Inhalers for AERD (Samter's Triad)
Asthma and AERD
Research has found that about 15% of adults with severe asthma have Aspirin Exacerbated Respiratory Disease. AERD (Samter's Triad) patients typically develop asthma symptoms 1to 3 years after sinus symptoms begin, but in rare cases asthma never develops. Studies have found that most AERD patients meet the criteria for severe asthma, but asthma in AERD can range from nonexistent to very severe and difficult to treat. Some patients have mild asthma and only need to use an albuterol inhaler occasionally, but most require stronger medications for long term asthma control. It is crucial to keep your asthma well controlled - asthma can be fatal. Research has found that AERD is associated with airway remodeling, which causes permanent damage to the lungs. The best way to protect your lungs is to keep your symptoms well controlled.
Types of Inhalers
Rescue inhalers are used in emergencies - to stop an asthma attack after it's started. The most common type of rescue inhaler is a beta-agonist bronchodilator. Beta-agonist drugs provide short-acting, quick relief of wheezing and chest tightness. The most common rescue drug is albuterol (brand names Ventolin, Proair, Proventil). Never leave home without your rescue inhaler!
A rescue inhaler should only be used to treat a sudden asthma attack. If you're using your rescue inhaler more than a couple times a week, you need to be on a preventative medication. This is important, because long term inflammation can damage to your lungs over time. Corticosteroids are the most effective treatment for long-term control. Steroid inhalers work by reducing inflammation, swelling, and mucus production in the airways. As a result, the airways are less inflamed and less likely to react to triggers.
The two most common types of preventative inhalers are combination inhalers and inhaled corticosteroids. Inhaled corticosteroids should be the first line of treatment for asthma that is not adequately controlled with occasional use of a rescue inhaler. Inhaled corticosteroids include Qvar (beclomethasone), Flovent (fluticasone), Pulmicort (budesonide), and Asmanex (mometasone). These medications come in different strengths and are used once or twice daily for maintenance.
Combination inhalers include an inhaled corticosteroid in addition to a long-acting bronchodilator. These inhalers include Advair (fluticasone/salmeterol), Symbicort (budesonide/formoterol), Breo (fluticasone/vilanterol), and Dulera (mometasone/formoterol). These inhalers are used once or twice daily, depending on the severity of symptoms. Combination inhalers should only be used when asthma is not adequately controlled with an inhaled corticosteroid alone.
This chart contains a helpful comparison of the most commonly prescribed inhalers.