Asthma, especially in the severe form, belongs to the health disorders, which interfere greatly with the ordinary lifestyle of sufferers, making them seek for medicinal options to cope with their disorder. Happily, modern medicine offers many treatments against asthma, and inhaled corticosteroids are among them.

First of all, it is important to understand that inhaled corticosteroids are not the so-called “rescue inhalers”, which work immediately to treat the acute attack of asthma and help a person resume normal breathing within seconds. Inhaled corticosteroids, also known as “maintenance inhalers”,  work differently – they help to prevent the occurrence of asthma attacks. Their main task is to work gradually in order to help a sufferer control his asthma, reducing the frequency and severity of acute attacks.

For the time being, there are several inhaled corticosteroids, approved for the maintaining therapy of asthma. Generic and brand names of some of them are presented in the following table.

How do corticosteroid inhalers work to control asthma?

While the exact mode of action of corticosteroids remains unknown, doctors consider they help control asthma attacks by controlling inflammatory processes in the lungs and airways. In other words, corticosteroid inhalers prevent, reduce, and reverse swelling of the lungs, thus improving breathing.

On the other hand, corticosteroids are known to be able of controlling allergies; and since asthma is the disorder of allergic origin, the use of corticosteroids makes a person less susceptible to different allergic asthma triggers.

What corticosteroid inhaler is the most effective?

In fact, all the inhaled corticosteroids have approximately the same rate of effectiveness, when used in the recommended doses. However, these inhalers can still be ranged from the point of view of their potency (the amount of medication required to provide the therapeutic effect). Flovent is considered to be the most potent inhaler, followed by Asmanex, Qvar and Pulmicort.

Corticosteroid inhalers should be used strictly in accordance with the instructions provided with the certain medication. There are aerosol based inhalers (e.g. Flovent, Qvar) and dry-powder inhalers (Asmanex and Pulmicort). The difference is that with aerosol inhalers the active ingredient is inhaled along with the special gas, marked as HFA, which is completely safe for humans; moreover, it helps to deliver the medication right to the place of its action. When using Asmanex or Pulmicort a patient inhales dry powder of medication without any additional ingredients.

Aerosol inhalers seem to be easier to use because it is usually more comfortable to inhale gas than dry powder; however, dry-powder inhalers also have their benefits: they provide strictly controllable release of medication in the predefined amount.

This is how to use aerosol inhaler:

This is how to use dry-powder inhaler:

What are the key characteristic features of certain corticosteroid inhalers?

-         Flovent HFA is approved for treating asthma in children ages 4 to 11.

-         Pulmicort offers specially designed inhaler, called Turbuhaler, to make dry-powder inhaling more comfortable and effective.

-         Qvar contains the smallest particles of the working ingredient, which ensures medication delivery to the smallest airways.

What’s the buzz about aerosol inhalers and ozone layer depletion?

The point is that earlier all aerosol inhalers contained CFC gas, which is safe for humans, but harmful for the atmosphere. The emission of CFC gases was shown to deplete the ozone layer of our planet. However, when this fact was discovered, most of the aerosol producers, including medicinal inhalers, started to use HFA gas instead of CFC. HFA does not harm the ozone layer.