Key points about asthma medicines
- inhalers (puffers) are the most common medicine for tamariki with asthma
- there are 2 main types of inhalers - relievers and preventers
- asthma medicines help open the airways and reduce swelling inside them
- some tamariki may also need other medicines to help control their asthma
Different asthma inhaler medicines
An asthma inhaler delivers medicine to your child’s lungs.
There are different inhaler medicines to manage asthma. Your child’s asthma medicines will depend on how their asthma is affecting them.
Relievers
Reliever medicines relax the muscles in the airways in the lungs. This helps your child to breathe more easily.
Reliever medicines work quickly, and their effect can last for up to 4 hours. Use a reliever if your child has coughing, wheezing or tightness in the chest.
Reliever medicines can help your child to feel better quickly. If your child needs to use their reliever more than 2 to 3 times a week, talk to your health professional. Your child may need to trial a preventer inhaler.
If your child gets asthma symptoms with exercise, your health professional may suggest trying a reliever before exercise.
Relievers work best when used with a spacer.
Examples of reliever medicines
A photo of a Respigen (salbutamol) inhaler attached to a spacer.
Source: KidsHealth
A photo of a Salair (salbutamol) inhaler attached to a spacer.
Source: KidsHealth
Preventers
Preventers reduce the chance of your child having an asthma attack. Talk to your health professional about whether your child should have a preventer. Preventer medicines help reduce swelling and narrowing in the airways in the lungs.
Preventers work slowly to help improve your child's asthma symptoms. Your child won't notice any instant change in how they feel.
For a preventer inhaler to work best, your child needs to take it every day.
It’s best for your child to use a spacer with their preventer. This helps get the medicine to the right place in the lungs.
Examples of preventer medicines
A photo of a Flixotide (fluticasone) inhaler attached to a spacer.
Source: KidsHealth
A photo of a Pulmicort (budesonide) turbuhaler.
Source: KidsHealth
Combination inhalers
Combination inhalers contain both preventer and reliever medicines. They help to relieve asthma symptoms and prevent asthma attacks.
They need to be used every day, even if your child feels well. Some combination inhalers can be used during an asthma attack. Ask your health professional to fill out an asthma action plan for your child. It's important that you understand which inhaler to use in different situations.
Some tamariki need a different reliever during asthma attacks.
Examples of combination inhalers
A photo of a Symbicort (budesonide with formoterol) turbuhaler.
Source: KidsHealth
A photo of a Seretide (fluticasone with salmeterol) inhaler attached to a spacer.
Source: KidsHealth
Inhalers look different and deliver the medicine differently
There are different types of inhalers - metered dose inhalers and dry powder inhalers.
- they deliver the medicine in different ways
- they look different
- you need to use a different technique to deliver the medicine depending on which inhaler your child uses
Most inhalers for children - relievers and preventers - are metered dose inhalers. You need to use them with a spacer.
Metered dose inhaler (MDI) with a spacer
A metered dose inhaler (MDI) delivers a set amount of medicine when you press the top of the inhaler.
In this video, Lachlan is showing how to use an MDI inhaler with a spacer.
Source: Asthma Waikato
transcribeTranscript
[Music]
[Health professional]
Hi everyone, this is Lachlan and he is my asthma star today and he's going to show us how to use the MDI inhaler with the spacer correctly.
Right Lachlan, first of all we're going to take off the lid of the inhaler.
We're going to shake the inhaler - mix the medicine and aerosol together. We're going to place the inhaler into the spacer and place the spacer mouthpiece into the mouth forming a good seal.
Now one puff with 6 breaths.
Using the spacer delivers 50% more medicine.
Well done Lachlan.
To have another dose, we need to shake the inhaler again, place the inhaler into the spacer and repeat the sequence.
Remember everyone, it's one puff with 6 breaths.
The spacer's washed once a week with warm soapy water and allowed to drip-dry.
Place the lid back onto the inhaler.
Children aged 0 to 4 years are recommended to use a mask with the spacer.
Between the ages of 2 and 4, start weaning off the mask.
Using the spacer without the mask delivers ⅔ more medicine to the lungs than using the mask. However, during an acute flare-up, a good seal with the mouthpiece may not be achievable. So using a mask might be required.
Well done Lachlan and thank you for showing us how to use the MDI inhaler with the spacer correctly.
Dry powder inhaler
Some older tamariki can use a dry powder inhaler. These contain medicine in a powder form. This inhaler does not need a spacer.
You don't need to shake this inhaler before your child uses it. Your child breathes in the medicine directly from the inhaler’s mouthpiece. Ask your health professional to show you how to use the inhaler. Make sure your child is comfortable with it and using it correctly.
A video about how to use a Turbuhaler - a common dry powder inhaler.
Source: Healthify He Puna Waiora
transcribeTranscript
Kia ora, my name is Tasha and I'm a pharmacist at Auckland City Hospital.
Today I'm going to show you how to use your Turbuhaler.
First you'll need to remove the cap.
Do this by twisting the cap until it comes off.
Next, you'll need to activate your dose.
To do this, twist the base, first anti-clockwise and then back til you hear a click
To inhale your dose, you will need to breathe out away from your device.
Then, make a tight seal around the mouthpiece with your lips, and breath in rapidly.
Once you get down to around 10 doses, this window will become partially coloured red.
When this happens, you'll need to go and get a repeat from your pharmacist, or a new prescription from your doctor.
After you've inhaled your dose, replace the cap and twist it until it is on properly.
Do not wash this device in water as it will damage the inhaler.
If it needs a clean, clean it with a clean dry cloth, especially around the mouthpiece.
If you have any questions about any of the inhaler devices, please go and ask your pharmacist.
They'll be more than happy to help and answer any questions.
Asthma medicines other than inhalers
Oral steroids
If your child's asthma symptoms are not settling with inhalers, they may need steroids. Oral steroids come as tablets or a liquid. Only some tamariki with asthma will need oral steroids - usually for 3 to 5 days. Your child will need to continue with their usual inhalers. Oral steroids improve the swelling inside your child's airways. They can reduce the amount of mucus in the airways.
Examples of oral steroids include:
- Redipred (prednisolone)
Prednisolone For An Asthma Attack
Other medicines
There are some other medicines, such as montelukast that are helpful for some children with asthma.
Asthma action plan
Ask your child's health professional for an asthma action plan. The best way to manage your child’s asthma symptoms is to follow their asthma action plan.
Having an asthma action plan gives guidance on what medicines to use and when. This is for interval symptoms and asthma attacks. It’s a good idea to review the asthma action plan every year.
Take a look at the Cardiac + Respiratory Foundation NZ website for an example of what a blank asthma plan looks like. It's available in English, te reo Māori, Samoan and Tongan.
Good management can stop asthma from interfering with your child's life, including enjoyment of sports and play.
More information and support
Asthma Interval Symptoms In Children
Cardiac + Respiratory Foundation NZ brings together the Asthma and Respiratory Foundation NZ, Kia Manawanui Trust – The Heart of Aotearoa, Lung Foundation NZ, and the Bronchiectasis Foundation NZ. Check out their website for information and resources on asthma and other respiratory conditions.
Asthma New Zealand provides information. They also offer free appointments to people with asthma in some regions, or nationally through telehealth. You can self-refer or a health professional can refer you.
Acknowledgements
Photos of asthma medicines taken by KidsHealth.
