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Bronchial asthma is a chronic inflammatory disease of the airways, which causes various respiratory symptoms such as cough, difficulty breathing, chest tightness and wheezing. Bronchial asthma is one of the most common chronic diseases of the respiratory system.

Data from the World Health Organization show that more than 260 million people, worldwide, live with asthma. The diagnosis of asthma is based on the patient’s history and clinical picture (periodicity of symptoms, worsening after exposure to irritants and history of exacerbations, etc.) and is confirmed by testing respiratory function with spirometry.

Asthma treatment aims to reduce asthma symptoms, improve and stabilize respiratory function and finally prevent asthma exacerbations.

Pharmaceutical treatment

Medication plays a key role in controlling asthma. There are two main categories in the treatment of asthma: regulatory drugs and reliever drugs. Asthma drugs are mainly administered through special breathing devices, the so-called inhaled drugs. It is worth emphasizing that there are other drugs for the treatment of asthma, which are used in selected cases of asthma patients (monoclonal antibodies, drugs against leukotrienes) as well as in patients with severe asthma during asthma attacks such as oral cortisone.

Inhaled drugs

Inhaled drugs are devices where the drug is delivered directly into the lungs.
They are mainly used for the treatment of asthma and chronic obstructive pulmonary disease (COPD), but also for other respiratory diseases.

There are several types of breathing apparatus for the administration of inhaled drugs, such as:

• Inhalants that deliver the medicine in the form of a spray
• Inhalants that deliver the drug in dry powder form
• Inhalants that deliver the drug in the form of a mist or mist

Inhaled medications are aimed at bronchodilation (bronchodilators) and reducing airway inflammation (cortisone).

What drugs are used in breathing apparatus?

Inhaled medicines used for respiratory conditions include:

• Reliever medicines, such as those used “emergency” during asthma attacks.
• Regulatory medicines for the management and prevention of asthma symptoms as well as the reduction of airway inflammation.
• Inhaled medications include short- and long-acting bronchodilators, as well as inhaled corticosteroids.

Inhaled corticosteroids (Inhaled corticosteroids-ICS)

ICS are the mainstay of asthma treatment as they target the pathogenesis of asthma, that is, they help reduce airway inflammation. ICS are used daily to reduce asthma symptoms as well as prevent asthma attacks.

Short-acting bronchodilators

These inhaled medications are used during asthma attacks when breathing becomes difficult. They are also called “inhaled rescue medicines”. They provide quick relief, but their action lasts only a few hours. It is particularly important to emphasize that when a patient with bronchial asthma needs regular intake of bronchodilator drugs “emergency” in order to relieve his symptoms, then he should contact his attending pulmonologist to rule out a possible exacerbation of asthma and receive the appropriate treatment.

Long-acting bronchodilators

They are used for patients with bronchial asthma in combination with corticosteroids but also in patients with COPD and. They last 12-24 hours and are taken daily.

It is important to emphasize that bronchodilators are not recommended to be used as monotherapy (ie without the co-administration of cortisone) for patients with asthma as they are not the mainstay of asthma treatment.

How are breathing apparatus used?

Each type of respirator has different instructions. General:

• Open or remove the lid.
• Exhale as much air as you can.
• Place the mouthpiece in your mouth.
• Hold the breath for 5 to 10 seconds.
• Rinse your mouth, especially after using inhaled cortisone ICS to avoid the growth of fungi in the throat.

Benefits of using inhaled medications

• Administering medication directly to the lungs.
• Daily regimen for symptom control.
• Immediate relief in emergency situations.

How many doses of inhaled medications are considered many?

• Do not exceed the doses your doctor has prescribed.
• Most inhalers have a dose counter, where you can check whether the medication has been administered.

When to contact a doctor

• If you have questions about using your inhaled medications.
• If you wake up at night with asthma symptoms.
• If you use your rescue inhaler regularly (more than 2 times a week).

Bibliography

1. 2024 update of the Global Strategy for Asthma Management and Prevention
2. Porsbjerg, Celeste et al. Asthma. The Lancet, Volume 401, Issue 10379, 858 – 873