When asthma symptoms persist despite inhaler use, it’s a serious concern. Effective asthma management relies on your inhaler providing relief. Several factors can make an inhaler seem ineffective, and understanding them can help you manage your condition.
Common Reasons Your Inhaler Isn’t Working
Incorrect technique is a frequent reason an inhaler might not provide relief. Many individuals do not shake their metered-dose inhaler (MDI) before use. Others fail to breathe in slowly and deeply while pressing the canister, or they do not hold their breath for about 10 seconds after inhaling. An improper seal around the mouthpiece can also cause medication to leak out.
Using an empty or expired inhaler is another common issue. Some inhalers have a dose counter, but many do not. Without a counter, it can be difficult to discern if the inhaler is empty, as a propellant can still produce a spray even when no medicine is left. Expired medication may also lose its effectiveness, so checking the expiration date is important.
Inhalers can also become clogged or malfunction. The small hole where the medicine exits can become blocked, preventing proper medication dispensing. Regular cleaning of the mouthpiece, typically once a week, can help prevent blockages and ensure proper function.
Using the wrong type of inhaler for the situation can lead to a lack of relief. There are two main types: quick-relief (rescue) and long-term control (maintenance) inhalers. Rescue inhalers are designed to quickly relax airway muscles for immediate symptom relief. Maintenance inhalers are taken daily to reduce inflammation and prevent symptoms over time; they do not provide rapid relief for an acute attack. Using a maintenance inhaler during an acute attack will not help quickly.
When to Seek Medical Attention
It is important to recognize when your symptoms indicate a severe asthma attack requiring immediate medical attention. Signs include rapid worsening of shortness of breath or wheezing, difficulty speaking, bluish lips or fingernails, straining to breathe, a rapid pulse, or feeling lightheaded. If your symptoms do not improve after using your quick-relief inhaler as prescribed, or if they worsen, it is a significant concern.
Call emergency services immediately if you experience severe breathing difficulty, are too short of breath to talk or walk, or if your lips or fingers are turning blue. This is especially true if your rescue inhaler is not providing relief. Persistent symptoms that return quickly after using your inhaler also warrant contacting your doctor or seeking urgent care.
Factors Beyond Your Inhaler
Beyond issues with the inhaler itself, several other factors can contribute to uncontrolled asthma. Unidentified or poorly controlled triggers are common. These include allergens (pollen, dust mites, pet dander) and irritants (smoke, pollution, strong odors). Respiratory infections, cold or dry air, and stress can also trigger or worsen asthma symptoms. Minimizing exposure to these triggers is an important part of asthma management.
Underlying medical conditions can also impact asthma control. Conditions like gastroesophageal reflux disease (GERD), sinusitis, anxiety, or obesity can worsen asthma symptoms or mimic them. Discussing all health concerns with a healthcare provider can help determine if other conditions are affecting your asthma.
Medication adherence plays a significant role in long-term asthma control. Consistently taking prescribed long-term control medications is essential for reducing inflammation and preventing symptoms. Poor adherence can lead to more frequent symptoms and an increased need for rescue inhalers.
Asthma can change over time, meaning your current treatment plan might need adjustment. If your symptoms are occurring more regularly, you are using your rescue inhaler more than twice a week, or if symptoms are waking you at night, it may indicate a need for a new asthma action plan or medication adjustment. Your healthcare provider can evaluate your current condition and modify your treatment, potentially adjusting dosages or prescribing different medications to achieve better control.