Inhalers The Most Effective Asthma Control Method: Experts

RESPIRATORY health experts say inhalers work more effectively than oral suspensions and tablets in the management of asthma in children and adults.
By Kudakwashe Pembere
Health workers often tell patients inhalers are not the best way to control asthma as chances are high they can be forgotten. But in an interview, Professor Hilda Mujuru said health workers have been spreading the wrong message.
She said what needs to be understood is that inhalers if used correctly, they effectively act on the lungs, unlike tablets or suspensions which circulate all over the body.
Dr Mujuru also said most people often have hyped heartbeats, tremors and shivers because the suspensions or tablets would have gone where unneeded.
She said the world even closer to home in South Africa, they have shunned the suspensions.
So what we are trying to do and what the world has done, if we cross our boarder, if we cross to the south where a lot of us cross, you will not see an oral. You will not see oral salbutamol. You will not see oral suspensions.  If you go north, some north have still got some oral because they are not as rich, inhalers are a bit more expensive than some orals, but some dont even have. If you then happen to get to the developed world they tell us they have got plenty. You will never see an oral, Dr Mujuru said. I always argue that the treatment which you think is the best is being given to a child in the UK, in the US and in Norway. Why shouldnt it be given to a child in Zimbabwe? Why should a child in Zimbabwe get what you think is not the best? So this is the message we are trying to spread. This is what is known that it goes straight and it works if done has been known to work. It has minimal side effects. This is what is done everywhere. That is what we want our children in Zimbabwe to have.
Dr Mujuru added they are trying to change guidelines in the management and control of asthma which might see the removal of oral medications.
So we are going to be targeting the nurses, that even in our guidelines we argue a lot that should we take out oral completely. In the guidelines which are used in the various clinics, they have not taken out the oral. And the reason is they dont have the money to make sure that the inhalers are available everywhere. We are realistic. if we take the oral and your heart beat very fast and your asthma is controlled,  and you are alive, arent you better? Than not taking anything because there is no inhaler. So we still need oral as an option because we know that at the moment we cant afford to make sure that every corner in Zimbabwe has an inhaler. But that is the correct thing to do, she said.
Dr Ismail Ticklay echoed that the misinformation was rife among health workers adding that inhalers are used to children after five.
You will actually in fact become worse because the asthma will not be controlled very well with oral medication. Even with very small children, inhalers are the way to go. Inhalers work very well with the smallest dose, with the smallest children using what they call a spacer. Its like an adapter, its a mask which allows them to inhale the medication at their own pace and thats why we tend to use them to those under five, he said.
He added that the spacers can be used even on adults and children over five. Dr Ticklay also quashed the myth that inhalers can be used forever.
Not necessarily. If the asthma is controlled, you may even come off the medication, he said.
He said spacers are a good alternative for nebulisers in the event that health institutions do not have power.
During this winter we had a lot of children whose asthma was triggered during the night. Now you dont have Zesa, so you cant use the nebulizer. But you dont need Zesa for an inhaler. You dont need Zesa for a spacer. You can take it wherever you want. On the bus. On the combi. In the car. Wherever you get an attack, you use it, Dr Ticklay said.

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