Asthma

Medications
& Devices
A guide to help people
with asthma
Quick referen
Medications
Reliever medication (blue) 6

Preventer medication (autumn/desert colours) 7

Symptom controller medication (green) 8

Combination medication (purple or red & white) 9

nce guide
Devices
Spacers 12 Spacers and masks 13

Puffers 14 Accuhalers 18

Turbuhalers 20 Autohalers 22

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Asthma Medications & Devices
Did you know ...
Up to 90% of people on asthma medications do not use them properly1

Asthma Looking after your

medications asthma
Asthma medications play a vital role in Asthma Australia recommends that
keeping you well and free of asthma everyone with asthma should have an
symptoms. Asthma medications work overall plan for managing their asthma.
very well when taken properly. However, This should include things like a medication
many people choose to use preventers list, the goals that you and your doctor
for short periods only or when they are have agreed for your treatment, triggers,
not feeling well, and end up relying on diet, exercise, regular review, and a written
their blue reliever puffer for short term asthma action plan telling you what to
relief. This means many people with do if your asthma is worsening. If you do
asthma put up with symptoms when they not have an asthma action plan, speak
to your doctor about this. A copy of the
dont need to and their every day life is
asthma action plan should be given to
affected. Making your medicine work for
carers (for example childcare workers,
you is an important step in living well with
school & preschool staff and relevant family
asthma.
members).

Taking your Medications

medication review
Even if you think you are using your
If you have asthma it is recommended
asthma medication properly, it is worth
that you see your doctor for an asthma
checking with your doctor, pharmacist
review at least twice a year. Check your
or local Asthma Foundation. Learn the
asthma medication is working and that
correct technique to give yourself the best
you are not having unnecessary asthma
chance of living well with asthma. Always
symptoms.
check with your doctor or pharmacist
if you experience side effects from
medication or you think your medication Storage
is not working as it should. Check your medication expiry date and
Looking after
1. Bashati IA, Armour CL, Bosnic-Anticevich SZ, Reddel HK,
exact storage instructions. Most asthma
medications require storage at room
Evaluation of a novel educational strategy, including inhaler
based reminder labels, to improve asthma inhaler technique.
temperature, in dry areas.
Patient Educ. Couns 2008; 72: 26-33
Do not leave asthma medication in your car.

4/ 5
Relievers - blue

Useful information
Common names Airomir, Asmol, Commonly called blue reliever
Bricanyl, Ventolin puffer

What it does Relaxes tight airway Keeps airways open for up to 4-6
muscles hours
How long it takes to Very quickly Provides relief from symptoms
work within 4 minutes
How to take it Inhaled See the devices section to
check that you are taking your
medication properly
When to take it When you have Symptoms may include:
symptoms Breathlessness
Wheezing
Tight chest
Persistent cough
Emergency Use a blue reliever puffer with a
spacer for Asthma First Aid
Before exercise as Exercise can trigger asthma.
prescribed Speak to your doctor about
managing your asthma so you
can continue to exercise
Helpful to know Carry it with you always In case of symptoms, or for
Asthma First Aid
If you are using your See your doctor for an asthma
blue reliever puffer 3 review. Over-use of your blue
times or more per week reliever puffer for more than a
couple of weeks may actually
make your asthma worse
Common side effects Shakes, rapid heartbeat These will pass quickly. Speak to
Children can become your doctor if concerned
restless
Asthma Medications & Devices
Preventers - autumn/desert colours

Useful information
Common names Alvesco, Flixotide,
Pulmicort, Qvar Corticosteroid
Intal Forte, Tilade Non-steroid
Singulair Tablet Non-steroid tablet
What it does Reduces swelling Preventers make airways less
Reduces mucus sensitive

How long it takes to Inhaled - starts to Preventers can take days and
work work within one day even several weeks to fully work
Singulair within one
day
How to take it Inhaled - Alvesco, See the devices section to
Flixotide, Intal Forte, check that you are taking your
Pulmicort, Qvar, Tilade medication properly
Oral tablet - Singulair

When to take it Every day as prescribed Take your preventer every day as
prescribed even if you feel well

Helpful to know The key to keeping well Preventers are most effective
with asthma if you take them every day as
prescribed

Common side effects Inhaled You can reduce these by

Corticosteroid - using a spacer with puffers.
possible side effects Always rinse, gargle and spit after
include oral thrush, using preventer medication.
voice change, sore Clean your teeth after use.
mouth and throat Speak to your doctor if you have
Intal Forte and Tilade any concerns about side effects
- cough after use
Singulair headaches
and stomach upset

6/ 7
Symptom Controllers - green

Useful information
Common names Oxis, Serevent Green
Sometimes called long acting
beta-agonists
What it does Relaxes tight airway Keeps airways open for up to 12
muscles hours

How long it takes to Varies up to 30 mins Oxis works within minutes

work Serevent up to 30 mins

How to take it Inhaled Must always be prescribed

for use with a corticosteroid
preventer
See the devices section to
check that you are taking your
medication properly

When to take it Every day as prescribed Always use with prescribed

preventer medication

Helpful to know Prescribed for people For example, if a person always

who have asthma takes their preventer, but
symptoms even with continues waking at night with
regular preventer use asthma symptoms, the doctor
must always be used may also prescribe a symptom
with a corticosteroid controller, as it can keep airways
preventer open for longer than blue reliever
medication

Common side effects Shakes, rapid These will pass quickly

heartbeat, headaches Speak to your doctor if you are
concerned

Asthma Medications & Devices

Combinations - purple or red & white

Useful information
Common names Seretide (Flixotide and Purple
Serevent) Red and white
Symbicort (Pulmicort Sometimes called combination
and Oxis) preventers

What it does Combination Preventers make airways less

medication = sensitive
Preventer (reduces Symptom controllers keep
swelling + reduces airways open for up to 12 hours
mucus) + symptom
controller (relaxes tight
airway muscles)
How long it takes to Preventer within one Preventers can take weeks to
work day work fully. Symptom controllers
Symptom controller work to keep airways open for
varies with type up to longer periods
30 mins

How to take it Inhaled See the devices section to

check that you are taking your
medication properly

When to take it Every day as prescribed For Symbicort SMART*

Take your combination
medication as prescribed
Helpful to know Prescribed for people Speak to your doctor if you
who have asthma regularly take your preventer
symptoms even with and continue to have regular
regular preventer use symptoms

Common side effects As for preventer and Speak to your doctor if you are
symptom controllers concerned

* SMART Symbicort Maintenance and Reliever Therapy Protocol Some people

over the age of 12 may have Symbicort prescribed as both their reliever and
preventer under strict guidelines. Speak to your doctor or pharmacist about this.

8/ 9
Devices
Asthma medicines come in a range of always ask for help. Your doctor,
different shaped containers (devices). pharmacist or local Asthma Foundation
Some asthma medicines come in more can help you.
than one type of device. This means you
By using the device properly and taking
can work with your doctor to choose the
medication as prescribed, you are giving
the combination of medicine and device
yourself the best chance of reducing
that works best for you.
asthma symptoms and living well with
If you find the device tricky to use, or you asthma.
are not sure if you are using it properly,

Asthma Medications & Devices

Key points to consider when
choosing a device
Checklist Importance Solution/options
Age Very young children are not For puffers, very young children
physically able to use all device will need to use a spacer and
types. mask. Children should always
use a spacer and puffer. If you
use a spacer with your puffer,
you are giving yourself the best
chance of benefiting from your
asthma medicine
Breath intake Some devices require you to Before you are prescribed a
take in a deep, forceful breath. new asthma medicine, ask your
Not everyone is able to do this doctor to check that you can use
the device correctly
Hand strength Some people find their hands Look for a device that requires
are weaker eg frail, arthritis little hand strength, such as an
Autohaler, or if you are using
a puffer, ask about obtaining a
Haleraid from your pharmacy
Coordination For puffers, do you have trouble Look for a device that is easy
co-ordinating the start of your for the person to use, preferably
breath in with pressing the without assistance
puffer?
Technique Most people can use any device Explore options
when they are shown how Watch someone teach the
talk to your doctor to work out correct device technique.Have a
what options there are go using the device until you are
confident you have mastered the
steps
Review Regular check-ups are necessary Communicating with your
to look at symptoms, how the doctor is important to living well
medication is working and with asthma
check device technique

Haleraids are a type of device

that make it easier to use a puffer.

Examples of Haleraids u

10 / 11
Spacers - what you need to know

What is a spacer? Why use a spacer?

Spacers assist with taking asthma It is recommended that all puffers are
medication. Spacers are only needed with used with a spacer
puffers. Spacers are usually plastic and There are fewer side effects from the
cylinder shaped; at one end, a puffer is medication
inserted, and the other end goes in your It is easier to use as it requires less
mouth. coordination than a puffer alone
A spacer helps you take medication by More medication is inhaled into the
reducing the amount of medicine that lungs
lands in your mouth and allowing more
to go down into your lungs where it is The diagram below shows the
needed. difference between how much
medication goes into the lungs, with
Choosing your spacer and without a spacer.
Spacers come in different sizes and
shapes. Small spacers are useful for
children and can be used by everyone
(including adults) with their blue reliever Throat

puffer when out and about. However, for
preventer medicine, some small spacers Lungs
may not deliver enough medicine to the
lungs. Stomach
Choosing a spacer depends on the
medication type, your personal
preference, budget and advice from
your doctor, pharmacist or local Asthma
Foundation.

Asthma Medications & Devices

Masks
Some spacers can be used with masks.
Very young children may require a mask
to ensure as much asthma medication
as possible is breathed into their lungs.
This is also useful for others who have
difficulty taking their medication. Spacers are not for sharing
Spacers are made for single person use
to stop the spread of infectious disease
each person should have their own
spacer, which they can wash and reuse as
shown below.

Cleaning your spacer

Plastic spacers must be prepared before
first use so they will work correctly. To
prepare your spacer, wash it in warm
water with detergent. Do not rinse it.
Leave it to air dry.
Clean your spacer the same way every
month. Make sure you put the spacer
back together again correctly after it is
dry.
Masks can be washed in the same way.

Spacer storage
Spacers should be stored in the following
way. After they have been washed in
warm water and detergent, and allowed
to air dry, they should be stored in a paper
(not plastic) bag, to minimise static.

12 / 13
How to use a puffer and spacer

1
Remove cap from puffer
Shake puffer well
Attach puffer to end of spacer

2
Place mouthpiece of
spacer in mouth and ensure lips
seal around it
Breathe out gently

3
Press down on puffer
canister once to fire medication
into spacer

4 Breathe in and out

normally for 4 breaths
or
Breathe in slowly and deeply, hold
for up to 10 seconds and breathe
out gently away from mouthpiece

To take more medication, shake

puffer and repeat steps 2 - 4

Asthma Medications & Devices

How to use a spacer and mask

1
Remove cap from puffer
Shake puffer well

2
Attach puffer to end of spacer

3
Gently place mask over mouth
and nose so there are no gaps
around the edges
Breathe out gently

4 Press down on puffer once to fire

medication into spacer
Breathe in and out normally for 4
breaths
or
Press down on puffer once to fire
medication into spacer, then breathe
in slowly and deeply, hold for a few
seconds and breathe out gently

To take more medication, shake

puffer and repeat steps 2 - 4

14 / 15
How to use a puffer
Using a spacer with a puffer will minimise side effects and deliver medication more
effectively to your lungs.
Puffers require good coordination so it is important to press down on the canister and
breathe in at the same time.

1
Remove cap from puffer
Hold puffer upright and shake well
Breathe out away from the
puffer

2
Tilt the chin upward to open your
airways
Put the puffer mouthpiece in mouth
and create a seal with lips
Start to breathe in through mouth, then
fire one puff of medication and continue
to breathe in steadily and deeply

3
Remove puffer from mouth, close
mouth and hold breath for 10 seconds
Breathe out gently away from
mouthpiece

4 Replace cover

To take more medication,

repeat steps 1 to 3

Asthma Medications & Devices

How to clean a puffer
Preventer and combination puffers must never be wet or washed: they should only be
wiped with a dry tissue.
Reliever puffers* require cleaning every week to prevent blockage from a build up of
medication.

1 Remove metal canister. Do not place in water

2 Wash the plastic casing only. Rinse mouthpiece through top and bottom
under warm running water for at least 30 seconds. Wash mouthpiece cover
3 Allow to air dry

4 Reassemble

*Intal Forte and Tilade puffers should be washed every day and allowed to dry for more than
24 hours before re-use.

16 / 17
How to use an Accuhaler
Accuhalers contain medication as a dry powder.

1
Hold accuhaler by its base in one
hand
Place thumb of other hand on
thumb grip
Open Accuhaler by pushing thumb
grip around until it clicks

2
Slide lever until it clicks
The medication is now loaded
Breathe out away from the
Accuhaler

3
Put mouthpiece in mouth
ensuring good seal is formed
Breathe in steadily through
mouth

4
Remove Accuhaler from mouth
then hold breath for up to 10
seconds, then breathe out gently
away from Accuhaler
If another dose is required, push
lever back to starting position
and repeat steps 2 to 4

5
When finished, close Accuhaler

Asthma Medications & Devices

How to look after an Accuhaler
How to look after an Accuhaler

Avoid breathing into the Accuhaler

Always keep it dry
Keep it closed when not being used
W
 ipe the mouthpiece with a clean dry tissue
If you are using an Accuhaler for dispensing your medication,
it is important that it DOES NOT get wet. If it requires cleaning,
use a dry clean cloth to wipe the device specifically the mouthpiece

How can I tell when the

Accuhaler is empty?
There are 60 doses of medication in an Accuhaler.
A dose counter on the side of the Accuhaler will show you
how many doses remain.
The last 5 show up in RED

18 / 19
How to use a Turbuhaler
Turbuhalers contain medication as a dry powder that requires deep inhalation to get
medication into the lung.

1
Unscrew and lift off cap

2
Hold Turbuhaler upright
Twist coloured base around all
the way, and then back all the
way

3
Breathe out gently away
from Turbuhaler
Do not blow into it

4 Put mouthpiece in mouth ensuring

a good seal is formed with lips
Breathe in through mouth
forcefully and deeply
Remove Turbuhaler from mouth
before breathing out gently away
from the mouthpiece

5 Replace cap
To take more medication,
repeat steps 2 to 4

Asthma Medications & Devices

Turbuhaler notes
It is very important to hold the Turbuhaler upright when you are twisting the
base, otherwise you will not get the dose
Y ou will not get a higher dose by twisting the coloured base more than once at
the same time
The rattling you hear when you shake the Turbuhaler is the drying agent built into
the coloured base of the Turbuhaler and is not the medication

How should I clean a

Turbuhaler?
If you are using a Turbuhaler for dispensing your medication, it is important that it
DOES NOT get wet. If it requires cleaning, use a dry clean cloth to wipe the device -
specifically the mouthpiece.

How can I tell when a

Turbuhaler is empty?
The indicator on the side of the device will either highlight the doses left in the device
(Symbicort) or appear in red to indicate that it is nearly empty (Bricanyl, Pulmicort and
Oxis).

You will need to check regularly to see if the red mark has appeared in the window,
or how many doses remain.

Empty

Empty

20 / 21
How to use an Autohaler
Autohalers are breath activated so the need for coordination is reduced.

1
Shake Autohaler to mix medication
and propellant

2
Remove cover from Autohaler
mouthpiece
Hold Autohaler in upright position
without blocking vents at base
Lift grey lever at the top of the device
Breathe out away from Autohaler

3
Tilt chin up, put mouthpiece in mouth,
closing lips firmly around it
Breathe in through mouth steadily and
deeply. Keep on breathing in when you
hear a click
The Autohaler will fire a dose of
medication automatically

4 Remove Autohaler, close mouth

and hold breath for up to 10
seconds
Breathe out gently away from
mouthpiece

5
Return grey lever to
original position
Repeat steps 1 to 5 if another dose
is needed

Asthma Medications & Devices

How can I tell when the
Autohaler is empty?
Load the Autohaler by holding it upright and lifting up the grey lever
There is a small sliding lever on the bottom of the Autohaler. Slide the lever across
If the Autohaler does not fire any medication, it is empty

How to look after an

Autohaler
R

 emove mouthpiece and rinse the mouthpiece in warm water

(Airomir only - Do not wash Qvar)

Leave it to air dry, then replace mouthpiece cover

Do not push anything into the mouthpiece as this may cause damage

Nebulisers
Nebulisers convert liquid medication into Used correctly, a puffer and spacer are just
a fine mist inhaled through a mouthpiece as effective as a nebuliser. A nebuliser is
or mask. The air-flow and pressure of your sometimes recommended by the doctor
nebuliser should be checked regularly if using a puffer and spacer is difficult for
(at least once a year). Depending on use, someone. For more information, talk to
disposable nebuliser bowls may need your doctor, pharmacist or local
replacing regularly, according to the Asthma Foundation.
manufacturers instructions. It is advisable
to always have a spare bowl. Nebuliser
filters should be changed regularly and
the machine serviced according to the
manufacturers instructions.

22 / 23
Asthma Medications & Devices
General medication information

Getting rid of Find out more

medicines you about your
dont need medications
You can return expired or empty Asthma medications come with
medications to your pharmacist for safe Consumer Medicine Information which
disposal. can be provided by any pharmacist or
doctor, or you can find them and other
information about medications online at
nps.org.au

Prescriptions Find out more

Most asthma medications require a about asthma
prescription. Ask your doctor if you need
a repeat prescription to make sure you Asthma Australia provides a range of
dont run out. resources in both hard copy and online to
assist people with asthma.
Most blue reliever medications can be
bought over the counter, but you should Your local Asthma Foundation has
still make sure your doctor knows when trained staff available to assist with any
and how you are using these. If you are questions you have regarding asthma for
using your blue reliever medication yourself, someone you care for, or people
3 times or more per week, speak to your you work with.
doctor as this is a sign that you are not You can also ask about community
well or your medication may need to be education and training programs.
changed.

Contact your local

Asthma Foundation
1800 ASTHMA (1800 278 462)
asthmaaustralia.org.au

24 / 25
Treatment of Asthma First Aid
acute asthma Asthma Australia provides community
education and training for Asthma First
If you are very unwell and have little Aid (see next page).
response to relievers, your doctor may
prescribe a short course of oral steroids We encourage everyone to learn Asthma
in liquid or tablet form (Prednisolone/ First Aid.
Prednisone). This is used to reduce the
swelling in the airways and quickly improve
asthma in an acute attack or when
symptoms persist. Asthma
When used in short courses of 3-5 days,
oral steroids are generally free of significant
Emergency Kits
side effects, but some patients experience Asthma Emergency Kits provide basic
temporary mood changes, weight gain, or equipment and instructions to assist
worsening of diabetic control. They may someone during an asthma attack.
cause side effects when used in high doses
for weeks to months at a time, or when Your local Asthma Foundation can
more frequent short courses are used. provide education and training for
Asthma First Aid.
The risks of not taking this treatment when
needed are far more serious than any side Asthma Emergency Kits are available
effects. If you are concerned, discuss this from your local Asthma Foundation.
with your doctor.

Asthma Medications & Devices

1 Sit the person upright
Be calm and reassuring
Do not leave them alone

2 Give 4 puffs of blue reliever puffer

medication
Use a spacer if there is one
Shake puffer
Put 1 puff into spacer
Take 4 breaths from spacer
Repeat until 4 puffs have been taken
Remember: Shake, 1 puff, 4 breaths

3 Wait 4 minutes
If there is no improvement, give 4 more puffs
as above

4 If there is still no improvement call

emergency assistance (DIAL OOO)*
Say ambulance and that someone is having an
asthma attack
Keep giving 4 puffs every 4 minutes until
emergency assistance arrives
*If calling Triple Zero (000) does not work on your mobile phone, try 112

Call emergency assistance immediately (DIAL 000)

If the person is not breathing
If the persons asthma suddenly becomes worse, or is not improving
If the person is having an asthma attack and a puffer is not available
If you are not sure if its asthma
Blue reliever medication is unlikely to harm, even if the person does not have asthma

To find out more contact your local Asthma Foundation

Translating and
1800 ASTHMA (1800 278 462) asthmaaustralia.org.au Interpreting Service
Asthma Australia 2013 Supported by the Australian Government 131 450
This brochure has been developed
for the community by Asthma Australia.
It provides information about:
Asthma Medications & Devices
Using asthma medication to keep you well
Using asthma devices properly
How to look after your device

Other Asthma Australia brochures:

Asthma Basic Facts
Under 5s
Seniors
Live well checklist
Could it be asthma?
10 Things to tell/ask your doctor
To find out more about asthma
contact your local Asthma Foundation
1800 ASTHMA (1800 278 462)
asthmaaustralia.org.au

Translating and
Interpreting Service
131 450

All Asthma Australia information is endorsed by our Medical and Scientific Advisory Committee and is consistent with the
National Asthma Council Australia clinical guidelines.
Asthma Australia information does not replace professional medical advice.
People should ask their doctor any questions about diagnosis and treatment.
Asthma Australia 2013

This work is licensed under the Creative Commons Attribution-NonCommercial 3.0 Australia License.To view a copy of this
license, visit http://creativecommons.org/licenses/by-nc/3.0/au/ or send a letter toCreative Commons, 444 Castro Street,
Suite 900, Mountain View, California, 94041, USA.