Dr. Andy: Used correctly, inhaler effective

The metered dose inhaler, also known as the pump inhaler, has been the main treatment for lung problems such as asthma since it was first sold in the 1950s. For most it is a convenient and cost-effective way to get medications such as Albuterol into the lungs. Earlier this year a major change in these devices occurred, a change which several of my patients are convinced has made their inhalers less effective.

In the past, the propellant in inhalers was a chlorofluorocarbon (CFC) such as freon. However, as freon has disappeared from our air conditioners, so it did from pump inhalers. In fact CFCs have been banned internationally. Today, the inhaler propellant is a hydrofluoroalkanes (HFA).

In the older CFC inhalers, up to 80 percent of the aerosol one breathed in from the inhaler was the propellant. The CFC also caused the cold sensation that many patients associate with their old inhaler medications. The newer HFA inhalers don't have the same cold sensation, and also do not propel the medication at as high a speed. This results in more medicine actually being delivered into the lungs.

Discussions of pump inhalers would also not be complete without mentioning spacers, or holding chambers. These are usually plastic tubes with the inhaler plugged into one end, and the other end in the patient's mouth. Using a spacer dramatically increases the effectiveness of pump inhaler medications.

Using a spacer with a pump inhaler has been shown in repeat studies to help kids with asthma improve faster than when treated with an inhaler without a spacer attached. There is also no need to coordinate the inhalation with the pumping of the inhaler.

The spacer allows more medication to get to the lungs by allowing it to slow down in the chamber, and may reduce some common complications with inhaled steroids, such as oral thrush. For younger children, a mask can even be fitted to the mouth end of the chamber.

Be sure to clean your spacer chamber prior to using it with a mild dishwashing detergent, and repeat that cleaning process occasionally. This will reduce the electrostatic charge that can build up on the plastic, which attracts the medication particles, reducing the amount available for inhaling into the lungs.

In regard to nebulizer machines vs. the pump inhalers with a spacing chamber, numerous repeat studies have shown that a correctly used pump inhaler with a spacing chamber is as effective, if not more effective, than a nebulizer treatment. The significantly lower cost of inhaler medication, ease of portability and lack of reliance upon electrical equipment are just added benefits of inhalers over nebulizer machines.

So if you, or your child, use an inhaled medicine, be sure to talk with your doctor to verify you are using it correctly. Don't be afraid to ask questions, and remember - we work for you.


P.S. prevent asthma attacks by eating Vitamin C and Vitamin D rich foods and fruits.



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