When the muscles that wrap around the airways tighten making it harder to breathe it is known as an “asthma flare-up” or an “asthma attack”.
People with asthma have sensitive airways that tend to overreact and narrow when they encounter even the slightest triggers.

Triggers can include smoke, fragrances, cold air, physical exercise/activity, Sinusitis, extreme emotional arousal such as anger or fear and respiratory infections such as the common cold or flu.

Medication is not the only way to control asthma. It is important to avoid asthma triggers or stimuli that irritate and inflame the airways. With your doctor’s help you can learn what triggers to avoid.

The WHO states that the strongest risk factors for developing asthma are a combination of genetic predisposition with environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways. These include: 

    indoor allergens (house dust, mites in bedding, carpets and stuffed furniture and pet dander). 

    outdoor allergens (such as pollens and molds).

    smoke (including tobacco smoke).

    chemical irritants in the workplace and

    air pollution.

Sulfites are chemical compounds used as food preservatives that maintain flavour and freshness, slows spoilage and prevents discoloration in many foods. Sulfites can worsen the symptoms of asthmatics who use steroid inhalers.

Salicylates are chemical compounds found naturally in plants and are also produced synthetically (e.g. aspirin). Salicylates are prevalent in so many otherwise healthy foods that they cannot be avoided. Asthmatics should simply try to ensure that each meal contains a moderate number of Salicylates.

Salicylates can worsen asthma symptoms to a greater extent than Sulfites.
 

A preventer inhaler is the main way to control asthma. Preventative inhalers contain steroids called corticosteroids. Corticosteroids are a copy of the steroids our bodies naturally produce. These low dose steroid medicines reduce inflammation and swelling in the airways. When inflammation is controlled, the airways are much less likely to become narrow and cause symptoms such as wheezing. With inhaled steroids, improvement in asthma symptoms can be seen in 1 to 3 weeks. The best results occur after 3 months of daily use.

Preventative inhalers can also contain a combination of a steroid with a long-acting bronchodilator. In addition to the steroid reducing the inflammation, the long-acting bronchodilator relaxes the muscles around the airways and helps to keep the airways open. They are considered long-acting as the effects last for at least 12 hours. The main medications used in Preventer Inhalers are Beclometasone, Budesonide, Fluticasone, Ciclesonide or Mometasone.

USE YOUR PREVENTER INHALER DAILY TO CONTROL YOUR ASTHMA

BREATH ACTIVATED INHALERS

These are alternatives to the standard Metered Dose Inhaler. The shape of the canister can be similar to a standard MDI or have a flat round disk shape. A breath-actuated metered-dose inhaler requires your inhalation in combination with a propellant to get the medication to your lungs rather than just a propellant. The technique is particularly important with these types of inhalers as their effectiveness depends on your ability to synchronize your breathe with the release of the medicine in order for it to reach your lungs.

BREATH ACTIVATED (PROPELLANT-FREE) INHALERS

A spacer device is a plastic container with a mouthpiece or mask at one end, and space to insert an inhaler at the other. The medication when released from the inhaler is held in the spacer allowing the patient to breathe in the medication easier increasing the amount that reaches the lungs. Spacer devices ensure the person with asthma gets the maximum benefit from their medication and helps direct it to where it is needed in the lungs.
Advanced specialized spacers are referred to as “valved holding chamber spacers” as they have a one-way valve to help further regulate the flow of medicine.
Some spacers have a whistle. Your technique is good if the whistle doesn’t sound during use, however, if the whistle sounds you should slow down your breathing.
The use of a spacer is recommended for all asthma suffers as use of an inhaler without a spacer often results in most of the medicine ending up inside the mouth or stomach instead of the lungs, where it is needed. Spacers are particularly useful for young children and older or frail adults. Spacers may require a prescription.
A face mask (generally used for infants or small children) can be attached to a spacer. The mask fits over the nose and mouth to make sure the right dose of medication reaches the lungs as small children tend to struggle with mastering their technique for proper inhaler use.

Dizziness, mouth infections and skin or eye irritation can be caused by leaking mist/spray or an incorrectly fitted spacer or mask. A sore throat can occur if the medicine is not fully inhaled. Slight temporary voice changes are caused by the drying effect the medication has on the muscles of the vocal cords.
The shakes can be caused by certain medications, which have the same effect on the body as adrenaline increasing the heart rate and blood pressure while expanding the air passages of the lungs. This rush can induce the body to shake for a short period time. The shakes are not dangerous if they are not accompanied by chest pains.

Inhalers and nebulizers that include a bronchodilator can be harmful to the enamel of your teeth making them more susceptible to tooth decay over time. This is due to bronchodilators being slightly acidic. An anti-microbial mouth rinse can help to reduce the chances of tooth decay.
Preventative inhalers with steroids can cause loss of bone density when used long-term if the daily dose of the corticosteroid is high, therefore, people who use steroid inhalers need to maintain a diet rich in calcium.

KEEPING IT CLEAN

Clean your inhaler at least once each week. The cleaning process is different for each type of inhaler as it depends on the type of medication(s) it contains. Manufacture’s cleaning instructions should be followed.
You may not see any medicine build-up on the inhaler, but it is important to keep it clean to avoid medicine build-up, which will block the spray. It is essential that you properly and routinely clean your device in order to minimize the risk of infection and skin irritation. 

TRACKING DOSES

A few metered dose inhalers have built-in dose counters that show how many doses remain. Alternatively, you can purchase a separate electronic dose counter to know when your inhaler is low on medicine. Some newer devices use wireless technology to help you count doses by allowing you to track doses with an app downloaded to your phone. If your metered dose inhaler does not have a counter, you will need to manually track the number of doses used.

“World Asthma Day (May 5, 2021) is organized by the Global Initiative for Asthma, (GINA) (www.ginasthma.org), a World Health Organization collaborative organization founded in 1993. WAD is held each May to raise awareness of Asthma worldwide.

This year on World Asthma Day the theme is 'Uncovering Asthma Misconceptions'. The theme provides a call to action to address common widely held myths concerning asthma that prevent persons with asthma from enjoying optimal benefit from the major advances in the management of this condition. Common misconceptions surrounding asthma include:

• Asthma is a childhood disease; individuals will grow out of it as they age.
• Asthma is infectious.
• Asthma sufferers should not exercise.
• Asthma is only controllable with high-dose steroids.

The Truth is:

• Asthma can occur at any age.
• Asthma is not infectious. However, viral respiratory infections (such as the common cold and the flu) can cause asthma attacks.
• When asthma is well controlled, asthma subjects are able to exercise and even excel at their sport.
• Asthma is most often controllable with low dose inhaled steroids

REMEMBER: Inhalers deliver medications directly to the lungs always use your inhalers.

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