We are more than half way to the asthma inhaler transition.
On December 31, 2008, asthmatics' old tried and true CFC-based inhalers will be taken off the market and replaced with HFA-based inhalers.
The New York Times wrote a piece about the transition outlining some critical differences between the old and the new inhalers.
From the New York Times: "Studies show that HFA inhalers are as effective as CFC inhalers and have the same rate of side effects. But if they are not used properly, patients will not get adequate doses."
There at least four critical differences:
• HFA inhalers must be pumped four times to prime them - a number that was not so critical with the more forgiving CFC inhalers, said Dr. Leslie Hendeles, professor of pharmacy and pediatrics at the University of Florida. And each brand of the newer inhaler requires a different frequency of priming .
• HFA inhalers have a weaker spray. Where CFC inhalers deliver a powerful force that feels as if the airway is being pushed open, the newer ones provide a warm, soft mist that also has a distinct taste.
• The HFA inhalers also require a slower inhale. If people worry that it's not working, they may not take the second puff, may fail to wait the necessary 30 seconds between puffs or may take too many puffs. Their anxiety may rise, further constricting their airways.
• HFA inhalers need to be washed with warm water and air dried once a week. The medication is stickier and will clog the hole, reducing the amount of medication the spray delivers.
"There are also important differences among the brands, though some doctors simply write Albuterol HFA on the prescription, leaving the pharmacist to choose the brand. Only one, Ventalin, has a dose counter, which helps users keep track of how much medication is left. ProAir appears to be on many insurance companies' lists of approved medications, but it has the softest spray..."
How many of you have scheduled appointments with your primary care physicians to discuss your asthma plan, your asthma care and how to use your new inhaler in case of emergencies?
AAFA has a great site called Transition Now that highlights questions to ask your primary care doctor, allergist or pulmonologist.
Questions to Ask Your Physician about the Inhaler Transition
* How can I transition to an HFA inhaler now?
* What should I expect from my HFA inhaler?
* In addition to my quick-relief inhaler, do I need a maintenance medication to manage my asthma?
* Are my strategies for asthma-trigger avoidance up-to-date?"
Too many asthmatics use their inhaler as a the primary treatment in their asthma care plan. As AAFA states: "When you talk to your doctor about transitioning, think about whether you find yourself using your albuterol quick-relief inhaler more than twice a week. If so, your asthma may not be properly controlled and you and your doctor may need to re-evaluate your long-term maintenance plan and the need for other treatments."