When a person with a chronic lung condition, such as asthma or COPD, develops a common respiratory illness like a cold or the flu, their symptoms often worsen significantly. These infections are a frequent trigger for flare-ups, known as exacerbations, which involve increased inflammation in the airways. Understanding how sickness affects the lungs and how to adjust medication use is important for maintaining control and preventing a severe episode. The decision to use or adjust inhaler medication when ill is guided by a personal action plan developed with a healthcare provider.
How Respiratory Illness Affects Airway Function
Respiratory viruses directly infect the lining of the airways, triggering a robust inflammatory response. This infection causes the immune system to release chemical mediators that lead to swelling of the bronchial tubes. The inflammation narrows the air passages, making it difficult for air to move freely.
The infection also stimulates the production of thick, sticky mucus within the airways, further contributing to obstruction and coughing. This combination of swelling and mucus accumulation increases resistance to airflow. Individuals with underlying conditions like asthma also experience heightened airway hyperresponsiveness, meaning their airways become more sensitive and reactive to triggers, leading to muscle spasms or bronchospasm.
The resulting tightening of the muscle bands around the airways, combined with inflammation, causes the characteristic symptoms of wheezing, chest tightness, and shortness of breath. This physiological cascade explains why a simple cold can quickly turn into a serious breathing crisis for someone with pre-existing respiratory disease.
Adjusting Your Inhaler Routine During Sickness
Management of a respiratory illness requires adherence to your personal action plan, which often includes a temporary adjustment of your daily inhaler regimen. Maintenance inhalers, which typically contain an inhaled corticosteroid (ICS), must be continued even when feeling unwell because they control the underlying inflammation. In the event of a flare-up, the common strategy outlined in many action plans is to temporarily increase the dose of the ICS component.
This temporary dose increase helps combat the heightened inflammation caused by the viral infection. Any change to the dosage of a maintenance medication should only be made after consultation and instruction from a physician, who will determine the appropriate short-term increase and duration.
Rescue inhalers, or short-acting beta-agonists (SABAs), are used to quickly relax the smooth muscles around the airways during an acute episode. Increased reliance on a rescue inhaler is the most direct sign that the respiratory illness is worsening your condition. If you find yourself needing to use your SABA more frequently than prescribed, such as more than two to three times per week, it indicates that your airways are poorly controlled and that a medical review is necessary.
In cases where the exacerbation is severe and does not respond adequately to increased inhaled medication, a physician may prescribe a short course of oral corticosteroids (OCS), such as prednisone. These systemic medications work powerfully to reduce widespread inflammation throughout the body, providing relief from severe symptoms. Oral steroids are typically prescribed for a short duration, often five to ten days, to manage the acute flare-up and are not meant for long-term daily use.
Essential Inhaler and Spacer Hygiene
When you are sick, maintaining the hygiene of your respiratory devices prevents the reintroduction of germs or the growth of mold or bacteria. For a Metered Dose Inhaler (MDI), remove the metal medicine canister and rinse the plastic casing and mouthpiece under warm running water for about a minute. The metal canister should never be submerged in water.
If you use a spacer or holding chamber, it should be cleaned more frequently than when you are healthy, ideally with warm water and a mild dish soap solution. After soaking the spacer for about fifteen minutes, rinse it thoroughly and allow it to air-dry completely without wiping. Wiping can create static electricity that causes medication to stick to the sides.
Dry Powder Inhalers (DPIs), unlike MDIs, should never be exposed to water or moisture, as this can ruin the powder medicine. To clean a DPI, simply wipe the mouthpiece with a dry or slightly damp cloth to remove any residue.
Recognizing When to Seek Emergency Care
A worsening respiratory illness can quickly progress into a medical emergency, and knowing the warning signs is essential. Seek immediate emergency care if you experience a persistent or rapidly increasing shortness of breath that makes simple tasks difficult.
Specific physical signs indicate a severe lack of oxygen and require immediate attention. These include a bluish tint to the lips, nail beds, or face, known as cyanosis. You should also seek urgent help if you are unable to speak in full sentences, having to pause frequently to catch your breath.
A significant warning sign is when your rescue inhaler fails to provide relief after multiple doses, or if you must use it repeatedly within a short timeframe. Other alarming symptoms include the visible use of accessory muscles to breathe, such as the chest retracting or the shoulders hunching with each breath. A fever that spikes and persists alongside severe breathing difficulty suggests that the airways are critically narrowed and medical support is needed.