How exactly do inhaler work?

Early 20th century writer, Marcel Proust, finished his magnum opus “In Search of Lost Time” from bed— in a cork-lined room to keep allergens out. Proust suffered from severe asthma. At the time, there weren’t great treatments. When breathlessness set in, he’d burn powders that filled the space with smoke and fumes. Or, for a quick fix, he’d smoke a doctor-recommended anti-asthma cigarette. These powders and cigarettes commonly contained thorn apple, which can open your airways. However, both were clearly terrible ideas.

Smoking and fumes bring damaging, carcinogenic toxins into your lungs. Thankfully, today we have inhalers— simple but powerful devices that deliver lung medications straight to the source and without the nasty side effects of smoke inhalation. Inhalers are mainly used to treat two conditions: asthma and chronic obstructive pulmonary disease, or COPD. And there are two main types: preventative inhalers and rescue inhalers. Preventative inhalers can be used every day to control symptoms. There are also rescue inhalers, which are great in an emergency,

but using them regularly can be dangerous. So how do they work? When you take a breath, air travels through your lungs using tubes called airways, or bronchi. The airways funnel to sacs, called alveoli, where your red blood cells absorb all the oxygen your body needs. But if you have asthma, the muscles around your airways may tighten, the lining of your airways may get inflamed, and your lungs may make too much of the mucus they use to trap dust and germs. Essentially, this clogs the pipes and makes it difficult to exhale.

Rescue inhalers deliver a medication called a bronchodilator that quickly relaxes these muscles, making it easier to breathe. These bronchodilators are short acting, lasting around four hours. Rescue inhalers can be used for COPD, too. COPD is a catch-all term to describe the most common breathing conditions, like emphysema and chronic bronchitis, which people often have at the same time. In emphysema, repeated exposure to smoke or irritating particles breaks the inner walls of the alveoli. Because there's less surface area for blood and oxygen to interact,

less oxygen makes its way to your bloodstream, causing you to constantly feel out of breath. In chronic bronchitis, the airway’s lining is inflamed and produces more mucus to trap incoming smoke or dust particles. And the little hairs lining the airways that normally help push the mucus out are often damaged, so the mucus gets stuck. During a COPD attack, rescue inhalers open the airways, just as they do for asthma. Preventative inhalers are used daily to stop asthma and COPD symptoms before they even start.

They often contain both a corticosteroid, which reduces inflammation, and a long-acting bronchodilator. In fact, one class of bronchodilators for patients with COPD is related to the compounds in thorn apples. These drugs block signals from the nerves that tell the airway muscles to contract. Those same nerve signals are thought to be responsible for increasing mucus in the lungs, so these drugs may help clear the airways as well. The real beauty of inhalers is how they get these medications into your lungs.

They work by suspending, or aerosolizing, medications into the air to be easily inhaled. Each type of inhaler does this in a slightly different way. Dry powder inhalers require a person to breathe in to aerosolize a powder medication. Nebulizers, on the other hand, use either ultrasonic vibrations or compressed air to turn liquid medication into a mist. The pressurized metered-dose inhaler works a lot like hairspray. This medicine is dissolved in a fluid called a propellant, and it's under high pressure.

This causes the fluid and medication mixture to shoot out in a fast-moving mist. But this mist can sometimes be hard to coordinate with breathing. So there’s one more device, called a soft mist inhaler, that administers doses at lower speeds, without the use of a propellant. Asthma and COPD each affects hundreds of millions of people worldwide each year. But thanks to inhalers, what once kept Proust confined to a cork-lined room, can now be treated in a few short puffs.Follow for more stories like this.