Treatment of bronchial asthma always begins with the use of inhalers. This is due to the fact that inhalations for asthma show high efficiency in the fight against bronchospasm.

The drugs used in inhalers help dilate the bronchi and reduce mucosal edema. Thanks to this, it is possible to avoid exacerbations by applying small doses of medicine.  

Often, patients are not explained the rules for using inhalers, and the effectiveness of treatment depends on this. In addition, the variety of inhalation methods allows for an individual approach to asthma therapy.

The effectiveness of inhalation for asthma

Inhalation for bronchial asthma is the most effective method of treatment. The main thing is the ability of the devices to deliver the agent exactly to the focus of inflammation, which avoids systemic influence.

In addition, the direct effect on the bronchi makes it possible to stop choking in the shortest possible time, as well as to get rid of the debilitating cough, which is quite often observed in asthmatics.

With other methods of administration, the drug first undergoes biotransformation in the body, some of its active substances are neutralized by enzymes.

In addition, spraying the agent during inhalation allows it to be distributed in an even layer and affect a large area of ​​the affected organ.

An important advantage is the possibility of independent use of inhalations by young children and the elderly. With the correct technique of manipulation, improvement occurs after 1–2 uses.

Contraindications for inhalation in bronchial asthma

The use of inhalers for bronchial asthma is an important and necessary part of treatment. But you must always remember that each drug has its own contraindications, and inhalers are no exception.

All contraindications or side effects are associated with the effect of active substances that are part of the drugs used for the procedure.

In addition, there are conditions in which inhalation is simply prohibited. For example:

• pulmonary bleeding, as well as episodes of hemoptysis, especially if their nature has not been established;
• emphysema of the lungs;
• pneumothorax;
• the presence of heart and / or vascular diseases;
• hypertension of various etiologies;
• postinfarction condition;
• post-stroke condition;
• increased body temperature – from 38.3 ° C;
• individual intolerance to the main active ingredient.

Also, some inhalations are not recommended for more than 8 times a day. If the intensity of asthma attacks necessitates frequent inhalations, then you need to consult a doctor to correct the basic therapy.

Inhalation types

The main types of inhalations:

1. Air: the essence lies in spraying a substance from a can using compressed air. Usually mucolytic or brocholytic agents are used for this .
2. Steam: the most affordable, as they only require a steam nebulizer. Indicated for the treatment of acute respiratory infections of the trachea and bronchi, therapy of occupational diseases. Contraindicated in polyposis of the mucous membrane of the respiratory tract.
3. Ultrasonic: the principle is based on breaking the drug into microparticles. Often bronchodilators are used for such inhalations . Indicated mainly for the treatment of asthma.
4. Wet: A portable inhaler is used and the medicine is sprayed without preheating or otherwise. They use mainly antihistamines, as well as antibiotics, saline solutions, and bronchodilators .
5. Heat and moisture : during the procedure, solutions are used, heated to a temperature of 39-43 ° C. Usually used to improve mucociliary clearance. Instead of medicine, mineral water is used.
6. Insufflation : inhalation of dry particles of the drug, special inhalers – insufflators are used for these funds . Often, such inhalers are used to treat bronchial asthma during an exacerbation.
7. Oily: inhalation of particles of heated vegetable oil. Mineral oils cannot be used. When using these inhalations, the mucous membrane is covered with a thin layer of oil that protects against the harmful effects of environmental factors. Cannot be used by people who come into contact with dust, since the dust is mixed with oil and small bronchi are blocked.

Nebulizer inhalation

The nebulizer converts the medicine into fine dust, which, in combination with a uniform supply, distributes it equally between the upper and lower bronchi. Nebulizer benefits:

• inhalations can be performed by all patients, regardless of age group;
• with nebulizer therapy, breathing should be normal, there is no need to take a deep breath;
• the ability to stop an asthmatic attack in a short period of time, since the drug immediately enters the inflammation focus;
• the nebulizer can be used even if the patient is in serious condition;
• the ability to use the device yourself;
• several agents can be placed in the medication container at the same time;
• continuous delivery of medication while the compressor is running.

It is necessary to remember to observe the cleanliness of the device and its parts: after using the nebulizer, the mask should be thoroughly rinsed with aseptic solution and then dried.

This device is often used for bronchial asthma during treatment at home. Also, periodic inhalations are recommended for people working in conditions of high air pollution to prevent the development of occupational diseases, which include asthma.

To prevent undesirable consequences of inhalation, it is worthwhile to undergo an examination and consult a specialist before using a nebulizer. Self-treatment is not recommended.

Preparations for inhalation with a nebulizer

In bronchial asthma, inhalers are filled with the medicine prescribed by the doctor, taking into account the severity of the condition:

• slight exacerbation: a single inhalation with the use of bronchodilators , to prevent seizures and complications, you can repeat the procedure after 4–5 hours;
• moderate or severe: 2-3 doses with an interval of 20 minutes, the cycle is repeated after 4-6 hours.

If after nebulizer therapy there is no improvement in breathing, then the patient is recommended to be hospitalized.

Bronchodilators

These drugs are prescribed for mild attacks to make breathing easier. This effect is achieved through the activation of beta2-adrenergic receptors located in the walls of the bronchi.

Under their influence, actin and myosin – proteins responsible for muscle contraction – do not interact with each other, and the smooth muscles of the bronchi relax.

As a result, the lumen of the airways increases and breathing is restored. From this group, substances such as salbutamol , salmeterol , fenoterol and orciprenaline are used for inhalation .

But also ipratropium bromide has a bronchodilating effect , which blocks muscarinic receptors in the walls of the bronchi.

The suppression of these receptors prevents the penetration of calcium ions into the cell. Since calcium causes muscle contraction, calcium deficiency causes relaxation.

For inhalations, combined agents are used that have a more pronounced effect. For example, drugs containing fenoterol and ipratropium bromide are often prescribed by pulmonologists because of their effectiveness in relieving seizures of any degree.

Glucocorticosteroids

For inhalation, only dexamethasone and triamcinalone are most often used . Their anti-inflammatory effect is due to the narrowing of small vessels, while the formation of fluid decreases, the accumulation of leukocytes in the inflammation zone stops, the activity of macrophages decreases, and the production of inflammatory mediators decreases.

Thus, glucocorticosteroids reduce the activity of the local cellular response of the immune system, destroying the central link in the pathogenesis of bronchial asthma. 

In addition, medications containing substances such as fluticasone , budesonide, and beclomethasone are used . The use of these drugs at the time of an attack will not help an asthmatic.

But modern combinations of glucocorticosteroids and bronchodilators , used as basic therapy, help to avoid serious exacerbations and normalize breathing.

Membrane stabilizers for asthma

Drugs in this group prevent the release of histamine from mast cells, which contributes to the development of choking and sputum production.

Normally, histamine is involved in immune responses, altering vascular tone and attracting other immune cells. But in the pathogenesis of asthma, it is part of the mechanism for the development of an allergic reaction.

During an attack and during an exacerbation of the disease, this group of drugs will not help, because histamine has already been released. Therefore, asthmatics take these medications as a preventive measure.

To date, only cromolyn sodium is used in asthma therapy.

Mucolytics

The action of these drugs is to relieve swelling and improve sputum discharge. They are especially important in asthma, because due to spasm and too viscous consistency, the secretion is not excreted from the bronchi.

The mucociliary clearance in the bronchi in asthma is impaired, and secondary inflammation is formed. By mucolytics applied by nebulizer, include acetylcysteine.

It is used only after consulting a doctor. In addition, the drug should not be used during asthma attacks, because it increases bronchospasm.

Steam inhalation folk remedies for asthma

You do not need a nebulizer for steam inhalation. For inhalation of this type, it is enough to choose a container that keeps heat well and does not allow steam to dissipate.

Steam inhalation should not be carried out during exacerbations and children under 7 years of age. Traditional medicine offers many recipes for asthma.

The most famous recipes:

1. Using eucalyptus leaves. To do this, take 1 tablespoon of dried leaves and pour 2 glasses of water. Then put on fire, bring to a boil and cook for about 15 minutes. After that, the broth must be infused for another 15 minutes. It is recommended to inhale the steam under a towel for 10-15 minutes up to 3 times a day. The full course is 20 procedures.
2. Inhalation with pharmacy chamomile. Take 2 tablespoons of dried flowers and pour 250 ml of boiling water, insist in a thermos for 2 hours. Before use, warm up and breathe steam under a towel for 10-15 minutes with a frequency of 1-2 times a day. The course lasts up to 14 days.
3. Infusion of mother-and-stepmother often helps relieve spasms and promotes sputum discharge. For inhalation, you need to take 1 tablespoon of dried leaves and pour 2 cups of boiling water, then insist for 10 minutes. The procedure is carried out under a towel for 10 minutes up to 2 times a day for 10 days.

Before using folk remedies, you need to consult a doctor, since the components that make up them can lead to bronchospasm, because many flowers and herbs are powerful allergens.

Basic rules for inhalation

The effectiveness of inhalation for asthma depends on the correctness of its implementation. If it is a nebulizer or steam inhalers, then there are no particular difficulties.

True, it is worth remembering that when using glucocorticosteroid solutions for inhalation with a nebulizer for bronchial asthma, you need to rinse your mouth after the procedure, since a fungal infection may develop.

General rules for inhalation:

• breathing should be even and calm;
• clothes should be chosen loose so as not to interfere with breathing;
• incorrect position of the body is not allowed;
• the break between inhalation and food intake should be 1 hour, the same applies to physical activity;
• after the procedure, you should rest for 15-20 minutes, in winter – up to 40 minutes. During this time, you should not talk, eat, smoke or sing;
• with bronchial asthma, inhale through the nose, then hold the breath for 2 seconds and exhale slowly through the nose;
• when using several drugs at the same time, their compatibility should be taken into account;
• breathing exercises help to clear the airways before manipulation;
• solutions are prepared immediately before the procedure.

Compliance with these simple rules, as well as the simplest safety measures, contributes to a more efficient procedure and helps to avoid complications.

Finally

Despite the fact that inhalation is considered a very simple procedure, knowledge of its features and rules of conduct will allow you to achieve the best result in the treatment and prevention of bronchial asthma.