Over-the-Counter Asthma Inhalers Should Be Used Cautiously
Sept. 15, 2000 -- With asthma on the rise in children, many
parents of asthmatics can probably relate to this story. "We've spent many
a night in the emergency room, trying to get Adam's asthma under control,"
Robin Stauffer, Adam's mother, tells WebMD. "He's much better when we keep
him on his medicines and reduce his exposure to things that irritate his
breathing, but every once in a while, we have used an asthma inhaler from the
Robin's use of this type of inhaler, called an
over-the-counter, or OTC, asthma inhaler, is how these medicines should be
used, occasionally and only for mild asthma, according to a special report
published by the American Medical Association Council on Scientific Affairs in
the August issue of the journal Chest. However, a large number of people
who use OTC inhalers may use them too often or for more severe asthma. This
improper use may result in progression of the disease or even death.
"Our recommendation at this time is that labeling on OTC
inhalers should be strengthened to let users know appropriate and inappropriate
use of these medications," Roy Altman, MD, tells WebMD. "An estimated
20% of OTC inhaler users have more severe disease and should be under the care
of a physician with a treatment plan including the use of corticosteroids."
Altman is chief of rheumatology and immunology at the University of Miami and
vice chair of the council.
Altman and his colleagues on the council looked at studies and
reports related to the use of OTC asthma inhalers to assess their safety.
"For the most part, what we're seeing is so far, so good," he says.
"The inhalers have generally been used properly, but the public needs to
know that if they aren't experiencing relief, they need to see a
Altman says this issue is particularly important for older
people. "Older people tend to have more severe disease and may be on a
number of other medicines or have conditions that may worsen with the use of
OTC inhalers," he says. "Any older person who is just starting to
wheeze needs to be evaluated by a physician."
According to Nicholas Malerba, director of respiratory therapy
at Mather Memorial Hospital in Port Jefferson, N.Y., use of OTC asthma inhalers
often results in patients' not seeking medical attention, which can have very
serious consequences. For this reason, he maintains that OTC inhalers should be
taken off the market.
Malerba tells WebMD, "We have gotten a lot of patients who
come in here after using an OTC inhaler improperly. They think that if a little
is good, a lot must be better, and that's simply not true. They end up with
rebound effect [where their air passages shut down], and it's very difficult
for us to pull them out of it."