Inhalation Therapy For Bronchial Asthma

Why Inhalation therapy is Advised for asthma-Holistic doctor online

Inhalation Therapy For Bronchial Asthma

What is Inhalation therapy ( Aerosol Therapy)?

Inhalation Therapy is a method to administer(deliver) drugs directly into the airway in patients with chronic( long-lasting) diseases of respiratory system like Asthma, COPD (Chronic Obstructive Pulmonary Disease) and Bronchiectasis.

In Inhalation Therapy (Aerosol Therapy), the medicine is made to float as mist in air(Aerosol) to be inhaled (breathed in) by the patient and deposited directly in the airway and lungs.

Why is Inhalation therapy Advised? ( Advantages of inhalation therapy).

In Inhalation Therapy the medicine reaches the airway directly, so the action is faster.

As the medicine is given directly to the airways, a small dose of the medicine is enough. So lesser side effects.

No gastritis as in oral medications and it is painless.

What are the drugs given through inhalers?

Inhalers come with Bronchodilators (Relievers) or Steroids (preventer/controllers) alone or in the combination of both.

Bronchodilators are used when the patient is breathless to relieve broncho constriction.

The combination of reliever and controller are used for prevention of bronchial asthma.

What are the common types of Inhalation Therapy (Aerosol Therapy)?

Dry powder inhaler (DPI), Metered Dose inhaler (MDI) and Nebuliser(Nebulizer) are the types of devices used normally.

What is Dry Powder Inhaler?

In Dry powder inhaler, the drug is in the form of dry powder in the device and can be breathed (inhaled) in through the mouth.

It is activated by our breath.

Single dose and multi-dose devices are available.

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How to use Dry Powder Inhaler?

 

Take the device and insert the capsule ( containing the medicine) in allotted slot for the capsule.

Rotate the base of the device to separate the two halves of the capsule to release the medicine inside the device.

Breath out away from the device.

Keep the mouthpiece in the mouth and inhale the powder (medicine).

 

Hold the breath for as long as possible. Remove the inhaler and breath out.

Repeat the Process till the device is empty. Gargle the mouth and throat with water after use.

Advantages of dry powered inhaler

Easy to carry and easy to use. Hand-mouth coordination is not necessary.

Disadvantages of Dry powder inhaler

Cannot use when the patient is severely breathless.The powder can get deposited in the mouth and produce oral candidiasis (ulcers in the mouth).

Gargle the mouth and throat after inhaler use to prevent this.

What is metered Dose Inhaler?

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In Metered Dose inhaler the medicine is kept in a metal container under pressure.

The container is fixed in a plastic enclosure with a mouthpiece.

When the container is pressed down, a measured (prefixed) dose of medicine is released to be inhaled.

How to use Metered Dose inhaler?

Hold the device in between thumb and index finger.Shake the inhaler well. Breath out and keep the mouthpiece of the inhaler in the mouth.Take a deep breath and press down the container to release a dose at the beginning of the breath.

Inhale fully and hold the breath as long as possible. Remove the inhaler and breath out. Repeat if necessary.

Gargle mouth and throat after use.

Advantages of Metered Dose Inhaler

Easy to carry and easy to use.

Faster in action.

Disadvantages of Metered Dose Inhaler

Hand-mouth co-ordination (Press and start inhaling) is necessary.

Deposits of the drug in the mouth leading to ulcers in the mouth.

Cannot change the dose and composition of the drugs.

What is Spacer (Holding chamber)?

Spacer is a holding chamber used along with Metered Dose Inhaler.

In one end of the spacer is a mouth piece and the other end has a slot to fix the inhaler.

Fix the inhaler in the spacer, shake well, release the medicine and inhale. This prevents deposits in the mouth and prevents wastage of the drug.

What is nebulizer?

In nebulizer compressed air, oxygen or ultrasound is used to float (suspend) the particles of the medicine in air to be inhaled through a mouthpiece or oxygen mask.

Advantages of Nebulizer

No effort from patient necessary. Can be used in children, unconscious patients and patients on mechanical ventilator.

Deposition of the drug in the mouth is prevented.

Hand-mouth coordination is not necessary. The composition and amount of medicine can be altered according to the need.

Disadvantages of Nebulizer

Source of Power is  necessary (battery or electricity).

Difficult to carry.

Myths (belief) about inhalers

There is a belief that inhalers are addictive (Habit forming) and it is costlier to use. But it is not correct.

Inhalers are not habit forming but inhalers are to be used regularly to prevent the asthma attack.

If the patient uses inhalers regularly, it is cheaper than oral drugs or injections. The side effects are also less.

So it is better to use inhalers to prevent and treat Bronchial Asthma.

It is best for the patient to consult a Respiratory Therapist, and learn the correct methods to use inhalers and nebulizer.

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Causes, symptoms and treatment of Asthma

Bronchial Asthma

Causes, symptoms and treatment of ASTHMA

What is Bronchial Asthma?

Bronchial Asthma (Asthma) is a chronic (long-lasting) disease of the airway (Bronchus).

In bronchial asthma, the airway is hypersensitive (very sensitive) to allergens (Triggers producing allergy) and becomes narrow, thereby producing difficulty in breathing, cough and wheeze.

What causes Bronchial Asthma?

Bronchial Asthma can be due to Hereditary (Familial), Allergic or Seasonal.

The Triggers are the allergy to food, dust, smoke, pollen, cotton dust, perfumes, sprays, paint smell, pet’s hair, firecrackers, cooking smell, air pollution, etc…

Bronchial Asthma can also be triggered by infections like cold and flu, exercise, cold air, extreme changes in climates, emotional stress, anxiety, drugs like pain killers (NSAID) and beta blockers.

The acidity of the stomach (gastritis-acid reflux) can also trigger Asthma.

What happens to the airway in Bronchial Asthma?

Normal Airway                                    Bronchial Asthma

When the patient’s airway is exposed to triggers producing bronchial asthma, the following changes happen.

The airway becomes narrow due to bronchoconstriction (muscles of airway becomes tight).

The cells of the mucous membrane of the airway swell up. (Inflammation) and there is increased secretion of mucous inside the airway.

So the airway becomes very narrow and air passes through with difficulty. As the air passes through the narrow gap it produces a whistling sound called wheeze.

What are the Signs and symptoms of Bronchial asthma?

The Bronchial Asthma patient may have cough with or without wheeze, difficulty in breathing, shortness of breath, tightness of chest and may have chest pain.

What are the investigations for bronchial asthma?

The main investigation is Pulmonary Function Test. Spirometry is the PFT done. If the forced expiratory volume in 1 second is less than 80% of the normal value it shows airway obstruction.

The test is repeated after giving inhaled bronchodilators (medicine to widen airways) and if there is an improvement for more than 12% (reversibility) it is bronchial asthma.

Other tests done are X-ray chest, Arterial blood gas analysis (ABG), Blood oxygen saturation, Sputum examination and culture, White blood eosinophil count, Blood immunoglobulin E level etc…

What is the treatment for Bronchial Asthma?

For acute and severe asthma ( acute Exacerbation) hospitalization with oxygen support is necessary.

For milder form Bronchodilators ( Relievers) like salbutamol, theophylline, terbutaline or doxophylline can be given. These drugs widen the narrow airways.

Steroids( Preventers) like fluticasone or budesonide can be given to reduce swelling and mucous secretions. Other drugs like anticholinergics, montelukast, cromoglicate and anti-allergy medications can be given.

Inhalation Therapy is the best form of drug administration in bronchial asthma. Normally one Reliever and one preventer are given as inhalers for the regular treatment of Asthma.

How to prevent Bronchial Asthma?

Avoid triggers producing asthma, and regular breathing exercises can prevent Bronchial Asthma.