Is That Inhaler Empty?
Daily controller medications are part of my everyday. That also means that keeping on the dose counters on them, is something that I need to keep an eye on. I have to admit that I don't always check the counters dab it is especially dicey when your MDI inhaler does not have a dose counter.
Was I using an empty inhaler?
It started with a breakthrough cough, always a signal that something is on a downward slide. I had been feeling fairly well, and I didn't seem to have any other symptoms. I was wondering if my inhaler was empty. The issue with inhalers that do not have dose counters, is that if you don't keep track of how many doses you have taken. There is a definite possibility that you could be using it and it is empty. I do periodically look at the date on things and since I only get 20 days out of out this particular inhaler. My inhaler is an MDI (so this post will reference those in particular), it has a generally short life span.
Tracking my inhaler usage
I was curious about ways to test my inhaler. After consulting my RT's. Other than being proactive and keeping a journal of the doses or a running tally. There are very few ways to get an accurate determination. There are some does counters that can be purchased separately and fit on the canister of your MDI. They also rely on you remembering to turn a dial or push a button.
Another method that is controversial for testing canister fullness is the "float method". This method essentially has you float your MDI canister in a water bath and depending on the position of the canister, it gives you an approximate volume and dosage. This method is highly variable, product-specific and not particularly accurate1. The preferred method is used either an external counter or a built-in.
Getting to the bottom of my empty inhaler issue
The best solution I could up with at the time was to count back the days from the refill day. Since I am generally excellent with compliance and I take eight puffs a day, I could get a sense of where I am. The downfall of this method is, since I get three refills at a time, this will not always work. The verdict was that by one day, my inhaler was not empty.
I did, however, wonder if it defected and a trip back to the pharmacy concluded, that well it might be, but the evidence was inconclusive. They returned the inhaler back to the drug company for further analysis. They did mention that it was highly unusual for it to have a defect, however, anything is possible.
My inhaler was replaced, accompanied by an information sheet that included making sure that I periodically check my inhaler for foreign objects that may be getting in the way of proper use. I have to admit that I often have crumbs in my bag and I have had to shake out an inhaler or two before use. I will be using this advice to ensure that everything is working smoothly.
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