Inhaler reliability/consistency/misfire - British Lung Foun...

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Inhaler reliability/consistency/misfire

Strephon
Strephon

Hi everybody,

I would like to raise an issue and do a straw-poll to see if others have the same experience.

I use an 120puff preventer inhaler - should give 30 days at 4 puffs daily. However, about 2-3 weeks in, just about every month the inhaler stops firing properly. The volume and pressure of propellant is significantly reduced. I think it’s not delivering my meds in the stated dose. I always experience a downturn in symptoms at this time. When I start the new inhaler, they improve.

I have a theory - and in true scientific fashion I would love to be proved wrong - that the inhalers overdeliver dosage when new and heavily underdeliver towards the end of their prescripted time.

This did not happen back when I used the “tall” inhalers but has been a consistent experience since the new smaller (evohalers I think?) were prescribed.

Anyone else?

Best,

Jeff

20 Replies
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Could your hypothesis be an example of the logically particular such as "All swans are purple"? which might confound Popper's falsification theory, in that there could be a purple swan? Your hypothesis about inhalers may well be correct, but is that falsifiable if my tall inhaler works without fault every time?

Incidentally, is your avatar the typical rustic lover of poetry?

Chriskho
Chriskho
in reply to Cateran

🤷‍♀️

Your name reminded me of a poem by Sarah Teasdale, an American poet.

The Look

BY SARA TEASDALE

*

Strephon kissed me in the spring,

Robin in the fall,

But Colin only looked at me

And never kissed at all.

*

Strephon's kiss was lost in jest,

Robin's lost in play,

But the kiss in Colin's eyes

Haunts me night and day.

Thanks for that. I love American poetry. Very fond of Elizabeth Bishop. But my source for that name is a fictional universe where Strephon is the Emporor of a star spanning imperium. The author of that may have got the name from the poet 🌝

Hi Jeff

Do you mean your reliever inhaler (ventolin / salbutamol) 4 x daily?

If you are needing to use your reliever / preventer 4 x daily every day, maybe ask your doctor for a spacer as these help deliver the medicine more effectively to the lungs. Do mention to you doctor you are using it 4 x daily, perhaps you could benefit from a long lasting broncho dilater or just need your inhalers adjusting so they work better for you.

I use the aero chamber when I have chest infection, pneumonia or a cold as at these times I would use the reliever medicine 4 times daily.

The other thing that can hinder inhaler dose is checking for debris and washing the casing and drying only as recommended by the information leaflet that comes with the inhaler medicines.

Both reliever, some preventer inhalers and spacers need cleaning periodically as this does help keep things working as they should. (instructions on cleaning are in the information leaflets how to use etc.)

Just my thoughts on your post.

Strephon
Strephon
in reply to Bkin

Thanks - no it’s preventer I was talking about. It does happen with relievers too. I’ve tried cleaning to no avail. So far I’m not getting the that this is an issue that people recognise but it’s early days...

Bkin
Bkin
in reply to Strephon

What preventer do you take 4 x daily as a matter of interest?

If you can use a spacer with it I would go with that initially.

I was on seretide for years but recently they switched it sirdupla which is a cheaper version. Just recently as the meter gets down to forty or so doses left it seems it’s not firing the full dose. This has happened on the last two inhalers. I don’t seem to have any deterioration of symptoms so wondering whether it’s just manufacturing. Who knows but if it carries on I will requesting to go back to Seretide. Good luck with your investigations

I have noticed this with my Fostair I haler

I have thought for a while that the last 10 doses of my fostair inhaler do not seem full doses.🤔

I use seretide inhaler and have the same issue

I have raised this with my consultant. She said she had not heard of this. So I wondered if there are lots of people out there who have noticed but not reported. Let’s keep collecting opinions and then all flag up to our health professionals. Probably won’t achieve anything but at least it puts the idea out there.

Good point

I found this with the salbutamol evohaler, I specifically asked for an ’old style’ ventolin because of it.

Yes I get it with evohaler too and didn’t get it with the old “tall” one.

I find this with Ventolin, Serevent and Flixotide but not Spiriva Respimat

A nurse demonstrated using evohalers at the first Stoke Breathe Easy group I attended, to make sure we got the best out of our meds.

You should shake the evohaler vigorously before pressing the first dose, to ensure the contents are well mixed. Then wait 30 seconds for the frosting around the nozzle to disperse before vigorously shaking again and taking the second dose.

She recommended using a spacer too, as above.

Strephon
Strephon
in reply to Ergendl

Thanks. Doing all that. It still misfires.

Hi Strephon, this has been reported before, see link

asthma.org.uk/about/media/n...

Strephon
Strephon
in reply to Izb1

Thanks, I think this is a separate issue as it has been ongoing for years, rather than a specific one time fault.

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