See MHRA Drug Safety Alert July 2018 for further details. To prevent objects entering the mouthpiece during storage, the mouthpiece cover should be replaced securely after use. When prescribing a pressurised MDI, remind patients to check and remove the mouthpiece cover fully, shake the inhaler to remove loose objects that may not be visible, and check the inside and outside of the mouthpiece are clear before inhaling a dose. PMDI = Pressurised metered dose inhaler DPI = Dry powder inhaler SMI = Soft mist inhaler BDP = Beclometasone dipropionate
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NICE has produced a patient decision aid to help people with asthma and their healthcare professionals discuss their options for inhaler devices (available here) it is suitable for use by people aged 17 years and over, and many of the considerations are also applicable to patients with COPD.Īdvice on how to obtain placebo inhalers can be obtained from the NHS Devon ICB Medicines Optimisation Team, please contact: information on inhaled corticosteroid dose comparisons in asthma see here When discussing inhaled treatment options, consideration should also be given to the environmental impact of inhalers. Adherence to treatment regimens should also be checked. It is essential that patients can demonstrate the proper inhaler technique when prescribing an inhaler device recheck patient technique at each visit to ensure continued correct use of the inhaler. Patient preference should be considered when prescribing treatments. Prior to prescribing, the relevant Summary of Product Characteristics (SPC) should be checked. Generic prescribing of inhalers should be avoided as this might lead to people with asthma being given an unfamiliar inhaler device which they are not able to use properly in addition, not all inhalers with the same primary ingredient are interchangeable due to differences in particle size.ĭifferent products and doses are licensed for different age groups and some may be applicable only to older children or adults (aged 18 years and over). All combination inhalers included in the formulary are included as branded products.
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