Now the environuts are endangering people's lives...

[imported_elp6n]

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body"><div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: NotSoSilentBob</div><div class="ubbcode-body">The newer inhalers have a shorter opened shelf-life, require more maintenance and record-keeping by the user, and at best under optimal conditions are roughly equivalent in efficacy. </div></div>
Record keeping? [img]/LDPforum/ubbthreads/images/%%GRAEMLIN_URL%%/grin.gif[/img]</div></div>
The amount of usage has to be recorded to know when it runs out. There are only so many dosages per inhaler. With the current inhalers many can tell by taste, but with the new ones not so much because of how different it is.

The ones I know about come with a counter on the bottle. easy records.

[imported_elp6n]

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body">The ones I know about come with a counter on the bottle. easy records.</div></div>
I've never had one with a counter, and the two I have in my purse right now don't have counters.
Are you thinking about the older OTC inhalers perhaps?

No, within the last year. Perhaps you should ask the doc, it would make things easier. But probably a little more costly.

[imported_elp6n]

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Spuds</div><div class="ubbcode-body">No, within the last year. Perhaps you should ask the doc, it would make things easier.</div></div>
Is this albuterol or qvar?

I'm thinking it's albuterol. One of the guys at work is at about 60% lung function and has asthma and carries one all the time. When it gets close to 100 doses, he puts another one in the lunch. Proventil, I think.

These inhalers use a chemical propellant to force a measured dose of medication out of the inhaler. They consist of a pressurized canister containing medication, a mouthpiece and a metering valve that dispenses the correct dose of medication. The medication is released either by squeezing the canister or by inhaling. You may find it easier to use a hand-actuated inhaler with a spacer "? a short tube that attaches to the inhaler. Using a hand-actuated inhaler to release the medication into the chamber gives you time to inhale more slowly. It decreases the amount of medicine that's deposited on the back of your throat and increases the amount that ultimately reaches your lungs.

Some metered dose inhalers have counters so that you know how many doses remain. If there is no counter, you have to track of the number of doses you've used so that you know when the inhaler is out of medication.

The chemical propellant in metered dose inhalers has traditionally been a chlorofluorocarbon (CFC). But after an international agreement to ban CFCs because they damage the ozone layer, other propellants such as hydrofluoroalkane (HFA) are now used instead. The dose of medication released by an HFA inhaler may feel softer and warmer than the dose released by a CFC inhaler. If you're used to a CFC inhaler, it may not seem like a complete dose "? even though the medication is reaching your lungs

http://www.mayoclinic.com/health/ast...halers/HQ01081

The difference is not clinically significant at the usual 2-inhalation dose, but after 12 inhalations with an HFA MDI higher plasma levels of albuterol have been observed than with CFC MDIs. At usual doses, adverse reactions are similar for both CFC- and HFA-propelled albuterol MDIs. At higher doses, the HFA albuterol MDIs have been associated with more systemic beta agonist effects, such as tachycardia, than have the CFC albuterol MDIs. "Pharmacists can reassure patients that they work the same and have the same safety profile," Hendeles said.

There is a product available called the Doser. This is a dose counter that can be attached to MDIs to keep track of how many inhalations have been used. The Doser also tracks how often an MDI has been used over a 30-day period. Hendeles said the Doser costs about $30. The Doser may be helpful for some patients, but what they really need is something that counts both priming and inhaled sprays, Sander said. Her organization asked the FDA to write guidance to industry that manufacturers put counters on their devices. The FDA has done so, and Sander has learned that Schering and Teva are working on adding dose counters to their products.

So far, he said, about 65 percent of patients have been switched to HFA albuterol MDIs. While encouraging, that still leaves over a third of patients who have not. Also, the percentage does not seem to be evenly distributed across the country. Binaso noted that the percentage of patients still using CFC albuterol MDIs in Southern states, for example, could be much higher than 35 percent.

The HFA albuterol MDIs cost more than the generic CFC albuterol MDIs, and a generic albuterol HFA MDI will not be available until 2012 or later, Hendeles said. Programs are already in place to help patients pay the higher cost of the brand-name HFA inhalers. Most insurance companies will pay for at least one of the albuterol HFA MDIs. But even at the preferred brand level, the co-pay for the HFA product will be higher than for a generic albuterol MDI. Hendeles suggests that pharmacists help patients by checking with their insurance companies to see which albuterol HFA product is preferred and then have prescriptions changed accordingly. All three manufacturers of albuterol HFA MDIs have established assistance programs to supply inhalers to uninsured patients who meet certain income limits. In the end, Hendeles said, the cost of the albuterol HFAs should not be a huge issue. Albuterol is a short-acting beta agonist (SABA) and is intended for use on an as-needed basis. Ideally, SABA inhalers should last for months, so patients should only have to pay for them a few times a year.

http://www.modernmedicine.com/modern...date=&pageID=2