On 4 April 2017, GlaxoSmithKline, the world leader in Respiratory Medicines, recalled nearly 600,000 Ventolin inhalers in the USA, citing a possible defect. Ventolin (Albuterol) is used for dilating the airways in conditions like asthma. The inhaler is designed in such a way that it delivers the correct amount of dose to the patient. In addition, there is a meter on the inhaler that lets the user know how many doses are left.
The problem: Inhalers
According to the press release by GSK, there is some issue with the metering of the inhaler. Each 'actuation' of the inhaler is supposed to deliver the dose. However, that may not be the case as observed with the inhalers of these lots:
A puffing of the package was observed in a few units, possibly caused by the leakage. As a result, these lots have been recalled, albeit at a pharmacy level. The recall, classified as Class II according to the FDA is because "(the) use of, or exposure to, a violative product may cause temporary or medically reversible adverse health consequences or where the probability of serious adverse health consequences is remote"
Patients who are using may still use them, however, it could lead to sub-optimal dosing towards the end.
Quick recap on how to use an inhaler
I had an opportunity of working with these products as a doctor. In my practice, I observed that many times, a patient does not use the inhaler correctly. This leads to the medicine being deposited in the mouth instead of the airways, where it is supposed to work. I recommend using a spacer if your child is quite young. A spacer is a tube where the medicine will sit, removing the need for a coordination.
I am sure your child might be using it correctly, however, this is a quick recap on how it is supposed to be done.
This is one of my favourite videos for your child if he uses one.
To summarise,
- Sit up straight.
- Shake the inhaler 5 times, prime it if used after a long time.
- Attach the spacer to the inhaler.
- Breathe out as much as you can.
- With the chin up, oppose the spacer against the mouth.
- If it comes with a mask, make sure that there is no gap.
- If it is a breath into type, make sure that the lips are sealed against the oral end of the spacer.
- With the chin slightly up, actuate the inhaler. The medicine will be available inside the spacer.
- Breathe in and out six times to get the maximum effect of the medicine.
- If more than one puffs are recommended, repeat the process all over again.
- After you are done, make sure to clean the spacer, following the manufacturer's instructions.
If your child is big enough, you may exclude the spacer altogether. In that case, you could watch this video for the proper technique. It is not that difficult, but a certain amount of practice is required. Feel free to consult your doctor about the correct technique.
Remember mums and dads, it is vital that you supervise the use of an inhaler till your doctor is satisfied. Always read the storage and cleaning instructions provided by the manufacturer. Don't use it beyond the duration indicated.
Also read: First aid tips: What to do if your child has an asthma attack
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