Asthma inhalation therapy is a targeted local drug delivery method designed to address airway inflammation and spasms. Through specialized inhalers, medication is directly delivered to the respiratory tract to control symptoms and prevent attacks. This therapy is mainly divided into rapid relief and long-term control types, effectively relaxing bronchial muscles, reducing mucus secretion, and suppressing hyperreactivity. Its core advantage lies in the direct action of medication at the site of pathology, reducing systemic side effects, and it is listed as a first-line option in international asthma management guidelines.
Asthma inhalation therapy mainly includes three categories: rapid-acting bronchodilators (such as albuterol), anti-inflammatory inhaled corticosteroids (such as budesonide), and combination inhalers. β2 receptor agonists immediately bind to airway smooth muscle, blocking the action of chemicals that induce spasms; inhaled corticosteroids inhibit the production of inflammatory mediators (such as leukotrienes), reducing airway sensitivity over time. New biologic inhalers target specific allergic pathways, providing personalized treatment.
This therapy is suitable for all types of asthma patients, including children, adults, and the elderly, especially those with frequent symptoms or airway remodeling. Besides asthma, it is also used for bronchospasm management in chronic obstructive pulmonary disease (COPD). However, caution is required for patients allergic to medication components or with severe cardiac diseases, who should use under medical supervision.
The usage process involves five steps: mouth rinsing → shaking the inhaler → deep inhalation followed by breath-holding for 10 seconds → mouth rinsing. During acute attacks, rapid-acting inhalers are used as needed, with no more than 8 sprays per day; control medications require fixed daily doses (e.g., 200μg budesonide twice daily). Children should use spacer devices, and elderly patients need training on correct inhalation coordination. Physicians will adjust doses based on severity, and severe cases may require gradual dose escalation.
Common side effects of rapid-acting inhalers include hand tremors and palpitations; long-term high doses may lead to hypokalemia. Corticosteroids can cause oropharyngeal candidiasis or hoarseness; rinsing the mouth thoroughly after use is recommended. A very small number of patients may develop psychological dependence, requiring regular assessment of medication adherence. Studies show that with proper use, the incidence of severe side effects is less than 1%.
Contraindications include: Allergies to active ingredients, caution in patients with uncontrolled narrow-angle glaucoma when using β2 agonists. Prior to use, infections such as tuberculosis should be ruled out, and diabetic patients should be monitored as corticosteroids may affect blood glucose control. Pregnant women should use under medical supervision and avoid self-adjusting doses.
Children should use age-appropriate inhaler accessories; elderly individuals should have their inhalation techniques checked regularly to prevent misuse. Cardiac patients using β2 agonists should monitor heart rhythm changes. Patients are advised to keep a medication diary to record symptoms and responses.
Inhaled corticosteroids may enhance the side effects of immunosuppressants, and combined use with β-blockers may trigger bronchospasm. Theophylline levels should be monitored as some inhalers may affect metabolism. Before surgery, inform the anesthesiologist about inhaled medications to avoid interactions with anesthetics and bronchodilators.
Multicenter studies show that regular use of inhalation control therapy can improve lung function (FEV1) by 15-20% and reduce severe attacks by over 60%. The 2023 GINA guidelines emphasize that inhalation therapy improves quality of life indices (such as ACT scores) better than traditional oral treatments. Large randomized controlled trials have confirmed that low-dose inhaled corticosteroids in children have an acceptable impact on growth and development.
If inhalation therapy is ineffective, consider:
Shake the inhaler well before use. Before inhalation, place the mouthpiece of the spacer in your mouth, press the canister to release medication while slowly inhaling, hold your breath for 10 seconds, and rinse your mouth thoroughly afterward. Using a spacer can prevent medication residue in the mouth and improve lung absorption. It is recommended for beginners or children to prioritize this combination.
How to prevent oral side effects caused by inhaled corticosteroids?Long-term use of inhaled corticosteroids may cause dry mouth or throat inflammation. Solutions include rinsing the mouth thoroughly after inhalation and regularly maintaining oral hygiene. If signs of fungal infection (such as white patches) appear, report to your doctor immediately to adjust the medication plan.
How should exercise-induced asthma patients use rescue inhalers before exercise?It is recommended to inhale 2 sprays of a short-acting bronchodilator 15-30 minutes before exercise. If chest tightness persists during exercise, an additional spray can be used. After exercise, maintain moderate activity and avoid stopping abruptly. Carry medication for immediate response.
How to adjust inhaler drug concentration and dosage according to seasons?During high allergen seasons or days with air pollution, doctors may recommend temporarily increasing inhalation doses or adding anti-inflammatory drugs. In winter, cold air may trigger symptoms; using warm inhaled air or preventive medication is advised. Adjustments should strictly follow medical instructions.
What are the differences in efficacy between inhaled and oral medications?Inhalation therapy acts directly on the respiratory tract, with a quick onset (e.g., rescue sprays relieve symptoms within minutes) and lower systemic side effects. Oral medications have a slower effect but can supplement local treatment deficiencies. Both are often used together to achieve optimal control.
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