Several types of asthma medications come in pre-filled inhalers. These sprays have some very important differences.
Rescue Inhalers Treat Asthma Attacks
Recent laws aimed at preserving the ozone layer of Earth's atmosphere have forced a change in propellants used to deliver bronchodilating medications. Chlorofluorocarbon (CFC)-propelled albuterol inhalers are now banned from the market and have been replaced by Proventil or Ventolin inhalers that use a substance known as HFA in place of CFC. The result is that some so-called asthma "rescue inhalers" now contain chemicals that actually trigger attacks in some asthmatics. According to manufacturer Schering-Plough's website, "Rapid heart rate, vomiting, chest pain and palpitation occur more frequently with HFA Proventil" than with CFC albuterol inhalers. More than twice the incidence of side effects are reported by asthmatics using the new inhalers; so many that a significant number are buying CFC albuterol online from foreign pharmacies.
When using a rescue inhaler it is important to use it properly. Spraying too many times too close together not only wastes medication but increases the likelihood of side effects, including throat irritation. A spacer mixes active ingredients with a small amount of air, making inhalation easier and increasing absorption. The usual prescription is for two puffs, one minute apart. Sixty seconds is required for the first puff to open airways, making it possible for the second puff to fully reach the delicate bronchial tissue.
Ticklish lungs can become dependent on rescue inhalers and the chest may begin to tighten every four to six hours over time. Frequent use is an indication that symptoms are not well controlled and that other medications should be added to the asthma regimen.
The Second Approach to Asthma Is Treatment of Inflammation
Steroidal medication reduces inflammation in airways but long term use of pills or injections have resulted in increased infections, weight gain, fluid retention, suppressed adrenal gland function (Cushing's disease), thin skin that bruises easily and heals slowly, calcium loss (osteoporosis), high blood pressure, high blood sugar, glaucoma, cataracts, and mood swings. Inhalers provide smaller doses directly to the lungs, minimizing side effects. However, it is important to use steroid inhalers exactly as directed, usually twice a day, and to rinse the mouth with water after each use.
Black Box Warnings on Combination Inhalers
Beta-agonist long-acting bronchodilators found in combination with steroid medication in Servent, Symbicort, and Advair have benefits that may outweigh rare but serious risks of using these medications. Studies conducted by the manufacturers in 1996 determined that 13 of 13,179 participants died from severe asthma attacks brought on by the medication itself. The FDA required a "black box" warning to be added to prescribing information and product inserts, stating the risk of sudden death is associated with these medications. It is very important that patients do not exceed prescribed doses of these drugs.
Inhaled asthma medications provide relief of acute symptoms, reduce inflammation that causes airways to be ticklish, and new long-acting drugs offer better control but are not without risks. There is a choice of asthma remedies on the market and patients need to understand how they work to achieve compliance and better results.
References
The National Campaign to Save CFC Asthma Inhalers, www.savecfcinhalers.org
Schering-Plough Proventil homepage, www.proventilhfa.com
Food and Drug Administration, www.fda.gov/drugs/drugsafety , March 2, 2006
Physicians' Desk Reference, PDR, 63rd ed., Thomson Reuters, 2009
Mary Earhart - Mary Earhart, RN, BSN, is a Licensed Midwife. She has written articles for professional journals and grants for non-profit agencies as ...
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