Improper Use of Inhalers Causes Problems
Scientists believe that they may have solved the mystery behind misuse of inhalers. Airway opening inhalers such as albuterol, ventolin, and salbutamol appear to cause a biochemical reaction that aggravates swelling in the body's airway. The swelling, in turn, can block airflow and make breathing harder. A new generation of medications known as beta2-agonists has allowed asthma patients to breathe more easily by opening up the airways. Physicians, however, have known for a long time that those patients can relapse if they do not use another type of inhaler that reduces inflammation in the airway. The bronchodilating inhalers-known as "relievers"-are a good temporary measure "because they save lives while you do the things you need to do to reduce inflammation," said pulmonologist Thomas Stibolt, MD, of the Kaiser Permanente health plan in Portland, Ore. Patients, however, are often so impressed by the quick response of the inhalers that they do not use the anti-inflammation inhalers-known as "controllers"- that prevent a recurrence. "They say this medication isn't doing anything," Dr. Stibolt said. "But it's preventing a problem, not relieving it. The medications they desperately need to be on don't do anything they notice." As the inflammation on the walls of the airway gets worse, the reliever inhalers fail to work properly as they become overwhelmed. "It actually worsens the problem in the long term." Asthma patients need to understand the importance of using both the reliever and controller inhalers.