Asthma-Spray online: What inhaler recipe do I need?

Asthma bronchiale affects about 5 to 7 percent of adults in Germany and up to 10 percent of children. It is a chronic and endogenous disease of respiratory tracts, which leads to ingenious breathing, coughing, whistling breath and a narrow throat in the chest.

The disease is not curable, but can be controlled very well with the correct treatment. Most asthma patients can lead to a largely weightless life with an adapted therapy, drive sports and are hardly affected in everyday life.

The asthma therapy is central to inhalers (asthma sprays), which bring the drugs directly into the airways. It is differentiated between emergency inhalers (reliever) and permanent drugs (controllers) that play different roles in the treatment.

Emergency inhalers (Reliever): Shortly effective beta-2-sympathomimetics such as salbutamol extend the cramped bronchi within minutes. They are used in acute breathing and should always be ready to handle. If the emergency spray is rated more than twice a week, the continuous medication is probably not optimally adjusted.

Continuous Media (Controller): Inhalative corticosteroids (ICS) such as Budesonid or Fluticason have received chronic degeneration in the respiratory tract and are the remnant of asthma therapy. They are applied regularly (actually) even if there are no complaints. The effect builds up over days to weeks.

Combination inhalers: Praeparates such as Budesonid/Formoterol or Fluticason/Salmeterol combine an inhalative corticosteroid with a long-acting bronchodilatator in a kerate. They simplify therapy and improve compliance, as only an inhaler is denounced.

MART concept: Some combination inhalers (Budesonid/Formoterol) can be used both as a permanent medication and as an emergency spray (Maintenance and Reliever Therapy). This concept further simplifies therapy and reduces the number of severe asthma attacks.

The asthma therapy follows a step-by-step scheme that is adapted depending on the burden of complaint:

Level 1 (object symptoms): Low-dose ICS/formoterol or salbutamol in case of complaints.

Stage 2 (light asthma): Regular use of low-dose ICS plus, if necessary, reliever.

Stage 3 (medium asthma): Low-dose ICS/LABA combination as continuous therapy.

Stage 4 (heavy asthma): Medium to high ICS/LABA dose, optionally plus additional add-on therapy such as LAMA (tiotropium) or leukotriene antagonists (Montelukast).

Stage 5 (slightly uncontrolled asthma): Biologics (anticoerper such as Omalizumab, Mepolizumab, Dupilumab) with heavy allergic or eosinophilic asthma. These are usually prescribed by the pneumologist.

It is important to carry out regular examination: if the asthma is well controlled, the therapy can be gradually reduced. In case of deterioration, the stage is raised.

Studies show that up to 80 percent of asthma patients do not apply their inhaler correctly. A faulty technique means that the drugs do not get sufficiently into the respiratory tract and the therapy remains ineffective.

Dosing aerosol (spray): Coordination of extinction and inhalation is crucial. Breathe slowly and deeply, then stop the breath for 5 to 10 seconds. An inhalation aid (spacer) significantly improves the active substance deposition and is particularly recommended for children and older patients.

Dry powder inhaler: Requires a juicy, fast Einatemsog. The advantage: no coordination between exhaustion and inhalation. Disadvantage: In the case of very heavy breathing, the breathing force can be inadequate.

Let your doctor or pharmacist show and control inhalation technology. Even experienced patients benefit from occasional refreshments of technology.

All asthma inhalers (except salbutamol in very low dosage in some laenders) are subject to prescription in Germany. Follow-up recipes can be easily displayed online via telemedical platforms.

Suitable for online recipes: Patients with known, well-set asthma, which require a follow-up recipe for their usual inhaler. The doctor pauses the current symptom control and presents a new recipe with a stable situation.

Not suitable for online recipe: First diagnosis, poorly controlled asthma, frequent emergency spray use or the desire for a therapy conversion. In these cases, a personal examination by the pneumologist or pediatrician is required.

You can obtain your asthma-following recipe by telemedicine. Enter what inhaler you use, how often you use your emergency spray and whether your complaints are well controlled. The attending physician then assesses whether a follow-up prescription can be issued.