Inhalers are commonly used to treat respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD). There are several types of inhalers on the market that contain a single drug or combination of drugs.

Since respiratory disorders can significantly affect quality of life and daily activities, it is important to follow the action plan outlined by your health care provider for how and when to use your inhalers.

Drug classes used in inhalers

In general, there are two types of drugs used in inhalers prescribed for asthma or COPD, often called controllers and relievers. These drugs work together to manage symptoms (provide quick relief) and address the underlying inflammation in the lungs (maintenance).

Anti-inflammatory (controllers)

• These types of drugs (corticosteroids) focus on reducing inflammation by targeting inflammatory chemicals produced in the body or reducing secretions.
• The most common types of drugs used to reduce inflammation are corticosteroids.
• There are several different types of corticosteroids with different onset of action or duration of control.

Bronchodilators (relievers)

• These types of drugs help the smooth muscles in the lungs either relax or prevent constriction, which allow the airways to stay as open as possible.
• The most common drug used for asthma conditions is salbutamol (the “blue inhaler”)
  • Salbutamol belongs to a class called ‘Beta agonists,’ which help the smooth muscles relax and open wide.
  • This drug is often classified as a rescue medication to provide quick relief when respiratory symptoms begin to occur.

Depending on your diagnosis and the severity of the condition, your health care provider may recommend using a single inhaler (rescue and/or controller) or a combination of inhalers in moderate to severe cases. The order in which you use these inhalers is important, so always follow your health care provider’s instructions.

Some individuals may also benefit from taking an additional oral product (i.e., dexamethasone, methylprednisolone, or prednisone pills) or injectable therapy with newer biological treatments for more advanced conditions. These injections are usually self-administered at home to control asthma symptoms that do not respond well to inhaled corticosteroids.

What type of device is best?

One of the challenges of treating respiratory conditions like asthma or COPD, is that most individuals do not use their inhalers correctly. Unlike taking an oral or injectable product, it is difficult to measure the exact dose of an inhaled medication as it can vary significantly when inhalers are not used properly.

To help solve this issue, drug manufacturers have developed different devices to assist with delivering a more consistent dosage of medication to the lungs. Your community pharmacist can help you select the best device for you. You can also find inhaler demonstration videos online that have step-by-step instructions, developed by the Canadian Lung Association.

Do I need to use my inhaler every day?

Anti-inflammatory inhalers (controllers) require consistent, daily use, whereas rescue medications should only be used when needed. For example, an individual with mild asthma may not need to use a daily inhaler, but an individual with COPD may require daily controller use and rescue medications when experiencing a flare-up or worsening of symptoms.

Using your inhaler(s) as directed by your health care provider helps keep lung inflammation under control even when you feel well. Over time, this can reduce the frequency and severity of your symptoms.

Developing an action plan

If you have asthma or COPD, your health care provider will work with you to develop an action plan to help you identify when your symptoms are worsening and what drugs (or changes) you need to make to lead an active and healthy life and prevent health complications.

The Canadian Lung Association has several action plan templates available online, including suggestions on what to discuss with your physician or nurse practitioner at your next appointment.