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Asthma Medication Safety Tips

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Asthma is a chronic disease of the lungs which affects both adults and children. During an asthma attack, the airways in the lungs become inflamed and narrowed. When the airways are irritated, they can spasm which results in coughing and the wheezing sound we commonly associate with an asthma attack.

The treatment of asthma involves developing a person-specific action plan to prevent asthma attacks by determining what factors trigger the person’s symptoms. Common triggers include cold temperatures, the presence of dust or mold in the environment and cigarette smoke. Awareness of triggers, along with education on the use of asthma medications (with strict adherence to the medication schedule), can help an asthmatic avoid needing emergency medical care and hospitalizations.

Many of the medications prescribed for asthma are inhaled directly into the lungs and are available in inhalers and nebulizers and pill form. Inhalers are a small canister with a mouthpiece at the bottom that dispenses medication in metered or precise dosing. A nebulizer is a device that turns liquid medication into a mist so that it can be breathed into the lungs. Both delivery methods require some coordination and proper technique in order for the medication to be absorbed into the lungs. Because the inhaled medications look different than those taken by mouth, curious children may view them as more of a toy than a medication. The equipment and the medications should be should be put away right after being used and stored like any other medicine—up high and out of sight.

child with inhaler

There is an over-the-counter (nonprescription) inhaler called Primatene® Mist that advertises for its use in relieving mild intermittent asthma symptoms. However, use of this medication will not replace the need for regular follow-up with a physician and should not be used in place of a prescription inhaler or action plan. Like any medication, there are side effects associated with using this inhaler and when used improperly or by someone that doesn’t need it those side effects can be intensified and even require hospitalization if they are severe.

A common call to the poison center involves a prescription medication called Spiriva. This is an inhaled treatment that relaxes airway muscles and increases air flow into the lungs. It comes in capsule form and has its own inhaler device which the capsule is loaded into and pierced releasing the powder medication. Calls to the poison center involving Spiriva are common because the capsule looks just like a medication you would normally take by mouth. While the medication is absorbed well by the lungs when inhaled, the opposite is true when it is in the stomach where very little of the dose is absorbed. Expected symptoms after swallowing the capsule include a dry mouth. The issue with this mistake is this is considered a missed dose. The poison center routinely makes a follow-up call to the home after a medication error, and for these calls, if all is well, the caller is advised to inhale a dose of Spiriva as intended.

What should you do if your child has gotten into asthma medications or a mistake has happened involving these medications with a child or an adult?

Call the Poison Help line at 1-800-222-1222 for any questions or concerns about accidental ingestions for these or any medications. Specially trained nurses and pharmacists are available 24/7/365 to answer your questions. The service is free and confidential.

Additional Resources

The Asthma and Allergy Foundation of America (AAFA) website is a great resource for more information about asthma.

Proper use of an inhaler:

  • Inhaler should be used while the person is standing up, or sitting up straight.
  • Take a deep breath in, tilt head back slightly, then sharply breathe out to empty lungs.
  • Form a close, tight seal around the mouthpiece.
  • Press down on the inhaler to release the medicine, breathe in slowly for 3-5 seconds.
  • Hold breath for 10 seconds to allow medications to reach deep into the lungs.
  • Wait a minute before taking another puff if more than one is prescribed.

This technique can be used for most rescue inhalers, however, certain maintenance asthma medications require a different technique. If you are ever unsure what technique to use, contact your doctor’s office or pharmacy for guidance.

Proper use of a nebulizer:

child using oxygen mask

  • Place the mouthpiece between the front teeth and keep your lips firm around the mouthpiece.
  • Hold the nebulizer in the upright position to prevent spilling.
  • Breathe in deeply through the mouth only, occasionally tap on the side of the nebulizer to help the solution drop to where it can be misted.
  • Do not speak during the treatment.
  • Continue the treatment until there is sputtering heard indicating all the medicine has been used, this takes about 10-15 minutes.
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