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A few weeks ago, I took my eight-year-old child to the doctor for croup. The doctor noticed that he was also wheezing. Our son had infantile asthma when we adopted him and occasionally has still has episodes of wheezing. We have a nebulizer at home for treatments and I used to take it with us if he was having a day of difficult breathing. I asked the doctor if my adopted child was old enough for an asthma inhaler. I explained my concern about not having an emergency treatment with us during hockey or soccer games. The doctor assured me that he was old enough and agreed that my son should always have an inhaler with him. He told me about a new type of inhaler called Maxair. You prime it first, and then suck the air and medicine in. The doctor wasn’t sure if my son would like using the new type of inhaler so he also wrote me a prescription for the regular Albuterol inhaler that most people are used to seeing and using.
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Having an inhaler allows children to have more freedom and live life like a normal child without fear of a breathing attack. An inhaler is a hand held portable device that delivers medication directly to the lungs without batteries or electricity. There are two categories of inhalers, each having several varieties. There are metered dose inhalers that use a chemical propellant to force a measured dose of medication out of the inhaler. These devices have a mouthpiece, a pressurized canister containing medication, and a metering valve that dispenses the correct dose of medication. Inhaling or squeezing the canister releases the medication.
There are dry powder inhalers that do not use chemical propellant to push the medication out of the inhaler. Medication is released instead by breathing in more quickly than you would with a traditional metered dose inhaler. These inhalers don’t require the hand-lung coordination that conventional pressurized metered dose inhalers require.
Some inhalers are used to assist in long-term control of asthma symptoms and others provide quick relief of symptoms. The short-acting bronchodilators that provide immediate relief of asthma symptoms are Albuterol (Proventil, Ventolin) and pirbuterol (Maxair.) Then there are the long-acting bronchodilators that relieve symptoms for longer periods such as salmeterol (Serevent) and formoterol (Foradil.) There are also medications designed to prevent asthma attacks called corticosteroids. These medications include beclomethasone dipropionate (Qvar), fluticasone (Flovent), budesonide (Pulmicort), triamcinolone acetonide (Azmacort) and flunisolide (Aerobid). The nonsteroidal medications that are used over the long term to prevent inflammation are Cromolyn or nedocromil. Finally, there are combination medications that have Corticosteroid plus long-acting bronchodilator these are Advair and Symbicort.
Directions for use may vary so your child needs to follow the instructions carefully. Your child’s doctor might want to demonstrate the procedure for your child if you are not familiar with inhalers. Those who cannot use an inhaler, such as infants, young children, and the seriously ill, can use a nebulizer. The nebulizer works by converting medication into a mist and delivering it through a mask or mouthpiece. Your child’s asthma treatment plan may also include checking lung function with a peak flow meter, eliminating asthma triggers, and exercise.
Photo Credit Julia Fuller 2008
