Though both are obviously important, long-term and quick-relief asthma medications have key differences. Long-term medications are used to control symptoms and reduce the possibility of your child having an asthma flare-up. Quick-relief medicine is for when your child is having an asthma flare-up, and it acts immediately to bring relief.

• Long-term asthma medicine is taken daily to reduce swelling of the airways. Your doctor may prescribe one or two doses per day, seasonally or year-round. This type of medicine should be taken every day your doctor prescribes it, even if your child has no symptoms of asthma that day. These include:
  • Inhaled Corticosteroids: Controller medicines that reduce and prevent airway inflammation or swelling. Used daily, inhaled corticosteroids help to prevent asthma symptoms from happening. They need to be taken daily to be effective. 
  • Combination medicines: Medicines with both long-acting bronchodilator and inhaled corticosteroids that prevent and reduce swelling of the airway and relax the muscles around the airway for up to 12 hours. 
  • Leukotriene modifiers: Medicines that block the effect of leukotrienes, which are molecules in the immune system that can cause asthma symptoms. Leukotriene modifiers can help prevent symptoms for up to 24 hours.
• Quick-relief asthma medicine (also called “rescue” medication) should be taken as soon as possible after the first signs of an asthma attack (flare-up). These medications act within a few minutes to relax the muscles around the airways and allow more air into the lungs. They have an effect of a few hours. They should be kept with your child at all times to treat asthma symptoms. These include:
  • Short-acting inhaled bronchodilators: Can save your child’s life during an asthma flare-up. They relax the muscles around the airways to open them and help with breathing. They work very quickly but only for a short amount of time (about three to six hours).
  • Anticholinergics: Given with short-acting inhaled bronchodilators for severe asthma flare-ups. Anticholinergics also relax the muscles surrounding the airways to open the airways and help with breathing.
  • Oral corticosteroids: Used for asthma flare-ups that are not relieved by short-acting inhaled bronchodilators. These medicines work to reduce the swelling in the airway.

Many asthma medicines are dispensed using a pressured inhaler called a meter-dosed inhaler (MDI). MDIs can deliver much-needed medicine directly to the airways. In all patients, a “spacer” is needed to make sure the medicine reaches the lungs rather than remaining in the back of the mouth or the throat. Your doctor can help you learn how to use it with your inhaler.

“When and how a child’s asthma medication is administered is tremendously important to their treatment,” says Matthew Hazen, MD, a Pulmonologist at Children's Healthcare of Atlanta.  “That’s why it’s crucial for parents to know how to help their children use their inhalers and spacers properly to deliver the medicine to the airways.”

What is a spacer?

A spacer is a tube-like holding chamber that attaches to an MDI to help deliver the medicine. Not all inhaled medications for asthma require a spacer, but many do. A spacer can:

• Make it easier for your child to take asthma medicine.
• Help the asthma medication reach the lungs.
• Make it easier to press the inhaler pump and breathe at the same time.
• Help your child take long, deep breaths to avoid breathing in the medicine too fast.

How do you use a spacer with an inhaler?

1. First, make sure there is medicine in the inhaler. 
2. Stand or sit up straight.
3. Remove the cap and shake the inhaler.
4. Insert the inhaler into the end of the spacer.
5. Breathe out all the way.
6. Place the spacer mouthpiece in the mouth. If using a spacer with a mask, place the mask firmly on the face, covering the nose and mouth.
7. Press down on the inhaler. 
8. Take a slow, deep breath; hold it for 10 seconds; and then breathe out. If your child is not old enough to do this, hold the mask in place for 10 breaths before removing it.
9. If you are prescribed more than one puff, you should wait 30 seconds before doing the next one. 
10. Rinse your mouth with water, or brush your teeth.
11. Wipe your face if using a spacer with a mask.

Proper care of inhalers and spacers can make sure they deliver your child’s asthma medicine as needed.

How do you clean a child’s inhaler?

• Remove the medication canister before washing.
• Clean the L-shaped plastic sleeve at least once a week with warm water.
• Shake and allow to dry before using.
• Store the inhaler in a safe, dry place (never in a hot or cold car).

How do you clean a child’s spacer?

• Rinse the spacer with warm, running water.
• Pull the pieces apart once a week to clean.
• Soak the pieces in soapy warm water for 15 minutes. Do NOT put them in the dishwasher.
• Rinse the pieces with clean water.
• Allow the spacer to air dry before reassembly.
• Do not clean or dry the inside of the spacer with a cloth or fabric (this creates an electric charge that decreases the amount of medicine that goes into your child’s lungs).
• See manufacturer’s instructions for more information.

Understanding the different kinds of asthma medications and how to administer them can help you, the parent, make sure your child gets all the medication he needs to reduce the symptoms of asthma.