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an acute asthma attack. These medications work quickly to relax the muscles that tighten around the
airways, opening the airways right away so that the person can breathe more easily. Both long-term control
medications and quick-relief (rescue) medications may be given through an inhaler, a nebulizer (Box 5-1)
or orally.

Box 5-1. Asthma Inhalers and Nebulizers

The most common way to take long-term control and quick-relief (rescue) medications is by inhaling

them. Inhalation allows the medication to reach the airways faster and work quickly. There also are fewer

side effects. Medications are inhaled using a metered dose inhaler (MDI), a dry powder inhaler (DPI) or a
small-volume nebulizer.
Metered Dose Inhalers (MDIs)

An MDI delivers a measured dose of medication for the person to use the inhaler correctly. The
in mist form directly into the person’s lungs. The medication goes into the spacer, and then the
person gently presses down the top of the inhaler. person inhales the medication through the
This causes a small amount of pressurized gas mouthpiece on the spacer. For children, a spacer
to push the medication out quickly. Sometimes may be used with a face mask instead of a
a spacer (or chamber) is used to make it easier mouthpiece.

Dry Powder Inhalers (DPIs)

A DPI delivers a measured dose of medicine in a
dry powder form directly into the person’s lungs.
Instead of pressing down on the top of the device
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to dispense the medication, the person breathes
in quickly to activate the DPI and dispense the
medication. Some people have difficulty using DPIs
because they require the user to take in a quick,
strong breath.

Small-Volume Nebulizers

Small-volume nebulizers convert liquid medication
into a mist, which is delivered over several minutes.
Nebulizers are especially helpful when the person
is unable to take deep breaths, for children younger
than 5 years and for older adults. They also are
used for people who have trouble using inhalers
and for those with severe asthma.

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