Classification of asthma inhalers, their principle of action and rules of use

Asthma is a serious bronchial disease that threatens the patient’s life. It is known that an attack can happen at any, even the most inopportune moment.

An asthma inhaler is a modern remedy that allows you to quickly stop the negative manifestations of the disease and alleviate the patient’s condition.

This therapy has found wide application in the treatment of patients of any age. There is a wide range of medicines for inhalation use.

When you need an inhaler for asthma

One of the main dangers of an asthma attack is the development of a state of asthma of varying severity.

The main symptoms of an incipient attack include:

  1. Cough, mainly in the morning or at night.
  2. Discharge of clear sputum.
  3. Inhalation is short and difficult.
  4. The exhalation is longer than the inhalation.
  5. Respiratory rhythm change.
  6. Wheezing is heard in both lungs.

If the patient is not given timely assistance, symptoms may worsen. Respiratory failure and shortness of breath develop.

An asthma inhaler is the fastest and most effective way to prevent and treat. With its help, the medicine goes directly to the bronchi, which ensures the maximum speed of action.

Several types of devices for inhalation administration of drugs have been developed.

There are stationary and portable devices.

For the treatment of bronchial asthma at home, inhalation through a nebulizer is recommended. This is a stationary device that provides the most efficient delivery of medication to the most distant parts of the bronchial tree.

It is used both for relief of seizures and for basic treatment of the disease. The nebulizer is widely used for prophylactic purposes.

For self-help with bronchial asthma on the road, pocket inhalers are well suited. They are easy to carry and use in case of urgent need due to their low weight and compactness.

Types of inhalers by the method of drug delivery

There are many types of inhalers used for bronchial asthma. Most often they are subdivided according to the way the medication is given. 

The following types of devices are distinguished:


These inhalers consist of a valve system made of plastic or metal. They attach to the medication inhaler itself. The principle of operation is based on the supply of the active substance only during inhalation.

In this case, when the patient exhales, the valve closes and the supply of medication is stopped.

This device allows you to save asthma spray and strictly observe the dosage of the drug prescribed by your doctor. Spacers are good for children who cannot control the breathing cycle.

The main disadvantages of this device include their large enough size, which does not allow the use of the inhaler as a portable one. Most often it is used at home.


The most efficient inhalation device. It provides a uniform spray of the drug on the surface of the bronchi. Fine particles penetrate even the most distant parts of the respiratory system, ensuring deep distribution of the active substance.

Due to its large size, the nebulizer for asthma is used only at home. That is why this device has not found application in the relief of acute attacks. However, it is effectively used for subsequent treatment, as well as for the prevention of exacerbations of the disease.

According to the principle of operation, nebulizers are divided into compressor and ultrasonic.

Compressor devices are the most popular. With the help of compressed air supplied to a special nozzle, the liquid is converted into an aerosol.

Fine dispersion is achieved by passing through the deflector. The advantages include the ability to use a wide range of medicines.

In ultrasonic nebulizers, an aerosol mixture is created by means of high-frequency ultrasonic vibrations. Such devices operate very quietly, which makes them indispensable in pediatric therapy.

Currently, work is underway to reduce the size and weight of nebulizers.

Metered inhalers

A common portable inhaler is the aerosol type nebulizer. These are balloon devices, inside of which the drug is injected under pressure. When pressed, the substance is sprayed. The drug is delivered in a strict, constant dosage. In addition, these inhalers have a fairly low price, which makes them available to any segment of the population.

The disadvantages include the fact that the application requires special training in breathing techniques. In aerosol inhalers, the medicine enters the body along with the air when inhaled. In addition, some of the drug is deposited in the oral cavity. Then it is swallowed along with saliva and enters the digestive system. When choosing a dose, it is important to take this nuance into account.

Metered-dose powder inhalers should be mentioned separately. With their help, not an aerosol enters the human body, but a dry powder mixture. Ease of use (compared to aerosol inhalers) is an undeniable advantage. It should also be noted the high efficiency due to the fact that the drug enters the bronchi, and does not settle in the oral cavity and pharynx. The disadvantages include a higher price. 

Preparations for inhalation use

For each type of inhaler, its own groups of drugs are used. Some asthma medications are anti-inflammatory. Others contribute to the rapid removal of a suffocating attack by expanding the lumen of the bronchi. There are also medications to treat allergic reactions.   

For inhalation, the most popular are Salbutamol and Symbicort . They quickly and effectively relieve asthma symptoms in both adults and children.

In some cases, with asthma, inhalation is carried out using a nebulizer with ordinary mineral water or saline.

Most often, non-medicated nebulizer liquid is used for individuals with individual drug intolerance.

Types of inhalers by purpose

Step therapy is used to treat bronchial asthma. This means that the doctor prescribes treatment with the lowest possible dose of the drug. Gradually, the concentration of the active substance increases until all symptoms of the disease are completely stopped. 

For each patient, this dose is individual and depends on the severity of the disease.

Most of the drugs are delivered directly to the focus of the pathology by inhalation.

In the treatment of bronchial asthma, two main approaches are used:

  • basic therapy;
  • symptomatic (to stop an attack).

Basic therapy is aimed at relieving inflammation and preventing exacerbations of the disease. When prescribed correctly, drugs reduce the frequency and intensity of attacks. If, nevertheless, there was an attack of suffocation, then aerosols prescribed for asthma to relieve symptoms come to the rescue. They have no effect on the cause of the disease, but significantly improve the patient’s condition.

For basic therapy

The main goal of basic therapy is continuous control over the course of the disease. Aerosols prescribed for bronchial asthma in this case have an anti-inflammatory effect.

Inhaled drugs are used daily, thereby reducing the frequency and intensity of attacks.

For effective treatment, the doctor prescribes one or more basic drugs from the following list:

  1. Inhaled glucocorticoids. This is the basis of basic therapy. They are the most effective medications for asthma. To enhance the effect, it is recommended to use them in combination with non-hormonal drugs. Depending on the form of the active substance, it is possible to administer the drug by inhalation using a nebulizer, as well as a powder dispenser.
  2. Cromones . These drugs are recommended for the treatment of children, since their use is accompanied by a minimum number of side effects. The main action of these drugs is aimed at suppressing the body’s allergic reaction. The anti-inflammatory effect is weak.

3. Combined funds. As the name implies, such inhalation preparations include several active ingredients.   

To relieve an asthma attack

An asthma attack is accompanied by severe suffocation and can be life threatening. That is why the patient must constantly have an inhaler with him that can stop the manifestations of an exacerbation of the disease.

To relieve symptoms of an asthma attack, the following groups of drugs are used:

  1. Sympathomimetics. They directly affect the bronchi, providing an expanding and stimulating effect. The most popular are: Levalbuterol , Salbutamol, Terbutaline .
  2. M- cholinergic receptor blockers . They give a bronchodilatory effect. These include Ipratropium bromide and Atrovent.
  3. Methylxanthines . The mechanism of action of these drugs is based on blocking the enzymes that cause bronchospasm.

Asthma attacks do not always begin when the patient is at home. Therefore, nebulizers, despite their high efficiency, cannot be classified as first aid devices. Most likely, in such a situation, you will have to use a pocket powder or aerosol device.

Hormonal inhalers have shown good results. They contain drugs based on glucocorticoids and significantly reduce the swelling of the bronchial tissue, improving the patient’s condition. This therapy is gentle, since the active substance is practically not absorbed into the bloodstream.

Pocket inhalation technique

Before using a pocket inhaler for bronchial asthma, it is important to carefully read the rules for use. It is also important to know all possible contraindications and understand the risk of complications and side effects. 

The rules for using the inhaler are extremely simple:

  1. Remove the protective cap from the can.
  2. Before starting use, you need to shake the inhaler well.
  3. After taking a deep breath, you need to tightly clasp the mouthpiece with your lips.
  4. It is very important to simultaneously press the medication delivery button and inhale the incoming air containing microparticles of the medication.
  5. After inhaling, the mouthpiece must be removed from the mouth and hold the breath for at least 10 seconds.
  6. After that, you can breathe normally.
  7. Before storing the cylinder, it is necessary to wipe the mouthpiece and tightly close the protective cap.

The inhaler should only be used if it effectively relieves the symptoms of an asthmatic attack. If this does not happen, you must immediately contact your doctor to adjust the appointment.

The use of an ineffective medicine can not only worsen the patient’s condition, but also cause a number of complications.

Contraindications to the procedure

In the treatment and relief of an attack of bronchial asthma, inhalers give good results. But there are a number of contraindications for their use. The main one is the intolerance of the active substance of the inhalation drug. In addition, each medicine has its own limitations for use. They are listed in the instructions supplied with the inhaler.  

Inhalation with a nebulizer, like any medical procedure, especially with the use of medications, has a number of contraindications.

Inhalation is unacceptable in the following cases:

  • with some diseases of the respiratory system;
  • in people with pathology of the cardiovascular system;
  • with violations of hematopoiesis;
  • with hypertension;
  • during the rehabilitation period after a stroke or heart attack;
  • during pregnancy, the inhalation procedure itself is not prohibited, but there is a restriction on the use of certain medicines;
  • when treating children under 2 years of age.

There are also time limits and recommendations:

  1. After eating, you need to wait 2 hours.
  2. After exercise, at least 2 hours should also pass.
  3. It is not recommended to smoke after inhalation. Passive smoking is also prohibited.

To avoid possible complications, it is advisable to be under medical supervision for at least 30 minutes after the procedure.


Bronchial asthma is a disease that requires constant supportive treatment. There are many types of therapy. Inhalers in this case are the most effective and fast-acting way to improve the patient’s condition.

Inhalation is used for supportive care as well as for relief of seizures.

It is important to remember that the treatment regimen must be prescribed by the attending physician. Self-administration of drugs, their replacement, as well as dosage adjustments are unacceptable.

event_note September 27, 2020

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