Medication Classification Tips

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Australian Report states up to 90% of people misuse their asthma inhalers

Hands down, inhalers are the best way to deliver asthma medication. The first metered dose inhaler (MDI) was created in 1953, but was not used in mass market or home use until years later.

The medication, whether it's controller (daily) or rescue (fast acting to stop an attack), the inhaled medication acts quickly and goes exactly where it needs to. The medication breaks down into small molecules and can get into deep parts of the lungs where it's most needed.

But according to a statement released by the National Asthma Council Australia in 2009, "up to 90 per cent of patients who use inhalers do not use their inhalers (puffers) correctly."

How do people not know how to use an inhaler, you ask? Its seems like a simple process, push the chamber and the medicine comes out. You inhale it and go on with your day, but it does take coordination. There are ways everyone can misuse the inhaler, therefore not getting the medication's full effect. This can lead to having more asthma symptoms and poorly controlled asthma.

Here are five ways you could be misusing your inhaler.

(1) Not using an aerochamber. Although the thoughts on this vary per doctor and specialist on whether the patient gets the medicine better, the aerochamber can help give medication to those who haven't coordinated the inhale and pump method of administration. This includes those with difficulty holding the inhaler such as people with arthritis or hand injuries.

The aerochamber is great for children who don't know when to breathe in for the medication. It also helps eliminate the bad after taste some people complain about when placing the inhaler in their mouths.

(2) Pumping in multiple doses. Each inhale of medication is for one puff. If two to three puffs are administered at the same time, with or without the aerochamber, aren't going to save time. The medication is designed to be given in one dose increments so the extra is being wasted.

(3) Not shaking medication between doses. It's important to shake up the puffer before giving it. Like many things, molecules can settle at the lowest point of the canister. Shaking it up helps more evenly distribute the medication before it's given.

(4) Taking too quick of an inhale. The medication is better penetrated when inhaled slowly and deeply. If the person takes a quick intake of breath, the medication can't get to those small spaces in the lungs.

(5) Not exhaling before taking inhaler. To give your lungs the space they need for the slow, deep breath, asthmatics should take a good exhale before the slow inhale. This empties the lungs and gives the asthmatic plenty of room for the medication.

Any asthmatic, especially those who are newly diagnosed can have quite a bit of trouble figuring out all the techniques. If there is any question or confusion on the medication and how to take it, call your physician or check into many free classes offered by the local chapters of the American Lung Association (, Asthma and Allergy Foundation ( or your local hospital facilities.


Asthma, Child Abuse, and Second-Hand Smoke

It's obvious that an asthmatic shouldn't smoke, but what if the asthmatic is a child?

Parent’s second hand smoke is not only an obvious trigger to a child's asthma, but some states and custody cases, can be seen as a form of child abuse.

There are three categories of abuse, mild (not restraining a child in a car seat), moderate (i.e. child consistently dressed in shorts and no jacket in the winter), and severe (e.g., a child with asthma who has not received appropriate medications over a long period of time and is frequently admitted to the hospital). In these cases of severe child abuse, CPS should be and is usually involved, as is the legal system.

According to statistics from the San Antonio Tobacco Prevention and Control Coalition, more than 126 million nonsmoking Americans continue to be exposed to secondhand smoke in homes, vehicles, workplaces, and public places. Among these, 200,000 to 1 million are children with asthma.

Asthma isn't the only problem kids have when inhaling second hand smoke. They are more likely to have chronic sinus infections and ear infections as well as more asthm attacks. This is one of the reasons asthmatic children miss school so much. In fact, childhood asthma is one of the number one reasons that kids miss school.

Because of the severity of the chronic illnesses and the potential for scarring of the lungs with repeated and poorly controlled asthma, courts have ruled that smoking around children can be a form of child abuse.

In custody battles, it is not unusual for the non-smoking parent to file and win primary or full custody of the child because of the risks of secondhand smoke. In cases where both parents smoked and the child had chronic problems with asthma, there have been cases where the child was removed from the home and placed with a third party.

Many believe if the person smokes away from the child, in another room or outside, it will help. Problem with that theory is the smoke and chemicals in the cigarettes cling a person's clothes, hair, breath, skin. Even if the person changes clothes before being around the child, the child can still be exposed to 4,000 chemicals compounds and 69 of those chemicals are known to cause cancer.

These chemicals can set off even a well controlled child’s asthma and may send the child to the hospital. If there are enough cases of admission, Child Protective Services can get involved and a child can be removed from the home.

If a smoking parent is worried they will be reported for child abuse due to the child’s repeated asthmatic problems, don’t refrain from the child being seen because if the child suffers severely due to lack of medical attention, this can be seen as a form of child abuse.

Instead, work more towards quitting the habit and improving not only the health of the child, but the parent.

Plus, it can save thousands of dollars a year and keeps everyone out of the doctor’s office.

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Guru Spotlight
Patricia Walters-Fischer