Using an inhaler frequently can have both positive and negative effects. On the positive side, regular use of inhalers prescribed for asthma or COPD can help control symptoms and prevent exacerbations. However, overuse of inhalers, especially those containing steroids, can lead to side effects. Understanding the benefits and risks can help determine if inhaler use is optimal.
How do inhalers work?
Inhalers deliver medication directly to the lungs to treat respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). There are two main types of inhalers:
- Bronchodilators – Relax airway muscles to open up the airways and make breathing easier. Examples include short-acting beta-agonists like albuterol.
- Corticosteroids – Reduce airway inflammation. Examples include beclomethasone and budesonide.
Using an inhaler allows the medication to go straight to the lungs where it is needed. This maximizes the effectiveness and minimizes side effects compared to taking pills. When inhaled correctly, most of the medication reaches the lungs while very little is absorbed into the rest of the body.
Benefits of regular use
Using inhalers as prescribed can provide several benefits:
- Better asthma/COPD control – Preventing and relieving symptoms helps keep the conditions under control.
- Prevent exacerbations – Regular use, especially of corticosteroids, can reduce severe worsening of symptoms known as exacerbations.
- Improve quality of life – Breathing easier and avoiding exacerbations allows people to stay active and participate in daily activities.
- Prevent hospitalizations and ED visits – Keeping symptoms under control can reduce asthma-related emergency department (ED) visits and hospitalizations.
- Prevent permanent lung damage – Untreated, ongoing inflammation can lead to permanent changes in the lung’s airways. Inhalers help prevent this damage.
Using inhalers as prescribed by a doctor provides efficient delivery of medication straight to the lungs where it is needed most. This allows people with asthma and COPD to manage their symptoms and avoid complications from the disease.
Risks of overuse
While regular use of inhalers is beneficial for most people, overuse can cause problems. This is especially true for corticosteroid inhalers when used excessively over a long period of time. Potential risks include:
- Oral health problems – Excess steroids can lead to increased risk of oral thrush, hoarse voice, and oral candidiasis.
- Weakened immune system – Long-term overuse may suppress the immune system and increase risk of infections.
- Bone loss – High doses of inhaled steroids over many years is linked to increased osteoporosis risk.
- Eye problems – Extended overuse has been associated with glaucoma, cataracts and blurred vision in some cases.
- Growth issues in children – High doses may temporarily slow growth in children and teens who are still developing.
However, when used as directed, the risks of side effects are low. Doctors prescribe the minimal effective dose to control symptoms while minimizing potential problems.
Signs of overuse
Watch for these signs that excessive inhaler use may be occurring:
- Using more canisters of medication than expected
- Refilling prescriptions more often
- Inhaler does not seem to be working as well or lasts a shorter time
- Increasing difficulty breathing or more frequent exacerbations
- No symptom relief even with repeated doses
- Using a quick-relief inhaler daily or hourly
Keeping track of inhaler use and reporting any usage changes to a doctor can help determine if overuse may be occurring. Sudden increased use may indicate worsening asthma that requires a medication adjustment.
Reasons for overuse
There are several reasons why someone may overuse an inhaler without realizing it:
- Preventive inhalers not taken correctly so quick-relief inhalers overused to treat symptoms
- Not understanding proper inhaler technique so medication isn’t reaching lungs efficiently
- Exposure to triggers like smoke or allergens frequently causing increased use
- Undertreated asthma so higher doses of medication are needed
- Anxiety or panic leading to excessive doses when symptoms flare up
Identifying the root cause for overuse by reviewing inhaler technique, asthma triggers, adherence to preventive medication, and emotional factors can help correct the problem.
Effects of improper inhaler use
Using inhalers incorrectly can also cause increased use along with other problems. Common inhaler errors include:
- Not shaking the inhaler before use so no medication is released
- Inhaling too fast so medication hits throat/tongue rather than lungs
- Not holding breath long enough after inhaling to allow absorption
- Poor coordination pressing canister and breathing in fully
- Blocking air vent with fingers so full dose isn’t inhaled
These errors prevent the medication from reaching the lungs effectively. This results in poor symptom control so more frequent doses are needed. Reviewing proper inhaler technique at each doctor visit can help identify and correct any issues.
Safe use of inhalers
To balance the benefits of inhalers with the risks of overuse, the following precautions are recommended:
- Take preventive, anti-inflammatory medication as prescribed to control underlying inflammation.
- Limit quick-relief inhalers for sudden symptoms and minimize daily use.
- Use a spacer for better delivery of corticosteroids to the lungs.
- Rinse mouth after inhaled steroids to prevent oral side effects.
- Check inhaler technique regularly to ensure proper use.
- Track inhaler usage to identify increased use right away.
- See a doctor if sudden increased use occurs for evaluation.
- Have regular medical check-ups to monitor for potential side effects.
Following dosage instructions, proper technique, and ongoing medical supervision allows people with asthma and COPD to safely manage their condition with minimal risks from inhaler overuse.
Alternatives to frequent inhaler use
For people needing to use quick-relief inhalers multiple times a day, other options may be available to reduce reliance on inhalers while still controlling symptoms. This can help minimize both side effects of high steroid use and risks if poor inhaler technique causes medication to be wasted. Some alternatives include:
- Add-on or higher dose preventive medications – Additional long-term control medications can treat underlying inflammation.
- Allergy treatment – Allergen immunotherapy and antihistamines can reduce allergy flare-ups.
- Environmental control – Avoiding triggers like smoke and pet dander prevents symptom spikes.
- Bronchial thermoplasty – Heat treatment of airways during bronchoscopy reduces smooth muscle constriction.
- Biologic therapies – Monoclonal antibodies like mepolizumab help control severe eosinophilic asthma.
Doctors may recommend stepping up treatment to minimize acute symptoms while also treating the underlying disease if inhaler overuse becomes a concern.
Risks of abrupt discontinuation
It is important not to suddenly stop regular use of prescribed inhalers without consulting a doctor. There are risks associated with abrupt discontinuation, especially of corticosteroid inhalers after prolonged use. Potential complications include:
- Severely worsened asthma control
- Rebound inflammation in airways
- Increased exacerbations or attacks
- Emergency care and hospitalization
Doctors will create a tapering schedule to gradually decrease inhaler dosing frequency. This protects against risks associated with sudden discontinuation after regular use. Any concerns about reducing inhaler usage should be discussed with a doctor to determine safe options.
Key points
In summary, key points to know about frequent inhaler use include:
- Prescribed regular use helps control respiratory disease and prevent complications.
- Overuse, especially of steroids, increases the risk of short and long-term side effects.
- Watch for signs of overuse like refilling inhalers early and poor asthma control.
- Review technique regularly as improper use contributes to overuse.
- Add preventive treatments or trigger avoidance to minimize quick-relief inhaler use.
- Don’t stop inhalers suddenly – taper down use under medical supervision.
Finding the right balance of optimal yet safe inhaler use requires ongoing partnership with your doctor and vigilance about your own asthma control and medication use. Keeping track of symptoms and any usage changes is key to achieving the benefits of inhalers while minimizing the risks.
Conclusion
Regular use of inhalers is important to help control chronic lung diseases like asthma and COPD. But overuse can lead to side effects, especially when high doses of steroids are used excessively over long periods. Pay attention to prescription instructions, technique, symptom triggers, and early warning signs of overuse. Partner closely with your doctor for oversight and help optimizing your treatment plan. Finding the right inhaler balance provides the benefits of symptom control and prevention of exacerbations while minimizing risks of both under and overuse.