Asthma InhalersEver wonder if you're using an asthma inhaler properly? Do you puff and breathe, or breathe and puff with an asthma inhaler?Don't worry! Many people are confused when first using an asthma inhaler. Yet asthma inhalers are the most effective way of delivering lifesaving medications to those with asthma and other lung diseases. Whether you have asthma or care for someone with asthma, it is important to know more about asthma inhalers, including how to use an asthma inhaler correctly.What is an asthma inhaler?An asthma inhaler is a handheld device that delivers asthma medication straight into the airways. While asthma medications can be taken orally and intravenously, with an asthma inhaler the medication goes directly into the lungs to help relieve asthma symptoms faster and with fewer side effects.How is medication delivered in an asthma inhaler?Asthma inhalers can deliver medicine in a variety of ways, including the following:Metered dose inhalers (MDIs): A metered dose inhaler (MDI) delivers asthma medication through a small, handheld aerosol canister. The metered dose inhaler gently puffs the medicine into your mouth when you press down on the inhaler, and you breathe the medicine in.Dry powder inhalers (DPIs): Dry powder asthma inhalers require you to breathe in deeply as the medication enters your lungs. These asthma inhalers may be difficult to use, especially during an asthma attack when you cannot fully catch a deep breath. Read the instructions carefully for each dry powder inhaler because they vary considerably. The technique you learned for one type of inhaler often does not apply to others.What types of medications are used in asthma inhalers?Medications used in asthma inhalers are anti-inflammatory (steroids such as prednisone), bronchodilators (beta-2 agonist medications), or both (a combination inhaler).Anti-Inflammatory asthma inhalers. Anti-inflammatory medications used in asthma inhalers help prevent asthma attacks and reduce swelling and mucus production in the airways. These anti-inflammatory medications help people get better asthma control. Anti-inflammatory drugs used in asthma inhalers include: Corticosteroids including Advair, Aerobid, Asmanex, Azmacort, Flovent, Pulmicort, Symbicort, Qvar Mast cell stabilizers, which may prevent allergic reaction, including Intal and TiladeFor in depth information, see WebMD's article on Asthma, Steroids, and Other Anti-Inflammatory Drugs.Bronchodilator asthma inhalers . Bronchodilator asthma inhalers are either short-acting or long-acting. They are used to ease asthma symptoms such as wheezing, shortness of breath, and coughing. Inhaled bronchodilators dilate or widen the airways, which helps relieve asthma symptoms much faster than oral medications. Bronchodilator drugs used in asthma inhalers include: Short-acting beta-agonists including albuterol (Proventil HFA, Ventolin HFA, AccuNeb), Alupent, Maxair, Xopenex Long-acting beta-agonists, including Serevent (salmeterol) and Foradil (formoterol). The combination inhalers currently available in the United States are Advair and Symbicort. Combivent and DuoNeb inhalers contain both albuterol and ipratropium (an anticholinergic bronchodilator). This combination of albuterol and ipratropium may also be given using a nebulizer.For in-depth information, see WebMD's article on Bronchodilators: Relieving Asthma Symptoms.How can I be sure there's medication in my asthma inhaler?Many new inhalers include a counter. For the others, knowing how much medication is available in an asthma inhaler is a problem. Many people with asthma tell of using their inhalers until they can no longer hear a "puff" sound when they try to spray it. The problem is that most asthma canisters generate a puff sound long after the asthma medication is gone. You may be using the asthma inhaler properly and hearing the puff sound when you spray it, yet the asthma inhaler canister may be completely empty. This is a serious problem when you depend on the inhaled medication to relieve asthma symptoms.The best way to know how many doses remain in an asthma inhaler without a counter is to mark the number of doses used on the inhaler and then toss the inhaler after you've used this number of puffs. You can find the total number of doses on the asthma inhaler box or canister. Mark the date on your calendar when you expect to use all of the available puffs in the new asthma inhaler and obtain a new asthma inhaler before this date. Keep one or two extra quick-relief inhalers at home. Carefully review the instructions that came with the inhaler (or locate them online). Some inhalers must be shaken before each use; others must be primed if not used for several days.When is a spacer used with an asthma inhaler?A spacer is a tube that attaches to the asthma inhaler and holds the medication until you can breathe it in. This makes using the asthma inhaler easier and helps to deposit the medication into the lungs more efficiently. Not all inhalers should be used with a spacer, so discuss this with your pharmacist. There are times that an MDI or asthma inhaler may be used without a spacer. Your doctor will decide which method of using an asthma inhaler is best for you.Spacers with masks are available for use by small children or anyone else that may not be able to breathe in correctly through a standard spacer connect to an asthma inhaler.

Bronchodilators: Relieving Asthma SymptomsOne type of medication is used by almost all people with asthma: a bronchodilator. Short-acting bronchodilators are used only as needed as asthma rescue medications, while long-acting bronchodilators are used every day to control asthma. Bronchodilators open up the bronchial tubes so that more air can move through. Bronchodilators also help clear mucus from the lungs. As the airways open, the mucus moves more freely and can be coughed out (expelled) more easily.What types of bronchodilators stop asthma symptoms?The three types of bronchodilators are 1) beta-agonists, 2) anticholinergics, and 3) theophylline. These bronchodilators are available in inhaled, tablet, liquid, and injectable forms, but the preferred method of taking the beta-agonists and anticholinergics is by inhalation.What are the short-acting bronchodilators?Short-acting bronchodilators are called "quick acting," "reliever," or "rescue" medications. These bronchodilators relieve asthma symptoms very quickly by opening the airways. The rescue medications are best for treating sudden asthma symptoms. The action of inhaled bronchodilators starts within minutes after inhalation and lasts for 2 to 4 hours. Bronchodilators in asthma inhalers are also used 15-20 minutes before exercise to prevent exercise-induced asthma.For more information, see WebMDs article on Asthma Inhalers.Short-acting bronchodilators can be used in an asthma nebulizer (breathing machine) to treat an asthma attack at home. The problem with oral forms of bronchodilators compared with asthma inhalers is that they tend to have more side effects because they are in higher doses and travel throughout the bloodstream to get to the lungs. Contrary to this, bronchodilators delivered with asthma inhalers go directly into the airways and have fewer side effects.For in-depth information, see WebMDs article on Asthma Nebulizers (Breathing Machines).Overuse of short-acting bronchodilators, whether in asthma inhalers, in tablets, or in liquid, is a sign of unstable asthma that needs treatment that is more aggressive. If you need to use your short-acting bronchodilators more than twice a week, talk with your doctor about improving your asthma controller therapy.Short-acting bronchodilator inhalers available in the United States include: Albuterol (Proventil HFA, Ventolin HFA, AccuNeb, also available as a generic solution for nebulizers) Alupent (Metaproterenol, available as a generic solution for nebulizers, see below) Combivent (combines a beta-agonist and an anticholinergic, see below) DuoNeb (combines a beta-agonist and an anticholinergic, see below) Maxair XopenexWhat are the long-acting bronchodilators for relieving asthma symptoms?The long-acting bronchodilators are used to provide control -- not quick relief -- of asthma. These bronchodilator inhalers last for at least 12 hours. Those containing formoterol begin their action within a few minutes, while those containing salmeterol take up to 45 minutes to begin their action.Advair, Symbicort, Serevent, and Foradil inhalers include long-acting bronchodilators that are used twice a day. Long-acting bronchodilators probably increase the risk of asthma-related death when used regularly without an inhaled steroid. For details, see their black-box warning.Bronchodilators: Relieving Asthma Symptoms(continued)Long-acting bronchodilator asthma inhalers available in the United States include: Advair and Symbicort (a combination of a beta-agonist bronchodilator and an inhaled steroid) Serevent (salmeterol) Foradil (formoterol) Perforomist (formoterol solution for nebulizers)Are there common side effects of bronchodilators used for relieving asthma symptoms?Bronchodilators act as stimulants and have side effects such as: Nervous or shaky feeling Overexcitement or hyperactivity Increased heart rate or palpitations Upset stomach Trouble sleeping (insomnia) Muscle aches or cramps How do the anticholinergic bronchodilators work?The anticholinergics are bronchodilators used for treating smoking-related COPD (emphysema). They are approved by the FDA for treating asthma attacks in emergency room settings, but not for the treatment of asthma symptoms in other settings. They are rarely as effective as albuterol for relieving asthma symptomsAtrovent (an anticholinergic bronchodilator) is available as an asthma inhaler and also in a nebulizer solution. A dry throat is the most common side effect. If the medication gets in the eyes, it may cause blurred vision for a short period of time. An ultra-long-acting anticholinergic inhaler (Spiriva, tiotropium) is also available for patients with smoking-related COPD (as proven by airway obstruction that persists after an inhaled bronchodilator). The FDA has not approved this inhaler as an asthma controller medication.Is theophylline a bronchodilator for relieving asthma symptoms?Theophylline is a relatively weak but inexpensive bronchodilator that has a chemical similar to caffeine. Theophylline stimulates the heart, the central nervous system, and the skeletal muscles, while also relaxing the smooth muscles, including the airway muscles. Theophylline is sometimes used along with an anti-inflammatory drug to prevent nighttime asthma symptoms.Theophylline is sold as a generic pill or under the brand names Uniphyl, Theo-Dur, Slo-Bid, and Theo-24. Theophylline is available as an oral (pill and liquid) or intravenous (through the vein) drug. Theophylline is long-acting and prevents asthma attacks. Theophylline is used to treat difficult-to-control or severe asthma and must be taken daily.What are the side effects of theophylline?Side effects of theophylline include: Nausea and/or vomiting Diarrhea Stomachache Headache Rapid or irregular heartbeat Muscle cramps Jittery or nervous feeling HyperactivityThese side effects may also be a sign of having taken too much medication. Your doctor will check your blood levels of the medication to make sure you are receiving the proper amount.Always tell your doctors if you take theophylline for asthma because certain medications, such as antibiotics containing erythromycin, seizure medicine, and ulcer medicine, can interfere with the way theophylline works. Also, make sure your doctor knows about any other medical conditions you may have, since some diseases and illnesses can change how your body responds to theophylline.And keep in mind that not only is smoking and exposure to cigarette smoke especially dangerous for those with asthma, but it can also interfere with how your body responds to theophylline. Therefore, it is best to avoid smoke and cigarette smoking.Dr. Reddy's Launches Respiratory Inhalers In India; Forays Into Asthma Market

(RTTNews) - Dr. Reddy's Laboratories Ltd., an emerging global pharmaceutical company, has forayed into inhalation asthma market in India with the launch of Combihale - a combination of a steroid and a long acting bronchodilator.The Hyderabad-based company said that Combihale is used in the treatment of asthma and is available in two combinations, Combihale FF (Formoterol + Fluticasone) and Combihale FB (Formoterol + Budesonide).Combihale would be available along with Redihaler, a dry powder inhalation device that was designed in-house and which will initially be given free of cost with Combihale, the company said.Combihale comes in both dry powder inhaler and metered dose inhaler forms. The metered does inhaler is available in pack sizes of 120 doses, while the dry powder capsules will be available in 2x15's blister caps along with the Redihaler device, the company added.Salient features of Combihale:Firstly, Combihale is a combination of a steroid and a long acting bronchodilator.Secondly Combihale range of inhalational drugs is dispensed either through dry powder (DPI) or metered dose inhaler (MDI) forms.Thirdly, upon oral inhalation, they selectively deposit the drug at the site, where their action is needed.Lastly, these contain bronchodilator, which relax the constricted airways and corticosteroid, which limit inflammation and irritation in the airways in patients suffering from obstructive lung disease including AsthmaAccording to ORG IMS data, Inhaler market is presently valued at Rs.473 crores growing at over 17% annually.Recently, the company formally launched its US Specialty Business, Promius Pharma, a wholly owned subsidiary, in Bridgewater, New Jersey, to initially focus on the branded dermatology market. Promius Pharma's current portfolio contains innovative topical products for the treatment of psoriasis, atopic dermatitis and seborrheic dermatitis.The company clocked consolidated net profit of Rs.438 crores on total revenue of Rs.5,195 crores for the fiscal year ended March 31, 2008.At the BSE, Dr. Reddy's shares are currently trading at Rs.514.60, down by Rs.6.10 or 1.17% from the previous close.For comments and feedback: contact editorial@rttnews.com