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Medicine Informations

 

Asthma & Medicines

What is Asthma?

Asthma is a condition of the airways. People with asthma have sensitive airways which react to triggers that set off their asthma. Their airways swell and get thick with mucus and the muscles around the airway squeeze tight. This makes it hard to breathe.

How do you recognise Asthma?

People with asthma can have a range of symptoms:

  • Breathlessness
  • Wheezing
  • Tight chest
  • Persistent cough
  • Symptoms often occur at night, early in the morning or during/after activity

Symptoms often vary from person to person.

Who gets asthma and why?

Asthma affects people of all ages. Some people get asthma when they are young; others when they are older. The causes are not fully understood, although people with asthma often have a family history of asthma, eczema and hayfever (allergic rhinitis). There is some evidence that exposure to environmental factors such as workplace chemicals or tobacco smoke can lead to asthma.

How do your symptoms help you understand your asthma?

Everyone’s asthma is different and can change over time: that’s why it’s important for people with asthma to see their doctor at least twice a year for an asthma checkup and more frequently if they have concerns.

If you have asthma, see your doctor if you:

  • Wake up coughing, wheezing or breathless
  • Struggle to keep up with normal activity
  • Use your reliever more than three times a week
  • Are unsure about the way your medications can work best for you.

To find out more about asthma contact your local Asthma Foundation.

 How can Asthma be controlled or treated?

 Asthma can be well controlled by avoiding or managing triggers for asthma and using asthma medicines correctly. Most asthma medicines are inhaled into the lungs, but sometimes tablets, syrups or injections must be used. The three main types of asthma medicines are called relievers, preventers and symptom controllers. 

 Relievers  (e.g., Airomir, Asmol, Bricanyl and Ventolin inhalers) 

Relievers open airways quickly by relaxing the muscles around air passages. Reliever inhaler devices are blue in colour. 

• Can relieve asthma symptoms in a few minutes, with their effect lasting from 3 to 6 hours 

• Are usually recommended for use ‘as needed’ for quick relief of asthma symptoms 

• May be used before exercise, to prevent exercise-induced asthma 

• Are available from a pharmacist without a prescription. 

Some people may feel a little shaky and notice a fast heart beat for a time after using a reliever inhaler. Ask a doctor or pharmacist for advice. 

Preventers 

Preventers reduce inflammation in the airways, dry up mucus and make airways less sensitive to asthma triggers. They can prevent asthma symptoms and lung damage if used regularly. 

Preventers include: 

• Corticosteroids (e.g., Alvesco, Flixotide, Pulmicort and Qvar inhalers) 

• Cromolyns (e.g., Intal and Tilade inhalers) - medications that has anti-inflammatory effects & works by reducing histamine release that is responsible for the inflammation in the airways. Its great in management of exercise-induced asthma, and asthma triggered by allergens or when they know they are going to be exposd to these allergens (eg. when visiting a friend with a cat). This medicine only effective in mild asthma and infrequent attacks and who have been able to identify specific allergic asthma triggers. Cromones are used for both children and adults, but not much benefit to children under 5 years of age.

• Leukotriene antagonists (e.g., Singulair tablets): has anti-inflammatory effects & can be quite effective in managing exercise-induced asthma particularly in children, or in a particular subtype of asthma in adults who have nasal polyps, aspirin sensitivity, and allergic asthma. It is most commonly prescribed for children who need preventer medication, but in most adults it is not as effective as inhaled corticosteroids. Leukotriene receptor antagonists may also be used to treat the symptoms of hayfever (allergic rhinitis).


 

 Preventers:

• Must be taken regularly every day, even when you don’t have any symptoms 

• May take several weeks to improve symptoms 

• Will not relieve an asthma attack once it has started. 

Symptom controllers (e.g., Foradile, Oxis, Serevent inhalers) 

Symptom controllers relax muscles around the airways and when used regularly, in combination with a corticosteroid preventer, may improve symptom control. A symptom controller must always be used with a corticosteroid preventer. 

Combination inhalers (e.g., Seretide, Symbicort

Combination inhalers contain a corticosteroid preventer and a symptom controller in the same inhaler device. To prevent asthma symptoms, they must be used every day, even when you don’t have any symptoms. 

In certain cases the Symbicort combination inhaler may be used as both a preventer and as a fast-acting reliever. However, you must not use Symbicort as your reliever unless instructed to by your doctor. 

Other medicines 

• Ipratropium (e.g., Atrovent inhaler) – can relax airways and may help some people with severe asthma and other airways diseases. 

• Prednisolone and prednisone tablets or liquid (e.g., Panafcortelone, Predmix, Redipred, Solone) – anti-inflammatory corticosteroids that may be used to treat moderate and severe asthma. 

• Theophylline (e.g., Nuelin tablets, Aminophylline injection) – can relax airways and is occasionally used for severe asthma. 

Xolair injection (Anti-immunoglobulin therapy)– may prevent or relieve the symptoms of moderate-severe allergic asthma in adults and children over 12 years old.It is usually only given after other asthma medications have been tried without successful treatment of symptoms. Xolair works by blocking a substance called immunoglobulin E. Your doctor will measure the amount of this substance in your blood to help decide what dose you should have. Xolair is given by injection, every 2 to 4 weeks, usually only in a hospital clinic following a respiratory specialist’s advice. 

Inhalation devices 

Inhalers 

Inhalers deliver medicine directly into the lungs. 

There are two main types of inhalers: 

1. Aerosol inhalers (e.g., Metered Dose Inhalers and Autohalers) 

2. Dry powder inhalers (e.g., Turbuhalers and Accuhalers). 

Good asthma control depends on using inhalers properly. If you are prescribed an inhaler, ask a pharmacist, doctor or asthma educator to demonstrate it’s correct use and to check your inhaler technique regularly. A video showing correct inhaler techniques can be found on the National Asthma Council website www.nationalasthma.org.au. 

Spacers 

A spacer is a chamber that fits onto a MDI (Metered Dose Inhaler) to help get more medicine into the lungs. Spacers can also reduce side effects from inhaled medicines. The medicine is sprayed into the spacer at one end and breathed in from the other end. There is a variety of different spacers available including children’s spacers, large volume spacers, compact spacers and disposable spacers. It is recommended that an MDI always be used with a spacer. 

Nebulisers 

A nebuliser is a pump that sprays liquid asthma medicine as a fine mist. The mist is then inhaled through a facemask or mouthpiece. For most people, a puffer and spacer are easier to use than a nebuliser and just as effective. 

Self care 

• Avoid or manage triggers that make your asthma worse. 

• Use inhalers correctly. Check your technique. 

• Always carry a blue reliever inhaler with you (unless your doctor has told you to use Symbicort as both a preventer and a reliever). 

• Develop a written Asthma Action Plan with a doctor. Use this plan to manage worsening asthma symptoms. 

• Check there is medicine left in your asthma inhalers. 

• Check that your medicine has not expired. 

• After using inhalers containing corticosteroids (Alvesco, Flixotide, Pulmicort, Qvar, Seretide or Symbicort) rinse mouth with water, gargle and spit out. This reduces the risk of side effects of thrush and hoarse voice. 

• Clean inhaler devices regularly. Refer to the product information for cleaning instructions for each device. 

• If using a spacer, wash it before use, and then about once a month, in warm water and kitchen detergent. Leave it to air dry without rinsing or wiping. Wipe detergent off mouth piece before use. 

• Don’t smoke. 

Important information for you to know:

Asthma treatment aims to prevent asthma symptoms by regular daily use of a preventer or combined preventer and symptom controller. 

Consult a doctor or follow your Asthma Action Plan if you: 

• Need to use a reliever more than 3 times a week 

• Have asthma symptoms more than 3 times a week 

• Notice peak flow readings deteriorating 

• Have an asthma attack. 

Ask your doctor or pharmacist for information and advice about how and when to use asthma medicines and always read and follow instructions carefully.

For more information 

Asthma Foundations Australia Phone: 1800 645 130 Website: www.asthmaaustralia.org.au 

National Asthma Council Phone: 1800 032 495 Website: www.nationalasthma.org.au 

Healthdirect Australia Phone: 1800 022 222 Website: www.healthinsite.gov.au 

Consumer Medicine Information (CMI) Your pharmacist can advise on CMI leaflets. 

National Prescribing Service (NPS) Medicines Information Phone: 1300 MEDICINE (1300 633 424) Website: www.nps.org.au 

The Poisons Information Centre In case of poisoning phone 13 11 26 from anywhere in Australia.