Improper Use of Inhalers Causes Problems

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.