Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.


Subscribe or Register

Existing user? Login


A quick intervention recommendation for patients using inhalers

Many pharmacists are probably busy reviewing inhaler use and technique as part of their medicines use reviews and new medicine service processes for patients with asthma and chronic obstructive pulmonary disease (COPD).

The long-acting beta-2 agonist formoterol is a common ingredient in step-up therapy for asthma after an inhaled corticosteroid inhaler (e.g. in Fostair or DuoResp products). Glycopyrronium, umeclidinium and aclidinium are also now used for initial regular therapy for COPD (the long-acting muscarinic antagonists in Seebri, Eklira and Incruse inhalers).

All these bronchodilators have rapid onset, typically around 5 minutes, peaking from around 30 minutes to 120 minutes. This is not as quick as salbutamol (3 to 5 minutes), but is more than adequate for a patient who is not in acute respiratory distress.

I have been making a point of making sure that patients use their new inhaler and wait at least 15 to 30 minutes for the bronchodilation effect to kick in before considering using their short-acting bronchodilators. During follow-up reviews, patients tell me they did not need their short-acting beta-2 agonists (SABA) since they started using their new inhaler. One patient was so enthusiastic that he instructed his father to see his GP to request the same inhaler.

Many asthma and COPD patients are still requesting (and being issued) salbutamol alongside their long-acting bronchodilator and there is a real opportunity to make an intervention here because many are just using their SABA routinely ‘two puffs four times a day’ — according to the dispensing label.

I have now amended the label for the SABA inhalers to say ‘When required, use two puffs…’ and discussing how frequently they are being used by the patient every time I hand a SABA out. Most patients dislike using many medicines, so most are delighted with their simplified regimen.

Anne-Marie Kitchen-Wheeler

Beckenham, Kent



Citation: Clinical Pharmacist DOI: 10.1211/CP.2017.20202494

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Jobs you might like

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.