UNDERSTANDING THE CHANGES IN YOUR
Achange has recently been made in your metered-dose inhalers. While themedicine in the inhaler remains the same, the chemical used to propelthe medicine out of the inhaler has changed. Previously, the inhalerscontained the propellant, CFC (cholorofluoro carbons), which are harmfulto the ozone layer. Inhalers now contain HFA (hydrofluoroalkane), whichis safe, effective and environmentally friendly.
While some of you may have already begun using the new HFA inhalerssince 2008; effective January 1, 2009 the only type of inhalers, whichcan be manufactured and sold, contain the HFA. The new bronchodilatorinhalers are ProAir-HFA, Proventil-HFA, and Ventolin-HFA. Theessential ingredient, albuterol, remains the same for all of theseinhalers. Controller (corticosteroid and long acting bronchodilator)inhalers are also affected by this change.
Thesensation of the HFA spray is less forceful than what you wereaccustomed to with the CFC spray. Some people may think they have notused the new inhaler correctly or gotten the full dose of medication,and can over medicate themselves as a result. In reality, the new softerspray allows the person to breathe the medication in more slowly anddeeply into the lungs, helping to open the airways better. Some peoplehave reported the new inhalers also have a different taste.
Anotherdifference with the new inhalers concerns the cleaning and priming ofthe devices. There is more chance of the sprayer becoming clogged due tolack of cleaning, moisture, or improper priming. This can result in themedication not being expelled when it is needed. This can put a personwith asthma at a greater risk of office or emergency room visits due topoor control. More frequent cleaning is now required to prevent cloggingfrom occurring. After removing the canister from the plastic holder,the holder should be cleaned in warm running water and allowed to airdry. Do not use a cloth to dry the plastic. The canister can be put backin the holder once it is dry.
Primingis the process of pressing down on the canister in the plastic holderto release a spray or puff of the medication. This is required when anew inhaler is being used for the first time or if it has not been usedfor a specific number of days. The inhaler needs to be shaken and thenpressed to allow the medication to be expelled. Depending on thespecific brand of inhaler being used, the number of primes will bedifferent. The patient instruction insert in the inhaler box will tellyou how often and how many primes to do and when to clean the plasticholder. It is very important that you follow these directions.
The cost of the inhalers has also been affected by this change. Sincethe medication is brand name and no generic brands are available, thecost has gone up. This has caused a hardship for some people, especiallyfor those without any insurance. There is still financial assistanceavailable to help with the cost. A list of these resources is printedbelow. You can also talk to your health care provider about this.
Your school nurse is another excellent resource. The nurse can help youand your child by reviewing the instructions and technique for usingthe new inhalers. The nurse can also provide you with other asthmaeducation materials and information as well as assistance with financialassistance.
Financial assistance resources: