NHS Wales held an event to provide support and guidance for people or carers of people with asthma on getting the best out of their inhalers

Watch the event recording now…

• • How are inhalers used to manage asthma?
  • Is your asthma completely under control?
  • Working with your healthcare professional to find the best inhaler regimen for you
  • Can I make a sustainable decision about my inhalers without losing control?
  • Other factors that help achieve good control
  • Q&A Session

• Question: “I recently had a review with my fantastic asthma nurse. This led to a change in my meds for the first time in over 10 years. How long should it take to notice an improvement or change, so that I know the new inhalers are right for me?”
  • “After a month on your new inhaler, there should be enough of the anti-inflammatory effect built up in your airways that you should be able to notice the difference to your asthma control. If, at any time you think your asthma control is getting worse on your new inhaler, you should book another appointment with your asthma nurse.”
• Question: “Why the obsession with measuring exhalation flow when in reality your ability to take inhaler drugs and your asthma feelings are dependant on your inhalation ability and flow rather than exhalation. For example you may find it easier breathing out than in, so measuring exhalation gives a false impression of health to measuring how able to inhale”
  • “In asthma, the airways narrow due to inflammation and bronchoconstriction. This results in impairment to your expiratory flow rates (breathing out), and the more narrowed your airways, the more difficult it is to breathe out. This is why people with asthma experience wheeze, which is characteristically a whistling sound when you breathe out. So, it’s important to measure your peak flow and sometimes spirometry, which is an expiratory “blow”, because this tells us real-time how narrowed your airways are”
  • In contrast, your healthcare professional will assess your inhalation ability because this is how medication is delivered to your airways. Fortunately in asthma, your ability to breathe in is not typically impaired by airway narrowing, even when the airways are really narrowed you will still be able to take a strong deep breath in. It is still important to check that you have the correct technique and that the medication in your inhaler is reaching your airways, because this technique does differ by inhalers. ”
• Question: “I have been taking daily cetirizine hydrochloride (hayfever relief tablets) throughout the entire year, even in winter when hayfever is not a concern. I have been worried this will make the repeated medication less effective, but your earlier slide seemed to recommend daily anti-inflammatory medication. Is cetirizine hydrochloride one of these suitable medications?”
  • “Cetirizine is an antihistamine medicine that relieves allergic symptoms. The anti-inflammatory medication referred to in the slide is the corticosteroid within your “preventer” inhaler, which needs to be used daily. Some people do need to use antihistamines daily, all year round, if they have year-round allergies and it should not have a reduced effect from doing so. You will need to ensure that you use your “preventer” inhaler containing the anti-inflammatory daily as well as the anti-histamine. If you have any concerns that you are still getting allergic symptoms then you should speak to your GP as uncontrolled allergies could affect your asthma.”