Why Asthma Still Kills!!!!

Why Asthma Still Kills!!!!

If your an asthmatic - this could save your life......


Take your preventer every day and carry your reliever everywhere. And use an aerochamber to administer. 



During the week, I made a video about Asthma, and the importance of using your preventer inhaler, and not relying on your reliver inhaler. The response was huge. 

So I'm following it up with a short blog post.

Lets briefly go back to the begining. 

Asthma is a reversible lung obstruction. By reversible, I mean, the airways reopen when you use your inhalers. 

The air in the lungs cannot get out properly as the airways are inflammed and dilated. So asthma is an inflammatory condition - just like eczema. If you could see into the lungs of an asthma sufferer, they are inflammed and red like the skin of an eczema sufferer. But because you can't see your lungs, many people just treat their asthma when they are wheezy, and not all the time. 




Asthma is a lifelong condition - you never grow out of asthma. You may have many years of no symptoms, but it never goes away and can re emerge at any time. If you have more than one year of no symptoms - chat it over with your asthma nurse/pharmacist. 

  • Asthma is not diagnosed until you are 5-6 years old. The reason for this is the tools required to make a proper diagnosis cannot usually be used by small children. 
So lets skip forward, and assume you have had your diagnosis of asthma has been made.
  • You've been prescribed inhalers and have been advised to
  • use your PREVENTER inhaler daily (which has a steroid in it - as remember asthma is an inflammatory condition),
  • and use your RELIVER inhaler only if you are wheezy - but carry it everywhere! I'll explain why you carry the inhaler we don't really want you to use later on..I promise. 
If you use your preventer inhaler every day as prescribed, the inflammation in your lungs should go down and you may end up with very little symptoms, or symptom free. This is the desired outcome - and you continue to use your steroid inhaler until a medical professional advises you to reduce slowly.

So heres the important rule - 


Take your preventer every day and carry your reliever everywhere.

Above is examples of steroid inhalers
  • However, the problem with asthma is, when people feel well, they ditch the steroid inhaler. And they do one of two things -
  1. they realise they get quick relief from using their reliever inhaler, and take puffs of it instead, forgetting about their steroid inhaler (the one that has done all the hard work on getting you well)
  2. They stop taking their steroid inhaler until they feel really bad, and restart it again for a few weeks, and then stop again.
The long and short of this approach is that you will have all the nasty symptoms of asthma such as wheeze and shortness of breath, sleeplessness due to night time cough, and exercise intolerance. - because the underlying inflammation is still there. That's not including the fact that many adults and children will lose work and school days because of it.
  • Reliever inhalers contain short acting drugs such as salbutamol and terbutaline. Common brand names are Ventolin and Bricanyl.
So people will ask, why can you not just use your reliever if it works fast and forget about the preventer inhaler?
  • Well the reason this is not a good approach is that your reliever inhaler (salamol/salbutamol/ventolin etc) only opens up your airways for a few hours, and then the airways start to close again.
  • So the result of only using a reliver inhaler is that the constant opening and closing of the airways will eventually lead to airway fatigue, until one day the airways won't fully open - thats the day your in trouble!
  • The only place for your reliever inhaler is when you are wheezy, to get the airways to open quickly, and you can seek medical advice. Relievers do nothing to prevent you having asthma symptoms - they are a sticking plaster until we get your asthma under control. 


A report was commissioned to ascertain why asthma kills over 1000 people in the UK and NI every year. It was called the National Review of Asthma Deaths.
They looked at all patients that they could access records for that died of an acute exacerbation of asthma in 12 months (195 deaths) - they made the following key findings- (note i said that over 1000 people die every year from asthma - however, asthma isn't always recorded as cause of death - so the report could only use those cases recorded as asthma deaths) 
  1. All asthma patients who have been prescribed more than 12 short-acting reliever inhalers in the previous 12 months should be invited for urgent review of their asthma control, with the aim of improving their asthma through education and change of treatment if required.
  2. An assessment of inhaler technique to ensure effectiveness should be routinely undertaken and formally documented at annual review, and also checked by the pharmacist when a new device is dispensed.
  3. Non-adherence to preventer inhaled corticosteroids is associated with increased risk of poor asthma control and should be continually monitored.

 Now - read the shocking bit about overusing your reliver medication

There was evidence of excessive prescribing of reliever medication. Among 189 patients who were on short-acting relievers at the time of death, the number of prescriptions was known for 165, and 65 of these (39%) had been prescribed more than 12 short-acting reliever inhalers in the year before they died, while six (4%) had been prescribed more than 50 reliever inhalers. Those prescribed more than 12 reliever inhalers were likely to have had poorly controlled asthma.


You can access some of the information from the report here



So if your asthma is not controlled and your using your reliever inhaler more than twice a week - get into see your GP




 Now - there is a place for your reliever medication in the treatment of Asthma - but its only when you are wheezy.

So always carry a reliever with you in case of an emergency


There is a place for your reliever inhaler, but it should not be required if your asthma is well controlled.

If you do need to use your reliever inhaler quite frequently - make an appointment with your asthma nurse, asthma pharmacist or GP. We need need to look at your asthma treatment and increase or add in therapy.

But if you have a severe wheeze/shortness of breath you can do the following. This is why the reliever is so important. Relievers are what you need when your acutely unwell



So remember if you are having to use your reliever inhaler regularly, see your asthma nurse or asthma pharmacist asap


Again remember the rule



Take your preventer every day and carry your reliever everywhere. Use an aerochamber to administer. See below

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