Lung Diseases


Asthma is an inflammatory condition of the airways. The walls of the airways have a tendency to be “sore” and because of this may be thought of as being sensitive to Allergies, Animals, Air pollutants,Colds & viral infections, Emotions, Exercise, House-dust mites, Medicines, Moulds & fungi, Pollen, Smoking which cause the airways to narrow. This makes it harder to breath out leading to the characteristic wheeze sound.









You can’t go in with a tape measure to measure this. Hence we use a peak flow meter.You reset the meter to zero. You take a deep breath, put your lips tightly around the mouthpiece and blow out as fast and hard as you can. You always measure the best of 3.






















The peak flow varies depending on the time that you take it even for non-asthmatics. The peak flow is worst in the morning and at night andbetter in the middle of the day. Hence if you are very unwell and it is late seek help sooner as it may deteriorate.

You may keep a peak flow diary and this would help establish the level of asthma/control. It would involve measuring the peak flow and noting the number of puffs of each inhaler used.


You can also use the peak flow when your chest feels tight, use the inhaler and the repeat the peak flow.

The peak flow that you can do depends on your age, sex and height. There are charts on peakflow. com that allow you to predict your peak flow.

Please note these may have changed with the new meters.



Blue inhalers (Relievers) e.g. salbutamol, ventolin open up the airways and are good as relievers. They do nothing to treat the soreness.

Brown inhalers (Preventers)  e.g. Clenil The idea of using the steroid inhalers is that the steroids treat the soreness and hence reduce the sensitivity so hopefully you won’t get wheezy or need the blue inhaler at all.

Sometimes people still need additional inhalers. These contain a long acting form of the blue inhaler that you don’t get used to.



The difference of how much medicine reaches your lung can vary from 5% to 15% depending on how good your technique, so it is important to look at this and please review the videos.

Spacers minimize the problem of technique.


Useful Links

Asthma UK Asthma UK
This website has been revamped to meet the needs of the thousands of people with asthma who visit the site each day, either to find important information about asthma and how to control it

An excellent resource with useful video, audio, images and references relating to asthma.

NHS Choices – Asthma
Further information about symptoms, treatment, causes and prevention of Asthma.


Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. It makes it difficult to breathe. There are two main forms of COPD:

Chronic bronchitis, which involves a long-term cough with mucus.
Emphysema, is a destructive condition of the lungs over time which causes cavities (bullae) to form in the lungs.

Most people with COPD have a combination of both conditions.

Please stop smoking as this reduces the rate of progression !

Other lung disease

In the UK, the british thoracic association is a reputable body that gives advice to professionals such as GPs and nurses. They also provide information and links not just to asthma and copd issues but to a whole range of lung conditions including occupational exposure,cancer Please click on this link

Other Useful Links

NHS Choices
Guide to the symptoms, diagnosis, treatment and risks of COPD from the NHS

COPD Factsheet
This factsheet is for people who have chronic obstructive pulmonary disease (COPD), or who would like information about it.

British Lung Foundation
Information and guidance on living with COPD

Videos of Inhaler techniques by our clinical commissioning group

All inhaler related videos

Pressurised metered device link

Large/Small Spacer links

Accuhaler device link

Handihaler (Spiriva/Tiotropium) device link


Spiriva Tiotropium

This is a very  the good drug. However, if you have had the following please report any heart symptoms to us :

  • myocardial infarction in the last 6 months
  • unstable or life threatening cardiac arrhythmia
  • cardiac arrhythmia requiring intervention or a change in drug therapy in the past year
  • hospitalisation for heart failure (NYHA Class III or IV) within the past year

Report any worsening of cardiac symptoms after starting tiotropium; patients with these conditions were excluded from clinical trials of tiotropium, including TIOSPIR

  • Do not to exceed the recommended once daily dose

Eklira device link

Easibreathe device link

Easyhaler device link





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