ASTHMA

It is a disease affecting respiratory system.
Asthmatics have sensitive airways.
This sensitivity causes narrowing of airways which makes difficulty in breathing.
During an asthma attack spasm in the airways is caused and excessive mucous is produced.

Causes:

• Respiratory infection.
• Exercise.
• Cigarette smoking.
• Allergens like pollens, animal hair, fur, strong odors.
• Cold weather (mist).

Patient counseling:

Most of the asthmatic medications are inhaled, to facilitate it to the direct entry to the lungs, which indicates for the faster relief. There are basically 4 types of devices used to inhale medications.

• Pressurized aerosols
• Spacers
• Nebulizer
• Rotahalers

INHALATION AEROSOL

Shake the inhaler well just before each use

Take off the cap and look at the mouthpiece to make sure it is clean

Test spray in the air before using for the first time or if the inhaler has not been used for a while (3 to 4 days)

Breathe out fully, trying to get as much air out of the lungs as possible.  Put the mouthpiece just in front of your mouth with the
canister upright.

Open your mouth and breathe in slowly and deeply (like yawning), and at the same time firmly press down on the top of the canister once.

Hold your breath for about 5 to 10 seconds, then breathe out slowly. There after place the mouthpiece of the inhaler in your mouth between your teeth and close your lips around.

Tilt your head slightly backwards. Start breathing in slowly through your mouth. As you breath in, press down the canister to release one dose while continuing to breathe in steadily and deeply.

Remove the inhaler from your mouth and hold your breath for 10 seconds, or for as long is comfortable. Breath out slowly. After use replace the mouthpiece cover. If you are supposed to take more than one puff, wait 1 to 2 minutes between treatments. Repeat these steps for the next puff, starting with shaking the inhaler. After using the inhaler, either rinse your mouth or drink a glass of water, especially with steroid inhalers such as as beclomethasone, budesonide, fluticasone.

You can check how many doses of your Aerosol Inhaler you have left by placing the metal canister in a bowl of water.

Wash the mouthpiece with warm water. Do not store or expose the canister to fire or temperatures above 120 degrees F.  If you think your canister is empty, you can test it by putting it in a bowl of cold water.  If the canister floats, it is empty.

How to use the Spacer

1. To assemble your Spacer, line up the notch of one half with the slot of the other half. Then push the two parts together firmly.

2. Remove the mouthpiece cover from the inhaler and check that the mouthpiece is clean.

3. Shake the inhaler well.

4. Fit the inhaler into the inhaler slot opposite the mouthpiece.

5. Hold the Spacer as shown. Breathe out gently.

6. Close your lips firmly around the mouthpiece as shown but do not bite it

7. Press the canister to release a dose of medicine into the chamber. Then breathe in steadily and deeply through your mouth.

8. Remove the Spacer from your mouth and hold your breathe for 10 seconds, or for as long as comfortable. Breathe out slowly.

9. If a second dose is required, keep the inhaler upright and wait for at least one minute before repeating steps 3-8.
10. After use remove the inhaler and replace the mouthpiece cover.

For Children: Children should be supervised by an adult when using the spacer.

FOR ROTAHALER

1. Hold the Rotahaler vertically.

Note. It is important to position the two halves of the Rotahaler such that the fin is not directly below the raised square hole.

2. Take a Rotacap capsule from its container. Insert the Rotacap, transparentend first, into the small raised square hole of the Rotahaler.

3. Press the Rotacap firmly such that the top end of the Rotacap is level with the top of the hole

4. Holding the mouthpiece firmly with one hand rotate the base. The fin separates the two halves of the Rotacap and can be seen through the transparent body of the Rotahaler. The rotahaler is now ready for use.

5. Breathe out fully. Grip the mouthpiece between your teeth and seal your lips around it. Tilt your head slightly backwards. Breathe in through your mouth as deeply as you can.

Note: If you are doing this correctly you will hear the Rotacap shell rattling inside the Rotahaler.

6. Remove the Rotahaler from your mouth and hold your breath. Continue holding your breath for as long as you comfortably can, before breathing out. In case powder remains in the Rotacap shell after inhalation, repeat steps 5 and 6 till the Rotacap is empty.

7. After use, separate the two halves of the Rotahaler and discard the empty Rotacap shell. Reassemble the Rotahaler for subsequent use.

8. For Subsequent use: Insert a fresh Rotacap as shown in step 2. The shell lodged in the square hole (from previous use) will be pushed out when the fresh Rotacap is inserted.

Proceed with step 3 though 7.

INHALATION SOLUTION (Nebuliser) For usage with nebulizer. For oral inhalation only. Store in the refrigerator. The solution is given with a machine called a nebulizer. Make sure that you have been taught how to use it before your first treatment. The albuterol solution needs to be mixed (diluted) with saline (sodium chloride solution). Diluted solutions are good for 48 hours when refrigerated and 24 hours at room temperature.

Nebuliser