Wednesday, 19. October 2022
Bronchial asthma is the umbrella term of a range of persistent inflammatory diseases of the airways. The inflammation causes the mucosal linings to swell and the bronchial muscles to spasm. This causes more mucus to be secreted into the bronchial tubes and the airways to constrict. This, in turn, can make the chest feel tight and can trigger respiratory distress.
Symptoms such as breathlessness, wheezing and coughing often occur at night or early in the morning. With asthma, the obstruction of the bronchial tubes can be reversed by taking the right medication. Asthma is also variable. This means that those affected will have periods when they have no symptoms at all.
The most common form is allergic asthma, which often emerges in childhood, in which the immune system overreacts to external irritations, such as allergens. Triggers can include pollen, animal hair or dust mites. Non-allergic asthma often only emerges at the age of 30 or 40.
Airway treatment and care, such as inhalation therapy, play an important role in the management of bronchial asthma. We have compiled the FAQs and answers to any questions you may have concerning “inhalation for asthma”.
People who have bronchial asthma are dependent on the best possible airway treatment and care. Drugs have to be able to efficiently reach the bronchial tubes and the lungs. Because asthma is considered to be incurable, but with the right therapy, the disease can be well-managed. Successful asthma treatment preserves quality of life and maintains physical fitness as effectively as possible.
Besides drug treatments, special breathing or relaxation techniques from respiratory physiotherapy, targeted endurance training or a temporary change of climate can help. It is also important to avoid asthma triggers, such as allergens, certain foods or dust.
In emergencies, drugs used for the treatment of bronchial asthma are generally administered by inhalation, a tried and tested method to treat respiratory problems and diseases. This is the most direct delivery method whereby, if used correctly, the active substances reach the lungs directly. In patients with asthma, inhalation therapy also helps treat and soothe the airways – from the bronchial tubes down to the alveoli.
There are many different kinds of inhalation devices that can be used to treat bronchial asthma, so as to best address the individual needs of each patient. In asthma, inhalation therapy with a nebuliser, such as the PARI BOY or the PARI COMPACT2 provides invaluable support. With these nebulisers, fine droplets are inhaled with normal resting respiration.
As well as nebuliser inhalation, asthma patients also use metered dose aerosols and powder inhalers. With metered-dose aerosols, the active substance is in a pressurised container along with a propellant and is released as a puff and inhaled. With powder inhalers, the active substance is provided as a powder without any additional propellant and is also inhaled.
There are three important elements involved in inhalation therapy: the medication, the inhalation system and the patient. The asthma patient should be able to use the inhalation system properly. People who have coordination and/or breathing problems often also have problems using standard inhalation systems such as powder inhalers or metered-dose aerosols properly.
These people should use a nebuliser for their inhalation therapy, as this simply involves normal resting breathing. In contrast, inhaling with a metered-dose aerosol requires coordinated and concentrated inhalation. A spacer such as the VORTEX® can help in this case.
Firstly, saline solutions can be inhaled for bronchial asthma therapy. This is because they thin the mucus in the airways when mucus secretion is exacerbated. This makes it easier to cough up the mucus. Secondly, drugs designed to dilate the airways or to fight infections can also be inhaled.
As mentioned above, people with asthma can and should inhale medication. This is because inhalation delivers the active ingredient directly to the lungs or the bronchial system: just where it is needed. This reduces potential side effects and less medication is needed for the desired effect – compared to taking a tablet.
Firstly, drugs called corticosteroids are inhaled for bronchial asthma. They inhibit inflammation in the bronchial tubes and supress the allergic reaction. In the long term, this reduces the swelling of the bronchial mucosal membranes. They should be inhaled regularly with an aim to control the disease as best possible.
Secondly, drugs are used that dilate the bronchial tubes and so help counteract the constriction. Here we distinguish between short-acting and long-acting betamimetics. With the long-acting drugs, there is a lag between the time they are inhaled and when they start to work; and their effect lasts longer. They are used in combination with corticosteroids as the standard therapy. With short-acting bronchodilators, the effect is immediate. They are used for acute attacks and breathlessness.
NB: The attending doctor will decide which medications the patient should take, and will prescribe these accordingly.
Patients with bronchial asthma should inhale long-acting betamimetics and corticosteroids once a day to ensure long-term success of the therapy. It is important that patients stick to their prescribed treatment schedule. Short-acting betamimetics are used for acute relief. Saline solution can be inhaled on a daily basis to soothe the airways and, if necessary, to break up mucus.
Successful treatment of bronchial asthma requires using the inhalation system properly. If not, not enough or even none of the active ingredient reaches the lungs. It often remains stuck in the throat where it cannot have its desired effect. Certain medications such as corticosteroids can, in this case, also have unpleasant side effects.
To avoid these, it is firstly important that patients are properly coached and know how to use the devices properly. And secondly, as mentioned above, patients can use a spacer for metered-dose aerosols whose use requires a certain level of coordination. These spacers make the asthma spray easier to use.
Note: The information in this blog post is not a treatment recommendation. The needs of patients vary greatly from person to person. The treatment approaches presented should be viewed only as examples. PARI recommends that patients always consult with their physician or physiotherapist first.
An article written by the PARI BLOG editorial team.