Asthma puffers: types, technique and safe use

Puffer is a common name for an inhaler. A reliever is used according to an action plan when airways tighten, while a preventer is taken regularly to reduce airway inflammation. Some devices contain more than one medicine or have specific instructions for both regular and symptom-driven use.

Pressurised inhalers, dry-powder devices and breath-activated devices require different techniques. A spacer can make a pressurised inhaler easier to coordinate and helps more medicine reach the lungs. The colour or shape alone is not a reliable way to identify an inhaler's purpose.

Check the label, dose instructions and expiry, then follow the technique for that exact device. For many pressurised puffers, this includes shaking when instructed, breathing out away from the mouthpiece, sealing lips around it, coordinating actuation with a slow deep breath and holding the breath briefly if comfortable. Device leaflets take priority because steps vary.

Ask a pharmacist, nurse or doctor to watch you use the inhaler rather than only describing it. Keep the mouthpiece clean and dry as directed, track remaining doses if the device has no counter, and replace a damaged or empty inhaler. Rinse and spit after an inhaled corticosteroid when instructed.

Arrange a review if the reliever is needed more often, symptoms wake you, exercise becomes limited, or the device seems less effective. The cause may be poor control, an empty inhaler, incorrect technique or another breathing problem; taking repeated extra doses without following an action plan can delay appropriate care.

Call emergency services for severe breathlessness, inability to speak normally, blue or grey lips, confusion, collapse, or worsening symptoms despite the emergency instructions in your asthma plan. Sit upright if possible, use the prescribed reliever as the plan directs and do not drive yourself when seriously unwell.

Ask what each inhaler contains, when to use it, whether a spacer is suitable, how to tell when it is empty and what side effects to watch for. Have the written action plan updated whenever the device or prescription changes.