Asthma affects 5.4 million people in the UK and causes approximately 1,400 deaths per year — the vast majority of which are preventable with better management. Understanding your individual trigger patterns and how your medications work is the foundation of safe, effective asthma control.
The Physiology of an Asthma Episode
Asthma involves three processes that narrow the airways: chronic eosinophilic inflammation of the bronchial wall (thickening the mucosa), bronchospasm (smooth muscle contraction narrowing the airway lumen), and mucus hypersecretion. The resulting airway narrowing produces the characteristic wheeze (high-pitched sound from turbulent flow through narrow airways), breathlessness, chest tightness and cough — typically worst at night and early morning when vagal tone is higher.
Identifying and Avoiding Your Triggers
Respiratory infections — viral URTIs are the most common asthma trigger at all ages. Prompt treatment of infections and flu vaccination are high-priority preventive measures. Allergens — house dust mites, pet dander, pollen, mould. Allergen avoidance measures (mite-proof mattress and pillow covers, regular vacuuming with HEPA filter, avoiding pets in bedrooms) can significantly reduce symptoms. Exercise — exercise-induced bronchoconstriction affects ~90% of people with asthma. Pre-exercise SABA (2–4 puffs salbutamol 10–15 minutes before activity) and proper warm-up reduces this significantly. Well-controlled asthma should not limit exercise. NSAIDs — ibuprofen, aspirin and naproxen trigger asthma in approximately 10–20% of adult asthmatics. If you have NSAID-sensitive asthma, use paracetamol for pain relief. Cold air — breathing cold dry air triggers bronchoconstriction. Wearing a scarf or buff over mouth and nose in winter warms inspired air effectively. Occupational exposures — isocyanates, flour dust, latex, wood dust and many other workplace substances cause occupational asthma. If symptoms are consistently worse at work and better on holidays or days off, occupational asthma should be investigated.
Your Medications Explained
SABA (Short-Acting Beta-Agonist) — salbutamol (Ventolin), terbutaline (Bricanyl). The “blue reliever” inhaler. Relaxes bronchial smooth muscle within minutes. Should be needed no more than 2–3 times per week — more frequent need indicates inadequate preventive control. ICS (Inhaled Corticosteroid) — beclometasone, budesonide, fluticasone. The “preventer” inhaler. Reduces chronic airway inflammation with daily use. Must be taken every day regardless of symptoms — it does not work acutely during attacks. Rinse mouth after each use to reduce oral candidiasis risk. LABA (Long-Acting Beta-Agonist) — salmeterol, formoterol. Always used in combination with ICS in asthma (never as monotherapy). Peak flow monitoring: a peak flow meter measures maximum expiratory flow and tracks asthma control over time. Personal best readings form the baseline; progressive decline (particularly to 50–75% of personal best) should trigger written action plan steps.
Frequently Asked Questions About Asthma
Can you grow out of asthma?
Childhood asthma frequently improves in adolescence as airways grow. However, many people retain heightened airway reactivity and approximately 30–50% experience recurrence in adulthood. “Outgrowing” asthma doesn’t mean the underlying airway hyperreactivity is fully resolved.
Are steroid inhalers safe long-term?
Yes — inhaled corticosteroids at standard doses are safe for long-term use. Systemic absorption is minimal. Local side effects (oral thrush, hoarse voice) are largely prevented by rinsing the mouth after each use and using a spacer device. Using the minimum effective dose with regular review is best practice.
Do I need to use a spacer?
A spacer is strongly recommended for all pressurised metered-dose inhalers (pMDIs). It slows the aerosol plume, reduces the particle size, and removes the need for precise coordination of pressing and breathing. Studies consistently show spacers improve lung drug delivery and reduce oropharyngeal deposition compared to pMDI alone.
What should I do during an asthma attack?
Use your SABA reliever (1–2 puffs via spacer if available, repeat every minute up to 10 puffs). Sit upright. If no improvement after 10 puffs, or if symptoms are severe (unable to speak in full sentences, blue lips, exhausted from breathing), call 999. Do not drive yourself. Your written asthma action plan (from your GP or asthma nurse) defines specific steps — every person with asthma should have one.
Browse respiratory medicines at Huncoat Pharmacy. Related: Allergy Guide, Cold & Flu.
At Huncoat Pharmacy: Pharmacy First asthma support, Private prescription inhaler, Browse asthma products.