physician should always supervise these asthma medications.

Combination inhalers

Some long-term control inhalers contain two different medications, usually a corticosteroid and a long-acting bronchodilator. These medications provide ease of use for patients who need both drugs to manage their asthma. Common combinations include:

Budesonide and formoterol
Fluticasone and salmeterol
Fluticasone and vilanterol
Mometasone and formoterol

How to use asthma inhalers correctly?

The way you use your inhaler can negatively impact its effectivity. If you have any doubts on how to use your inhaler, don’t hesitate to ask your healthcare provider for detailed instructions. Common mistakes that can affect the effectivity of your inhaler include:

Not shaking your inhaler before firing it
Not holding your breath after inhaling the medication
Inhaling at the wrong time before or after activating the inhaler
Not breathing in and out a few times between each puff