New Albuterol HFA Inhalers May Increase Breath Alcohol

-
In an effort to save the ozone layer, the government has ridiculously mandated the phase out of standard chlorofluorocarbon (CFC) albuterol inhalers, and replaced them with hydrofluoroalkane (HFA).

Yep, in all their wisdom, the feds decided that all those asthmatics puffing away on their albuterol inhalers were creating a larger hole in the ozone layer than a gazillion automobiles or horrendously outdated factories. Don't get me started.

Well, don't puff on that new HFA inhaler within 5 minutes of getting pulled by the police over while you're speeding down the highway in your SUV... turns out that some of the HFA inhalers include ethanol, and it just might transiently raise your breath alcohol (less so than a drink of wine, though). Or so report researchers from Australia in a recent issue of the journal Respirology.

To be honest, if you need to urgently take albuterol, maybe you should just pull over for a while.

So... how long before the Hollywood lawyers start using the "inhaler-defense" at DUI trials?

Comments

  1. Sakina Bajowala, MDMarch 16, 2009 at 2:52 PM

    Thanks for your comment. Some of my patients have also been unhappy with the HFA inhalers. I would not go so far to say that HFA inhalers are causing deaths, though. Although I am not familiar with all the details of the cases described in the articles cited in your post, I think it is fair to say that the no investigation has confirmed HFA rescue inhalers as being responsible for an asthma related death.

    I believe that the main reason that people are unhappy with the HFA inhalers is that they are trying to use them in same way as they used CFC inhalers- this will result in not getting the active medication and only receiving a breath of the inactive component of the propellant.

    HFA inhalers must be shaken well before use. In addition, the HFA inhalers must be primed before use (the numbers of puffs with which to prime and the amount of time withour use before priming is necessary varies with each inhalers, so the onus is on the physician and pharmacist to properly train patients in the use of these inhalers.

    For more information, please see the following document from the Asthma & Allergy Network- Mothers of Asthmatics. This poster describes the differences and instructions for use for the various HFA rescue inhalers currently on the market. http://www.breatherville.org/pdf/HFA_side_by_side.pdf

    When used properly, I believe that HFA inhalers do work. The transition will take some getting used to, though. Ask your asthma specialist to work with you to make sure that your rescue medication is working properly- we will be happy to help you make the transition!

    ReplyDelete
  2. AnonymousMarch 17, 2009 at 4:33 PM

    Dr Bajowala,

    I want to thank you for posting my comment - I respect your blog and your knowledge as a Doctor. It is troubling to me as an asthma patient to have experienced problems with HFA albuterol and to witness what appears to be an alarmingly high number of complaints from people the nation over. If nothing else, I think this is something to keep an eye on and further studies may be warranted.

    Thanks again and kind regards :-)

    ReplyDelete
  3. cdgNovember 15, 2009 at 7:01 AM

    The HFA inhalers are 10 times more expensive (since they are not available in generic) and 10 times less effective. I now use a time-wasting nebulizer in order to get the same relief that the CFC inhalers provided with two puffs.

    But the alcohol-breath problem occurred with the CFC inhalers as well. Pulling over to take one's medicine is no help, since one can be arrested for being DUI if one is simply in a vehicle; he/she doesn't need to be driving!

    ReplyDelete

Post a Comment

Thanks for taking the time to comment on this blog's posts! Let's keep the discussion engaging and free of frivolous advertising or vulgarity. It's a family show, folks!

Popular posts from this blog

The Grotesquely Swollen Apple of My Eye- What to do When Bugs Attack Your Child's Face

-
Image
Son #2 woke up this morning looking like a streetfighter! Dramatic swelling of the eye(s) such as this can occur for a variety of reasons: 1. Allergic reaction to ingested food or drug (generally affects both eyes) 2. Direct contact with environmental allergen or food allergen (can affect one or both eyes) 3. Hereditary or acquired angioedema (can affect one or both eyes) 4. Injury (usually affects one eye) 5. Low protein levels (generally affects both eyes) 6. Infection (generally affects one eye) 7. Insect bite (can affect one or both eyes) In this case, my little one endured a mosquito bite at the outer corner of his left eye yesterday afternoon.  It was mildly swollen at the time, and became progressively worse as the night wore on. Does this mean he has a mosquito allergy? Actually, no more than anyone else.  Certain areas of skin, such as around the eyes and on the lips, are more loosely attached to underlying tissues and muscles than skin elsewhere on the body.  Thi
Read more

Keratosis Pilaris - Or, Why My Kid Looks Like a Plucked Chicken

-
Image
The skin is the body's largest organ. The condition of the skin is, in many ways, a window into our internal health. Therefore, it is only natural that people become immediately concerned by rashes. We often neglect our own elevated blood pressure, achey joints, or other ailments. The onset of a new rash, on the other hand, can quickly lead to a call to the doctor. Interestingly, there is one rash I see in my practice which rarely causes alarm among patients and parents. In fact, it is common for a parent to state, "Oh, that? His sister has that too. In fact, so do I!" Keratosis Pilaris is a common, heritable disorder which results in small bumps consisting of accumulated skin cells and keratin at the sites of hair follicles. It is especially common in people who have a history of allergies. Although it can be mildly itchy, the rash generally does not cause discomfort. Commonly described as "gooseflesh", keratosis pilaris can be a concern cosmetically, lea
Read more

Why Drug Allergies Matter (Or Why Penicillin Allergy is Responsible for My Son's Lopsided Neck)

-
Image
My 6 year son old just got over a rite of passage - strep throat and scarlet fever. Unfortunately, before we could even celebrate his recovery, I noticed a swelling on the left side of his neck. It was red and tender, and it was GROWING. The pediatrician in me worried, "Damn. Lymphadenitis (infected lymph node)". No sooner had we finished one course of antibiotics than we were onto another, and the side effects were bad enough to keep him out of school for another three days. Why did my munchkin suffer so? My answer: Drug allergy. Group A streptococcal bacteria (the cause of strep throat and scarlet fever) is remarkably sensitive to penicillin. Penicillin is the first choice treatment for strep throat, and has been proven to reduce the risk of developing rheumatic fever, a post-infectious complication which can result in chronic heart disease. Problem is, my son is allergic to antibiotics in the penicillin family. At 11 months of age (8 days into his second ever co
Read more