I Called It: The Ozone May Not Be Falling, but Something is About to Hit the Fan
It's been more than two years since I posted my screed about CFC-free inhalers under what I thought was the pretty cool title of The Ozone is Falling, The Ozone is Falling. To briefly recap, rescue inhalers for asthma deliver the drug albuterol. The CFC propellant used by the generic inhalers was deemed too dangerous for the environment, and so they were banned. The problem is that the new hydrofluoroalkane (HFA) propellant doesn't seem to work as well, and NOT just because patients aren't used to the weaker "whoosh."
I take a great deal of care explaining metered dose inhaler technique to patients, emphasizing the need to inhale the medicine slowly. As it happens, the lighter "blow" of the HFA inhaler makes this easier. Still, in spite of this, I too am hearing complaints about efficacy.
Now (two years later, but who's counting) KevinMD deigns to weigh in. *Sigh* None of this should come as any surprise. The only thing we're waiting for now is the first reports of deaths from ineffective HFA rescue inhalers. Scary times.