Asthma - Is it Under Control

Oct 8, 2021

By Barret Procyshyn, Pharmacist at Dauphin Clinic Pharmacy

This spring, summer and now Autumn have been exceptionally smoky. Forrest fires across Canada and the United States have made for some unpleasant days outdoors. This is especially the case for asthmatics.

In asthmatics the muscles around the airways are often sensitive and inflamed. When there is exposure to a trigger, like smoke or pollution in the air these airway muscles tighten even more and there is increased mucus production, causing inflammation and narrowing of the bronchial tubes. This chronic inflammatory disease of causes symptoms like shortness of breath, chest tightness, coughing and wheezing. There is currently no cure for asthma, but with proper treatment, it can be managed.

We have noticed an uptick of requests to fill asthma medications early because of increased use. Like many other illness es and diseases, from heart attacks to COVID-19, the best way to manage Asthma is to prevent the symptoms from occurring or at least keep them at their minimum. However, most asthmatics have poor control of their breathing and experience shortness of breath because their asthma is not controlled properly.

Asthma control is crucial to staying healthy and possibly prevent life threatening asthma attacks. If you are not in control of your asthma you need to start getting help from a health care provider as soon as possible.

Asthma Canada ( defines asthma control as:

-You don't have any breathing difficulties, cough or wheeze most days

-You sleep through the night without awakening due to asthma symptoms like cough, wheeze, or chest tightness

-You can exercise without having any asthma symptoms

-You don't miss any work or school due to asthma

-You have a normal lung function (spirometry) test

-You do not need to use your reliever (rescue) inhaler more than 3 times per week (except for exercise)

Asthma Canada ( defines poor control as:

-You have frequent breathing difficulties and find yourself coughing or wheezing most days

-Your asthma impacts your sleep; if your asthma symptoms wake you up or keep you up at night your asthma isn't controlled

-You can't exercise or exert yourself physically without experiencing breathing difficulties

-You frequently miss work or school due to asthma

-You use your reliever medication more than 3 times per week

A blue inhaler or Ventolin, known as the reliever or rescue inhaler, contains the beta agonist salbutamol. Salbutamol, when inhaled, works quickly to relax the muscles, and help open the airways. It is used frequently and sometimes too frequently because it works quickly and effectively. Reliever medications also help breathing if used shortly before physical activity. A salbutamol puffer contains approximately 200 doses of salbutamol. If you use 2 puffs of the blue inhaler each time that should allow for 100 uses.

An asthmatic who uses their reliever puffer daily before exercise and who has their symptoms in control should have their blue inhaler last at least 9 weeks. If your blue inhaler is not lasting two months, it might be time to get better control of your Asthma. In the meantime, use your blue inhaler when needed. You need to breathe.

Gaining control of your asthma often means using your controller puffer twice daily every day. These medications work to reduce or eliminate symptoms. An asthma control puffer will contain a steroid or a combination of a steroid with a beta agonist to help open the airways. Frequently these medications are under used for two main reasons. The user does not feel them work or provide relief. The second reason is these inhalers are quite more expensive when compared to salbutamol. On a positive note, the Flovent or fluticasone steroid inhaler has recently been replaced with a less expensive generic version. Talk to your clinic pharmacist for more information. When there is smoke in the air or increased risk of exposure you an allergen your asthma plan needs to include potentially increasing the dose of the controller medication.

Using your inhaler properly is also extremely important. Proper use of an inhaler is quite challenging for adults and almost impossible in young children. A spacer device known as an Optichamber should almost always be used as they significantly increase the delivery of the inhaled medication. Studies have shown spacer device can increase medication delivery to the airways by up to 80%. Also ensure you are shaking the inhaler before use, waiting one minute between multiple puffs, and cleaning your devices properly when needed.

Some asthmatics are also treated with a medication called montelukast. This oral medication works well for those who have asthma and allergies. The medication is quite safe, relatively inexpensive and might be worth a try to gain better control of your airways. It is also important to reduce allergens, ensure there is no exposure to cigarette smoke and of course get vaccinated against respiratory viruses like the flu, COVID-19, and pneumonia.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist, or other health care professional.


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