Asthma medications and inhaler devices

There are 3 main types of medications used to treat asthma:

• relievers (blue)
• preventers (orange or yellow)
• symptom controllers (green).

Relievers – blue coloured

• Commonly called the blue puffer or blue reliever puffer – for example Ventolin.
• Work quickly – within a few minutes.
• Open the airways by relaxing the tight muscles. Gives quick relief from cough, wheeze and shortness of breath symptoms.
• Should be given only when needed.

Side effects – the ‘shakes’, a rapid heartbeat, hyperactivity in children. These side effects only last for a few hours.

Preventers – orange or yellow coloured

• Work slowly.
• Reduce the swelling and mucus in the airways and make the airways less sensitive or ’twitchy’.
• Must be taken every day as directed to work properly.

Side effects – hoarse voice, sore throat or thrush in the mouth (rarely seen in children due to the low doses used). Potential side effects can be reduced by using a spacer and rinsing your mouth out after use.

Montelukast preventer medication is available in tablet form. It is not a steroid.

It is used in mild to moderate asthma and seems to benefit children whose asthma is allergy or exercise based.

Symptom controllers – green coloured

• Long acting medications to relieve symptoms of asthma.
• Work by opening the airways and keeping them open for 12 hours.
• Used in conjunction with preventers, usually as a combination inhaler.

Side effects – the 'shakes', a rapid heartbeat, hyperactivity.

Steroid medication

Steroid medication is used for severe asthma attacks which do not respond to regular reliever medication. This may come in tablet or liquid form.

These medications reduce the swelling and mucus in the airway. It takes about 4 hours for this to start working. Steroid medication is usually taken for 3 days.

In severe attacks, you may be given a longer course.

Side effects – increased appetite, weight gain, moodiness.

Combination inhalers – purple coloured, or red and white

Combination inhalers combine a preventer and symptom controller in one inhaler device.

There are a variety of inhaler devices which deliver these medications, to suit both children and adults.

Inhaling (breathing the medication in) means that the medication reaches the airways most effectively.

Metered dose inhalers (puffers)

Metered dose inhalers contain aerosol medications that are best given through a spacer device. There are 2 sizes available, small volume spacers for children under 5 and large volume spacers for children over 5, and adults.

These are the most common type of inhaler, often referred to as puffers.

Accuhalers and turbuhalers

Accuhalers and turbuhalers are dry powder devices that can be used by children over 8, and adults.

Autohalers

Autohalers are breath activated aerosol devices that can be used effectively by children over 8, and adults.

Some inhalers used to treat asthma and other airways disease can significantly harm the environment and add to climate change.

By keeping your asthma or lung disease well controlled, and by choosing greener inhalers, you can protect your health and reduce your impact on the environment.

It is important to make informed choices that work best for you.  Don’t stop or change the use of your inhalers without talking to a health professional – talk to them about inhaler choices at your next routine asthma appointment.

Aim for good asthma and airway disease control

Good asthma control means:

• not needing your blue or grey reliever puffer
• no asthma symptoms waking you up at night
• you wake up breathing easily
• doing everyday activities, sport, and exercise without problems
• no missed school, work, or fun because of asthma
• no asthma attacks or flare ups.

Reliever puffers

Using reliever puffers  can be a sign that asthma is not be well controlled. People who rely on reliever puffers a lot have a higher risk of asthma flare-ups and attacks .

Reliever puffers also impact the environment. The gas that sprays the medicine is a strong greenhouse gas that adds to climate change:

• One reliever puffer can create the same carbon footprint as about 25 kg of carbon dioxide, similar to driving a car from Perth to Busselton. 
• Across Australia each year, reliever puffers create a carbon footprint similar to driving a petrol car from Sydney to Perth more than 360,000 times.

Many people, have better asthma control if they use a regular preventer inhaler (inhaled corticosteroid). This reduces symptoms and helps avoid the need for frequent use of reliever inhalers (blue or grey inhaler).

Ask your doctor which inhaler is best for you

Not all inhalers are the same. At your next visit, ask your doctor or nurse if a more environmentally friendly inhaler could work for you.

Many of these inhalers are taken once a day, which can make them easier and more convenient to use.

Return used or unwanted inhalers to your pharmacy

If you use a puffer, try to only buy what you need. Avoid stockpiling inhalers that may expire or go unused.

Even if a puffer looks empty, it can still release greenhouse gases if thrown in the regular bin.