Asthma Rescue Inhaler Vs. Maintenance Inhaler

In our latest question and answer, the pharmacist discusses the difference between rescue and maintenance inhalers for asthma.

Asthma Rescue Inhaler Vs. Maintenance Inhaler
Jun 21, 2018

Ronnie asked

What are the dangers of a patient confusing a rescue inhaler with a maintenance inhaler?

Answer

Asthma InhalersAsthma treatment often involves multiple treatment options depending upon the patient’s triggers, symptoms and control of those symptoms.  Two drug therapies used in asthma treatment include the use of short-acting rescue inhalers such as ProAir HFA, Proventil HFA or Ventolin HFA and inhaled corticosteroids such as Flovent.

 The role of short-acting rescue inhalers is to provide immediate relief to patient by relaxing the bronchial smooth muscle in the respiratory tract which opens the airway allowing for easier breathing.  Patients may take short-acting rescue inhalers only when needed or, in some cases, on a set schedule.  Inhaled corticosteroids on the other hand are meant to treat the long term inflammation that is occurring in the respiratory tract that may be leading to difficulty in controlling asthma symptoms.  With inhaled corticosteroids, the goal is to diminish the need of a rescue inhaler so the patient has better control over his or her asthma symptoms.

Should a patient confuse the rescue inhaler with the maintenance inhaler, the main concern would be worsening of asthma symptoms over time.  It would be more concerning if the maintenance inhaler was thought to be a rescue inhaler while the patient was having an asthma attack.  The maintenance inhaler in this case, may not provide enough relief during an asthma attack, running the risk the patient’s symptoms are not brought under control quickly enough.  

Patients should make sure they know which inhaler is maintenance and which is the rescue inhaler.  If need be, request the prescriber place in the directions a note about which inhaler it is.  Pharmacists can also aid in helping patients who are confused by the two different types of inhalers.  Below is some general information on rescue inhalers and inhaled corticosteroids.

Rescue Inhalers

Rescue inhalers such as ProAir HFAProventil HFA or Ventolin HFA are often the first step in treatment for an asthmatic patient.  For patients with mild symptoms, adding a rescue inhaler when needed may be enough to control the asthma symptoms.  For a lot of patients, this will not be the case and rescue inhalers will be used during worsening asthma symptoms along with a maintenance medication.  For this reason, rescue inhalers are often used on an as needed basis.  

Some common side effects of rescue inhalers include:

  • Excitement or nervousness
  • Tremor
  • Upper respiratory tract infection
  • Runny nose
  • Pharyngitis

Maintenance Inhalers

One type of maintenance inhaler are inhaled corticosteroids such as Flovent. As stated above, the purpose of using any maintenance inhaler is to decrease the amount of chronic inflammation that is present in the airways to allow for better control of the asthma symptoms.  How maintenance inhalers are utilized by patients may differ from patient to patient.  Some patients may use them all the time, while other patients may be taken off maintenance inhalers once the patient’s asthma symptoms are better under control.  

Some common side effects to Flovent are:

  • Fatigue
  • Headache
  • Oral candidiasis (oral thrush)
  • Muscle pain
  • Sinus infection
  • Nasal congestion
  • Throat irritation

Following the use of an oral corticosteroid inhaler, the mouth should be rinsed with water (do not swallow).  Different inhalers have different directions for use.  Any questions on proper use of an inhaler should be directed to the pharmacist or prescriber.  Proper usage is very important for the correct delivery of the drug.

Conclusion

Most times, confusing a rescue inhaler for a maintenance inhaler a couple of times will not cause any problems for a patient. Should this confusion continue, a patient may notice a worsening of his or her asthma symptoms.  It is much more worrisome if a patient were to confuse a maintenance inhaler for a rescue inhaler.  In this case, should the patient be having an asthma attack, the maintenance inhaler would not immediately provide the relief the patient may need and this could end in a medical emergency.  For this reason, any questions about the purpose of an inhalers should be immediately directed to your pharmacist or the prescriber of the drug.  

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