Don’t confuse “rescue” and “maintenance” inhalers

Inhalers are devices that contain medicines used to treat asthma and several other diseases that affect the lungs. By inhaling the medicine from the device, asthma sufferers and people with other lung diseases can breathe easier. It is important to learn how to properly use an inhaler and when to use it. This is especially true for people with asthma. Asthma is a breathing condition that affects both children and adults. Many people often need more than one medicine/inhaler to treat their asthma.

Inhalers contain either short-acting or long-acting medicines. Short-acting medicines relax and open the breathing tubes in the lungs. These are called rescue inhalers because they work quickly and help “rescue” a person if breathing suddenly becomes difficult. Long-acting inhalers are used daily.They help control asthma and prevent symptoms from occurring. These are called maintenance inhalers because the medicine works more slowly but lasts much longer. Maintenance inhalers do not work to treat sudden symptoms.

The case below is an example of an error that occurred when instructions on how to use the two different types of inhalers were misunderstood.

A young child needed two different inhalers to treat his asthma. The inhaler he used every day—his maintenance inhaler—was called Symbicort (contains the medicines budesonide and formoterol). His other inhaler—his rescue inhaler—was called Proair (contains the medicine albuterol) which he was supposed to use for quick relief when he had trouble breathing. While he was at camp one day, he began having trouble breathing. He went to get his rescue inhaler. The child had been taught to use the “red inhaler” for quick relief. However, both inhalers were red and similar in size (see Figure 1). As a result, the child grabbed his maintenance inhaler, not his rescue inhaler. The maintenance inhaler contains long-acting medicine that works slowly, so it did not help him. Fortunately, the mistake was noticed quickly, and the child used his rescue inhaler to rapidly ease his breathing.

To make sure you know which inhaler to use daily and which inhaler to use in an emergency, do the following:

• Ask for help.. Ask your doctor, pharmacist, or nurse to show you how to take the medicine. Sometimes a training device that doesn’t contain medicine is available to help you learn. 
• Show what you learned. After learning how to take the medicine, use the inhaler in front of the doctor, nurse, or pharmacist. 
• Get instructions.. Ask for printed instructions or a video demonstrating how to use the inhaler. 
• Learn about your medicines.. If you need to use more than one inhaler, learn which one has the “rescue” medicine and which one has the “maintenance” medicine. Learn the correct names of the medicines. 
• Learn to identify the correct medicine.. If the inhaler devices look similar, ask your pharmacist to help you come up with a way to quickly identify the correct medicine. Do not use color to identify the inhaler. Maybe a special label can be used.