Are inhaled asthma medications a common treatment?

I believe that many people will encounter asthma in their daily lives. Some people have mild asthma, while others have severe asthma. Most patients will have a long-term cough or have had multiple severe colds before. Once asthma occurs, the patient must take medication all year round to maintain it, otherwise there is a high probability of complications. Asthma inhalation drugs are a relatively common treatment method. They are effective and simple and can be cured quickly.

Inhaled medications are the most common treatment for childhood asthma

Usually after a visit to a children's asthma clinic, the doctor will give you inhaled medication. Everyone is familiar with the use of oral medications, intramuscular injections and intravenous injections, but is relatively unfamiliar with inhaling medications through the respiratory tract. A few days ago, a 5-year-old asthmatic child was treated. He had been diagnosed with asthma in another hospital and was given dry powder inhalation medication. At that time, the child was brought to the hospital by his grandfather. The doctor simply told the old man how to use it, but the child did not know how to use it after returning home. Due to incorrect medication use, the child's asthma did not receive timely and effective treatment, and asthma attacks occurred again, which not only delayed the treatment of the disease but also wasted medication.

Our lungs are open organs that exchange oxygen and carbon dioxide between the human body and the outside world. The total number of alveoli in each lung reaches 280×10*6, with a total area of ​​about 50 to 100m*2, which is roughly equivalent to the area of ​​a basketball court and equivalent to the area of ​​the intestinal mucosa. Therefore, administration by inhalation has a broad absorption space, just like oral administration. Moreover, there are a variety of receptors and sense organs in the mucosa and submucosal areas of the respiratory tract. Drugs inhaled from the airways can directly act on these receptors and sense organs, achieving a rapid and effective therapeutic effect.

The efficacy of inhaled drug administration depends largely on the amount of inhaled drug deposited in the lungs. Drugs inhaled from the respiratory tract are deposited in the lungs and airways by inertial deposition, gravity deposition, and diffusion deposition. The unique metabolic kinetics of inhaled drugs are conducive to the local effects of drugs. Since inhaled drugs can directly act on target receptors under the bronchial mucosa, the required inhaled drug dose is much less than that of oral and injected drugs. Because the dosage is small, the side effects caused are also small.

There are two types of inhaled medicines commonly used in children with asthma :

1. Mete-dose inhaler (MDI), such as fluticasone propionate aerosol, budesonide and salbutamol aerosol. MDI is the most commonly used drug for inhalation treatment of asthma. It can spray a fixed amount of liquid medicine with just a press of the hand. The use of MDI requires the coordination of hand-lifting aerosol device and the patient's deep breath-holding, i.e., hand-lung coordination. If the hand-lung coordination cannot be achieved, it will be difficult for the patient to inhale the predetermined amount of medicine. Usually, children over 4 years old can master the correct method of medication through repeated education, and children under 4 years old should be assisted by spacer inhalation.

2. Dry powder inhaler (DPI), such as formoterol/budesonide and fluticasone propionate/salmeterol dry powder inhalers. DPI uses the airflow of inspiration to drive the powder to be inhaled directly into the lungs along with the airflow. DPI is a new type of inhalation device for treating asthma developed after MDI. It does not contain propellant. The concentration of drug inhaled into the lungs is about 10% to 30%, slightly higher than MDI. It is suitable for patients who can cooperate with inhalation. Generally, children over 4 years old can master the correct usage after repeated education. Since dry powder inhalation drugs are ICS+LABA, they have better efficacy, fewer side effects, and can greatly improve the level of asthma control. They are the first choice for asthma in older children. Using ICS+LABA to treat childhood asthma is a sign of diagnosis and treatment level.

It should be noted that when using formoterol/budesonide dry powder, once you hear a "click" sound after rotating it, it means the drug has been loaded and you should not rotate it any further. Since the drug usage "scale" is displayed every 10 times, when a red sign appears, to determine whether there is still medicine, you need to turn it until a sound is heard, aim the medicine outlet at the black (or dark) paper or table and gently "knock the drum". If white medicine appears, it means there is still medicine and you can continue to use it.

Since children with asthma mostly use inhaled medications, and children often need repeated instruction and practice to master the correct methods, this places higher demands on our asthma specialists. We must personally teach the children and their parents the correct methods, and we must check whether the methods are correct when the children return for follow-up visits, in order to ensure effective treatment of the disease.