Asthma spray - what to watch out for!
What is an asthma spray?
The asthma spray is a form of drug therapy that can be very effective in treating asthma. It is taken as a spray (also called an aerosol) from a small can. You have to inhale slowly and press the spray button at the same time. The drugs contained in the spray are various substances that widen the airways and thus alleviate the symptoms of asthma. The use and type of application of an asthma spray should always be discussed with a doctor in advance, if possible.
When do you need asthma spray?
In the case of asthma, depending on the severity of the disease, various medications are used to prevent the further progression of the disease and to improve the symptoms. Most of these drugs are taken in inhalative form, i.e. as an asthma spray. Depending on the severity of the disease, different drugs are combined with one another. The indication for an asthma spray should always be discussed with a doctor, as the dosage is very important.
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Active ingredient salbutamol in the asthma spray
Salbutamol is the most commonly used drug that plays an important role, especially at the beginning of an asthma illness. This is a so-called beta2 sympathomimetic. This name is based on the special mode of action of salbutamol: It binds to beta2 receptors in the body, which are mainly located in the area of the lungs in the airways. There, salbutamol binds to the receptors to widen the airways and thereby relieve the symptoms of shortness of breath. Furthermore, there are beta2 receptors on vessels, in which an expansion is also triggered by the binding. It also has an effect on the uterus, which - through attachment - can inhibit labor in a giving birth mother. In addition, the beta2 sympathomimetics prevent the release of histamine, a substance that supports the allergic reaction in the lungs.
Salbutamol belongs to the class of short-acting beta2-sympathomimetics. The effect takes a few seconds, but only lasts between 4 and 8 hours. Alternatively, fenoterol or terbutaline can be used. As a short-acting drug, salbutamol is used primarily at the beginning of asthma with occasional attacks of shortness of breath.
For more information, see: Salbutamol
Asthma spray with cortisone
As the asthma disease progresses, at some point the therapy used only for seizures is no longer sufficient and there must also be permanent therapy, i.e. daily use of medication. Asthma sprays containing cortisone are used for this purpose and dosed in different amounts depending on the severity of the disease. From a certain therapy level, these can also be used as an alternative to the beta2-sympathomimetics described above in a rapidly effective form.
Well-known representatives for this are budesonide and beclometasone. These are preparations that have a glucocorticoid effect, i.e. have a similar effect to cortisone.The desired effect in asthma is the suppression of the immune system, which is to be achieved primarily locally in the lungs. By using asthma sprays containing cortisone, the inflammatory reaction in the lungs is stopped and the release of certain substances that lead to increased mucus accumulation and irritation of the airways is inhibited.
The use of asthma sprays with cortisone should always be discussed with a doctor due to the possible side effects of cortisone.
Further information on this topic can be found at: Cortisone therapy for asthma
Which asthma sprays are available without a prescription?
Asthma sprays are partly available without a prescription, depending on their exact mechanisms of action and the possible side effects. However, it is strongly recommended that if you suspect an asthma illness, first consult a doctor to discuss the diagnosis and any treatment that may be necessary. Independent treatment of the asthma is strongly discouraged without consulting a doctor, as many asthma sprays can lead to undesirable side effects if used incorrectly or through interactions with other medications that may be taken. In an urgent emergency, at least a brief consultation should take place in the pharmacy.
Various active ingredients are available without prescription. These include, for example, cromoglicic acid, ambroxol or bromhexine. These active ingredients are contained in various drugs and are used primarily to liquefy and loosen the accumulations of mucus in the lungs. In addition, some asthma sprays that contain cetirizine or acetylcysteine are available without a prescription.
Exact effect of the asthma spray
The effect of asthma sprays depends on the active ingredient of the drug, which is administered in inhalative form. In addition, the dose and duration of use play a role in many drugs. For example, asthma sprays with cortisone only develop their full effect after about a week when used as long-term therapy.
The main goal of asthma sprays is usually to widen the airways in order to make breathing easier. To do this, they bind to various receptors located on the surface of the airways. Furthermore, asthma sprays containing cortisone in particular can slow down the inflammatory reactions in the lungs by specifically suppressing the immune system and thus also lead to local decongestion and a reduction in mucus production. Other asthma sprays specifically dissolve the mucus that has already been produced in the lungs so that it can be coughed up. Beta2 sympathomimetics also dilate the vessels in the lungs, which promotes better blood flow. They also inhibit the excessive release of histamine, which as an endogenous substance plays a decisive role in the spread of the inflammatory reaction in the lungs.
Asthma spray side effects
The side effects are very different depending on the type and dosage of the asthma spray and the stage of the disease and can be very pronounced, but also not occur at all.
With the beta2 sympathomimetics, especially with the asthma sprays used as long-term therapy, restlessness and sleep disorders can occur. Since these drugs can also work in the heart, they may increase blood pressure (hypertension) and heart rate (Tachycardia) come and have seizure-like tightness in the chest (Angina pectoris). With long-term use, the body also develops a tolerance over time, which means that a higher dose is needed to achieve the same effect.
The cortisone-containing asthma sprays can, as an undesirable side effect, lead to an increased susceptibility of the oral mucosa to infection with the Candida fungus, which can lead to the symptoms of oral thrush (whitish, peelable coverings on the palate). This side effect can be prevented by rinsing the mouth after using the asthma spray. Furthermore, with long-term use, the muscles of the vocal cords can recede, which can lead to hoarseness.
When should asthma spray not be given?
With correct use and dosage, and the treatment provided by a doctor, there are seldom reasons why an asthma spray should not be given. Some patients may experience intolerance or even an allergic reaction when using an asthma spray. If this is the case, the asthma spray should no longer be used and the treating doctor should be discussed about switching to another preparation. Furthermore, the common side effects with regard to any other existing diseases and the development of tolerance with beta2-sympathomimetics should be kept in mind.
Read more about further treatment for asthma: Therapy of asthma
Alternatives to an asthma spray
The asthma disease can be treated with various methods. These are effective differently depending on the level and severity of the disease. The focus is certainly on the use of asthma sprays, but the symptoms can also be alleviated, for example, through breathing exercises and asthma sports. In the most pronounced stage of asthma, so-called biologicals (for example omalizumab) can be used therapeutically, which are taken in the form of tablets.
For more information, see: Medicines for asthma
Dosage of the asthma spray
The dosage of an asthma spray depends on the preparation and the therapy level (i.e. the severity of the asthma and the correspondingly popular therapy). For example, salbutamol is given in the form of two puffs (i.e. two puffs) in the event of an acute attack. However, more than ten strokes per day should be avoided. In the case of budesonide, on the other hand, there are preparations with different numbers of milligram strengths. The normal dose for mild asthma is 0.2-0.4 mg and can be increased to 0.8 mg per day.
Can you stop using an asthma spray immediately?
Many asthma sprays are designed for long-term therapy and only develop their full effect after a certain period of ingestion, as the level of the active ingredient in the body is only then high enough. Accordingly, for the asthma spray to have a sufficient effect in long-term therapy, it is important that it is used regularly. A sudden discontinuation of the asthma spray by hand is therefore not recommended, especially with asthma sprays with cortisone, a slow reduction of the dose is always recommended. If the asthma spray leads to side effects, the attending physician should always be contacted so that they can consider switching to another asthma spray instead of simply stopping it.
Asthma spray price
The price of an asthma spray depends heavily on the active ingredient and the manufacturer. Most asthma sprays start at a price of around 5-10 euros, although the price can go up as much. There are, for example, asthma sprays that cost 50 euros, where you can search for the active ingredient directly and then take a preparation from another manufacturer. If in doubt, it is advisable to always seek advice from the pharmacy.
Interactions of the asthma spray
The interactions in asthma sprays are very diverse and complex and always depend on the type of preparation and the dosage. It is therefore extremely important that the treatment of the asthma disease is discussed with the attending physician and that he or she is informed of any additional medication taken. In addition, there should be a lively exchange of information if, for example, new symptoms appear. Asthma sprays with cortisone can, for example, lead to a potassium deficiency or even be reinforced by estrogen-containing preparations or certain antibiotics and therefore develop their effect longer and in higher doses.
Asthma spray and alcohol - are they compatible?
Even when using an asthma spray, caution should always be exercised about possible triggers for an asthma attack. In addition to various drugs, this also includes alcohol and nicotine. Studies have shown that alcohol can trigger an asthma attack in many asthmatics. This could be proven especially with wine. It is of course also possible that alcohol is not a trigger for an asthma attack, but it should always be kept in mind.
Can it be taken during pregnancy and breastfeeding?
In principle, asthma sprays can be taken during pregnancy and breastfeeding. However, there should always be close consultation with the doctor treating the asthma and the doctor looking after the pregnancy, as the use depends on the type of asthma spray. Common asthma sprays, such as salbutamol, can be used during pregnancy and breastfeeding. Since salbutamol is one of the beta2-sympathomimetics, which also have a labor-inhibiting effect, its use should be clarified with a doctor before the birth and, if necessary, changed.
Does the asthma spray limit the effectiveness of the pill?
As a rule, the effectiveness of the pill is not limited by an asthma spray. If you are unsure, you should read the package insert or ask your doctor or pharmacist. Conversely, however, the pill can increase the effect of the asthma spray, since asthma sprays containing cortisone, for example, are broken down less by the estrogens in the pill and accordingly remain in the body as an effective drug for longer and can act on the lungs.
Can an asthma spray help build muscle?
There is no scientifically proven effect of an asthma spray on building muscle. An asthma spray usually widening the airways that otherwise contract due to asthma. This effect is of course certainly beneficial for extensive fitness training, but it should definitely not be a reason for using an asthma spray.
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Can you take asthma spray on the plane?
Most airlines allow asthma spray to be carried in hand luggage on the aircraft, as it is a medically prescribed medication that must be readily available in an emergency. If anything is unclear, the regulations for hand luggage can be found on the websites of the respective airlines.
Can an expired asthma spray still be used?
If an asthma spray has expired, a new spray should be used instead, as the active ingredients it contains may have lost their effectiveness. Therefore, the expiration date should always be checked before using an asthma spray.