Potential Risks of Asthma Inhalers
Inhaled medications deliver treatment directly to the bronchial tubes, aiding in their dilation. The side effects associated with these inhalers are generally minimal compared to those of oral or injectable medications.
It is important to categorize the medication found in asthma inhalers into three primary types:
- Relievers: Also known as short-acting bronchodilators, relievers are used to manage occasional asthma symptoms such as shortness of breath, chest tightness, or wheezing. These drugs work by relaxing the muscles surrounding the airways, allowing for immediate expansion and symptom relief. Two key medications in this category include Salbutamol and Terbutaline, commonly referred to as bronchodilators due to their airway-opening effects.
- Preventers: Typically containing steroids, preventers are recommended when an individual requires reliever inhalers three or more times a week. These medications focus on reducing inflammation in the airways, thereby minimizing the likelihood of constriction that leads to symptoms such as wheezing. Preventers are generally used daily to avoid asthma episodes.
- Long-acting bronchodilators: In some cases, a doctor may prescribe these alongside preventers when steroids alone are insufficient for symptom control. While their mechanism of action is similar to that of short-acting bronchodilators, their effects last for approximately 12 hours after each dose.
Inhaled Steroids
Inhaled steroids can lead to various side effects, akin to many other medications. These effects may be local, affecting a specific area, or systemic, impacting the entire body. Minor issues may include throat irritation and oral thrush, while more severe complications can involve eye disorders and bone loss. Systemic effects are particularly concerning and are often associated with long-term use of inhaled steroids. Potential side effects include:
- Inflammation of the mouth or throat.
- Oral candidiasis (a common fungal infection in the mouth).
- Decreased bone density in adults.
- Increased tendency to bruise.
- Minor growth retardation in children.
- Temporary hoarseness.
- Cataracts, which result in cloudiness in the eye.
- Laryngeal spasms.
- Glaucoma, characterized by increased intraocular pressure.
Most asthma patients achieve effective disease control when using inhaled corticosteroids; however, it is essential to reassess the situation if asthma remains uncontrolled despite their use. Patients should inform their healthcare provider about treatment efficacy and any side effects experienced. This communication aids in managing asthma with minimal medication. It is crucial not to discontinue inhaler use without consulting a physician. When stopping, a gradual tapering of dosage is necessary to avoid withdrawal symptoms such as malaise, severe pain, dizziness, and joint discomfort. Inhaled steroids are localized and do not typically circulate to other body parts, reducing the risk of unwanted side effects. Nonetheless, extended and high-dose usage may increase the risk of osteoporosis, which can be mitigated by regular physical activity, a calcium-rich diet, and abstaining from smoking.
It is also essential to evaluate the growth of children using inhaled steroids over extended periods due to the potential risk of adequate steroid transfer from the lungs to the bloodstream, which might delay growth. Although this risk is minimal, it is crucial to balance it with the potential adverse effects of not using inhaled steroids in asthmatic children.
Here are some tips for minimizing the side effects of inhaled steroids:
- Use the inhaler exactly as instructed by the physician, and consult healthcare providers if unsure about the correct usage.
- Utilize a spacer, a hollow plastic tube connected to the inhaler, to facilitate drug inhalation, especially beneficial for children or the elderly. This device allows for a slower inhalation, increasing the medication delivered to the lungs. Note that a prescription is required for spacers.
- Rinse the mouth with water after each dose of inhaled steroids.
Short- and Long-Acting Bronchodilators
Bronchodilators require a prescription and are utilized for various pulmonary conditions. These include beta-2 agonists, which improve airflow and reduce symptoms like breathlessness by relaxing the smooth muscles around the airways. Another category includes anticholinergic medications, which inhibit acetylcholine — a chemical released by nerves that cause bronchial constriction. Preventing its action allows the airways to remain open. Both classes of bronchodilators are available in short- and long-acting forms. It is important to note that bronchodilators may produce counterproductive effects, such as bronchospasm or worsening constriction. Allergic reactions may also occur, as with any medication. The severity of side effects can correspond with the dosage—while small doses may cause side effects, increased dosages generally elevate the likelihood and intensity. The side effects may also vary depending on whether they are anticholinergic or beta-2 agonist bronchodilators. Possible side effects include:
- Coughing.
- Increased heart rate.
- Dry mouth.
- Decreased potassium levels.
- Nausea.
- Nervousness.
- Headaches.
- Tremors.
Types of Asthma Inhalers
Asthma inhalers are the most common and effective means of delivering asthma medication to the lungs. They are available in various forms that differ in their mechanisms of action. The choice of the most suitable inhaler for a patient depends on several factors, including the type of medication needed and delivery method. Some medications are available only in specific inhaler types, while others may have inhalers with one or two types of medication. The inhalers prescribed by doctors include:
- Metered-dose inhalers: These devices use a small pressurized canister that releases a metered dose of medication through a plastic mouthpiece. Some designs automatically release the medication upon inhalation. Certain inhalers may also have counters that indicate the remaining doses, but if absent, users should keep track manually or invest in a separate electronic counter to monitor medication levels.
- Dry powder inhalers: These release medication when a patient takes a deep, fast breath, rather than relying on a chemical propellant. Some dry powder inhalers provide multiple doses (approximately 200 doses), while others contain a single-use capsule for each inhalation.
Other types of inhalers are available for patients who may struggle with the previously mentioned inhalers, including:
- Nebulizers: Typically used for individuals unable to use conventional inhalers, such as infants, young children, or those needing high medication doses, nebulizers convert asthma medication into a fine mist inhaled through a mask or mouthpiece.
- Metered-dose inhalers with face masks: This device employs a face mask to ensure the accurate delivery of medication to the lungs, covering the mouth and nose, and connecting to a spacer attached to the inhaler. They are particularly useful for infants and small children.
- Soft mist inhalers.
Video on the Risks of Asthma Inhalers
Although asthma inhalers can provide immediate relief for patients, like any other medication, they also have potential side effects. Watch the video to learn more about these impacts: