HealthInfo West Coast-Te Tai Poutini

Treating asthma in adults

Te whakarauora i te mate huangō ki ngā pakeke

Many people put up with asthma symptoms when they do not need to. Asthma is treatable.

Getting wheezy or short of breath more than 3 times a week is a sign that your asthma is not well controlled. It means you may need to use a preventer inhaler.

You and your healthcare team should be able to agree on a treatment plan that will control your asthma.

Inhalers

Adults with asthma are usually given inhalers as part of their treatment.

With some inhalers, using a spacer helps get more of the medicine into your lungs. Many of the newer inhalers are designed to be used without a spacer.

Talk to your general practice team if you are having problems with your inhalers.

If you are using your inhalers as agreed and are still having symptoms, it is important to discuss this with your health provider.

Single inhaler therapy or anti-inflammatory reliever therapy (AIR)

People used to have a reliever (blue) inhaler to use when they felt wheezy or short of breath. We now know that a combination inhaler is a better way of treating asthma. Combination inhalers contain a steroid preventer and a long-acting reliever.

The steroid part of the inhaler works by reducing the inflammation in your airways so they do not react to triggers.

The reliever part works quickly to relax the small muscles in your airways, opening them up.

You can use this inhaler every day, both as a preventer and when you need quick relief if you feel wheezy or short of breath.

Examples of inhalers that can be used in this way are Symbicort, Vannair and Duoresp Spiromax. These all contain the medications budesonide and formoterol.

Short-acting relievers

Short-acting relievers manage your symptoms quickly by relaxing the muscles in your airways. This opens them up to allow more air to flow. Examples of short-acting relievers include salbutamol (Respigen and Ventolin) and terbutaline (Bricanyl).

We now know it is better to use a combination inhaler as your reliever instead of a short-acting inhaler. Discuss this with your health provider.

Preventers

Preventers reduce the inflammation in your airways. Unlike relievers, preventers do not make you feel better straight away. But if you use them every day, they make your asthma symptoms less likely to occur. These preventers are usually mild steroids. Examples of steroid preventers include beclometasone and fluticasone.

Long-acting relievers

Long-acting relievers help to keep your airways relaxed and open. You usually take these medications when your preventer inhaler is not enough to keep your asthma under control. If you need a long-acting reliever, you will take it as part of a combination inhaler.

Combination inhalers

Combination inhalers contain a long-acting reliever and a steroid preventer. Examples of these include budesonide and formoterol (Symbicort, Vannair and Duoresp). Other types include fluticasone and salmeterol (Seretide and Rexair) and fluticasone and vilanterol (Breo).

Tablets

If you have a very bad asthma flare-up or attack and inhalers alone are not working, you may need a short course of steroid tablets. For adults, the course is usually at least 5 days. The most commonly used steroid is prednisone. Like the inhaled steroid preventer, prednisone reduces inflammation in your airways.

Many people have a written, agreed plan for when to start prednisone and have a supply at home. See the self-management plans on Self-care for asthma.

Nebulisers

Nebulisers are sometimes used in hospital for severe asthma attacks. A nebuliser is a machine that has an air compressor and a breathing mask. You put liquid reliever medication into a container and the nebuliser produces a fine mist that you breathe in through the mask.

Respiratory specialist

If your asthma is not well controlled with inhalers, you may need to see a respiratory specialist to consider additional treatments.

  HealthInfo recommends the following videos

• HealthSketch – What is asthma?

  A simple animated video about asthma. It includes symptoms and triggers, how it is diagnosed and treated and how it can be managed.

  HealthInfo recommends the following pages

• Asthma Foundation – Asthma medication

  Information about preventers, relievers, symptom controllers, combination inhalers and prednisone.

On the next page: Self-care for asthma

Written by HealthInfo clinical advisers. Last reviewed October 2024.

Sources

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Review key: HIASA-39947