Question 1

What is asthma, and how do inhalers work?

Accepted Answer

A long-term condition in which the airways are **inflamed and over-reactive**, narrowing in response to triggers — and the most important thing to understand is that the two main inhaler types do completely different jobs, which is where most poor control originates.

**What happens in the airways:** the lining is chronically inflamed; the smooth muscle around the airways tightens; and mucus production increases. Together these narrow the tube, producing wheeze, cough, chest tightness and breathlessness.

**The two inhaler types:**

**Relievers**, usually blue, containing a bronchodilator that relaxes the airway muscle within minutes. They treat the **symptom** and do nothing about the inflammation.

**Preventers**, usually brown or another colour, containing an **inhaled corticosteroid** that reduces the underlying inflammation over days and weeks. They do nothing in an attack and are what actually control the condition.

**The critical point.** Needing a reliever frequently — commonly defined as three or more times a week — is a sign that the condition is **not controlled**, not that the reliever is working. **Over-reliance on relievers and under-use of preventers is the pattern identified repeatedly in reviews of asthma deaths**, and guidance has shifted substantially towards combination inhalers containing both.

**Why technique matters so much.** A large proportion of people use inhalers incorrectly, delivering the drug to the mouth and throat rather than the lungs. **A spacer improves delivery considerably** and should be used with most metered-dose inhalers, not only by children.

**Common triggers:** respiratory infections, which are the commonest; allergens including pollen, dust mites and animals; cold air; exercise; smoke and air pollution; and some medications.

**What good management involves:** a **written asthma action plan**, which is associated with better outcomes; annual review; checking inhaler technique at every opportunity; and treating worsening symptoms early rather than waiting.

**When it is an emergency:** a reliever not working, difficulty speaking in full sentences, lips or fingers turning blue, or exhaustion. **Call emergency services — do not wait to see if it settles.**

General information, not medical advice.

Question 2

Why does a cough linger for weeks after you feel better?

Accepted Answer

Because the infection clearing and the airways recovering are separate processes, and the second takes considerably longer. What a cough is. A protective reflex clearing the airways, triggered by

Question 3

How do painkillers actually work, and why do different ones suit different pain?

Accepted Answer

Because pain is not one thing. Different painkillers act at different points in the chain between tissue damage and the conscious experience of pain, which is why matching the drug to the mechanism

Question 4

How does general anaesthesia work?

Accepted Answer

Remarkably well, and we do not fully know why — which is one of the more striking gaps in modern medicine given that it is administered millions of times a year with an excellent safety record. What

Question 5

How can I tell if I have allergies or a cold?

Accepted Answer

To tell if you have allergies or a cold, note symptom duration, nasal discharge, itching, fever presence, and onset speed. These factors help differentiate the two.

Question 6

What is sleep apnoea, and why does it matter?

Accepted Answer

Repeated interruption of breathing during sleep, lasting seconds at a time and occurring anywhere from a few to hundreds of times a night — and it matters because the person affected is usually

Question 7

Why does the same drug have several different names?

Accepted Answer

Because a medicine carries up to three distinct names serving different purposes, and confusing them is a genuine source of medication errors. The chemical name describes the molecular structure

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