pros and cons of different inhalers

hi, i'm writing a study on how asthma inhalers have changed over the years, and would really like it if you could tell me a bit about how your inhaler works, how easy it is to use and anything else about it.

Also if anyone has used an old inhaler please could you tell me about that too.

If anyone is an asthma nurse or works in that field then please could you tell me what influences your decision to provide a particular make of inhaler as i have noticed that each centre tends to only supply one make of inhaler.

thanks,

zoe

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  • Hi Zoe - sounds like you have an interesting project there!

    I am a GP Registrar working in Primary care so i prescribe inhalers on a fairly regular basis. I'm also asthmatic myself, but most of my experience in different inhaler devices comes from my professional experience rather than personal experience.

    Inhalers tend to come in two main ""varieties"" - either aerosol inhalations or dry powder inhalations. The ""standard"" kind of inhaler is the Metered Dose Inhaler (MDI) - this tends to be the kind of inhaler you see portrayed in the media, i.e. the ""puff and inhale"" kind of inhaler. It tends to convenient to use, acceptable to most people and easy to carry around. However in order to maximise drug delivery to the lungs you needs fairly good co-ordination in order to correctly time the ""puff"" with the ""inhale"" - so that you don't end up spraying the medication all around your mouth but not inhaling any of it. Easier said than done. In order to improve drug delivery a lot of people will use a spacer device with this kind of inhaler. Another option, particularly for those who find it difficult to co-ordinate using an MDI in an acute attack, is an ""Easibreath"" or breath-actuated inhaler - these have a special built-in device which automatically ""puffs"" the inhaler when you start to breathe in through it. Breath actuated inhalers vary slightly as to design but all work in basically the same way. Devices include Easibreath and Autohaler.

    The dry powder inhalers are preferred by some other people as well, and again removes the worry about co-ordination. These devices contain a powder which is inhaled via deep inhalation into the lungs, and don't require you to ""puff"" them at all. They can come in several different formats - Rotacaps were an old design which has now been discontinued; Diskhalers are also being slowly withdrawn and are now being superceded by accuhalers (the ones that look like flying saucers). Handihaler is another device which is very like the old Rotacaps device in principle. These devices do require you to have a certain amount of inspiratory flow, so won't necessarily be useful for people with very poor lung function.

    What influences my decision as to which device to prescribe? What I prescribe is the device that suits the patient, what they are able to use and what they find acceptable to use. It's no good prescribing an inhaler that the patient can't or won't use because they find it unacceptable or too difficult - from an health economics point of view that's wasting money to no benefit of the patient. If you get the right inhaler device, you're more likely to get a better response to treatment. That's good practice, and everyone benefits.

    I'm not sure what you base your comment about ""each centre seems to supply one make of inhaler"" - based on the above rationale you may very well see a variation in the kinds of inhalers prescribed. Bear in mind the MDIs tend to be the most commonly used inhalers, so you are likely to see a lot more of these prescribed. Also consider that certain types of medications don't come in all varieties of inhaler. And....that we only prescribe, say, ""Salbutamol CFC-free breath-actuated inhaler"" - the inhaler supplied by the pharmacy may then be, for example, either an Autohaler or an Easibreathe.

    Ahhh, the joys of inhalers.

    I'm bound to have missed something. No doubt someone will be able to give examples of other inhalers if I have, particularly older styles.

    Good luck with your project

    CathBear

  • Hi Zozzles,

    I use aerosol steroid inhaler and for salbutamol but use a Formoterol turbohaler as a long-acting dilator. My beclamethasone has recently been changed to Clenil, basically same drug but cfc free propellant. The only reason I use a turbohaler is because I reacted to serevent. I use a spacer with the aerosols. I prefer aerosols because I feel I am getting the whole dose by using the spacer. If my lungs aren't so good I don't feel I get the whole dose with the turbohaler.

    If you look on the AUK home page there is a link to a page on how to use all the different varieties of inhalers which will show you how many there are.

    Hope that is of some help.

    Ange

  • I now use 2 MDIs with a Volumatic spacer device, I find that when i am very bad it is very hard to take my inhaler, but now with the spacer, that is eliminated.

    Years ago when i was VERY young i used to have a Ventolin Diskhaler. That was an odd device, it consited of a sort of box that you had to slide the draw in and out to get a blister dose. then lift the lid of the box to pierce the blister and let the medicine drop in to a chamber which i then had to suck in to my lungs. Very awkward and probably hard to use during an acute attack really.

    Does anyone remeber or did they have ventolin syrup as a child?

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