The document outlines various asthma medications, including relievers such as salbutamol and anticholinergics like ipratropium, as well as preventers including corticosteroids and leukotriene modifiers. It details different inhaler types, their usage, and their respective advantages and disadvantages, such as the need for coordination and potential side effects like oral thrush. Proper inhaler technique and maintenance practices are emphasized to ensure effective medication delivery and reduce adverse effects.

1. NURHANANI BINTI ABD HALIM

2. • RELIEVERS (bronchodilator)
• SABA eg Salbutamol, Fenoterol
• Anticholinergic eg Ipratropium Br
• Corticosteroid (for serious asthma attack) eg Prednisolone,
Hydrocortisone
• CONTROLLERS/PREVENTOR
• Corticosteroid eg Fluticasone, Budesonide (Pulmicort),
Mometasone, Beclometasone
• Leukotriene modifier eg Montelukast (Singulair)
• LABA eg Salmeterol
• Theophyline tablet form – to prevent night time symptom
• Combination LABA & Corticosteroid eg Seretide Accuhaler
(Fluticasone, Salmeterol), Symbicort Turbuhaler (Budesonide,
Formeterol)

3. • Metered Dose Inhaler (MDI)
• Dry Powder Inhaler
• Handihaler
• Turbuhaler
• Accuhaler
• Ellipta
• Breezehaler
• Inhalation powder in hard capsule in inhaler
• Spiriva
• Respimat (soft mist inhaler)
• Spiriva respimat

4. • Preventor:
• Berodual N Inhaler (Ipratropium Br, Fenoterol)
• Symbicort Turbuhaler (Budesonide, Formeterol)
• Seretide Accuhaler (Salmeterol, Fluticasone)
• Seretide Evohaler (Salmeterol, Fluticasone)
• Spiriva Respimat (Tiotropium Br)
• Ultibro Breezehaler (Gylcopyrronium Br, Indacaterol)
• Pulmicort respules (Budesonide)
• Singulair tab, Aspira tab (Montelukast)
• Reliever:
• Ventolin Evohaler (Salbutamol)
• Combivent nebules (Ipratropium, Salbutamol)

5. • Require correct hand/breath
coordination
• Time & effort consuming
• May cause drug deposition
effect in the oropharynx
• eg: oral candidiasis
• Cheap
• Portable
• Fixed dose
• Low dose
• Can feel & hear dose
being delivered
• Less systemic effect
• More rapid onset

7. • Plastic tube-like device helps to reach medication from
MDI straight to the lungs.
• Commonly used in children and geriatics.
• Can reduce side effect like oral thrush.

8. 1. Take off the cap and hold the inhaler upright. Shake it
well. Put it at the end of the spacer.
2. Put the mouthpiece between the teeth and lips, making
it seal so that medicine can reach lungs.
3. Press the canister to put one puff of the medicine to the
spacer.
4. Remove the mask from face.
5. Breathe out gently and slowly from the inhaler.
*If dose indicated is more than one puff, wait for 30
seconds, shake the inhaler and repeat step 2-5.

9. • More expensive than MDI
• Not suitable for young
children.
• Not recommended in people
who cannot breathe in
strongly enough to inhale the
powder.
• Easy
• No coordination needed
• Know dose balance left
• Does not contain a
propellant.
• Does not require co-
ordination of breathing
in and pressing down.

14. • Require correct hand/breath
coordination
• May cause drug deposition
effect in the oropharynx
• eg: oral candidiasis
• Cheap
• Portable
• Fixed dose
• Low dose
• Can feel & hear dose
being delivered

15. • Clean mouth by rinsing / gargle with water or mouthwash
after using corticosteroid inhaler as can cause oral
thrush.
• Clean inhaler by flowing water (bring out canister first) if
used frequently.