Broadly speaking, there are two ways of delivering a drug to the body – by mouth (tablets, capsules or syrups) and by injection (in the vein or in the muscles)

In asthma, we have another very good route of drug delivery- by inhaling the drug.

So for asthma we can have:

1. Injections
2. Tablets
3. Inhaled medication.

Let us look at them one by one.

Injections: Their usefulness lies in the fact that they act very quickly and hence are used in an emergency. With inhaled medications now available (which also starts working very quickly) the use of injections has gone down considerably.

Tablets: they are cheap. Since they go to all parts of the body (and not only to the lungs where they are required) they cause side effects.

Inhaled medications: This is the best way of drug delivery in asthma. Very tiny doses of the medicine reach the lungs directly where they are required. Since it is not reaching other parts of the body, there are no significant side effects.

Inhaled medication could be thru many kinds of devices:

• Pressurized inhalers
• Dry powder inhalers like Rotahaler
• Disk halers
• Turbo halers
• Nebulizers

Each of these methods has their advantages and disadvantages .Discuss these with your asthma specialist to find which could be most suitable for you.

A few general comments on inhalers:

• They are the most efficient method of drug delivery for asthma
• They are the first line treatment and not the last resort
• They are not habit forming
• Unless they are taken perfectly, the full dose of medicine does not reach deep down in the lungs.

There are many pitfalls in their use. Have your asthma specialist explain and demonstrate the proper use. It is my experience that most patients use them wrongly and thus don’t get the desired benefit. The patients think that since he has been using it for a long time he knows how to use them.