Aerosol addiction

Article Abstract:

The case of a mildly retarded 27-year-old man with asthma who abused aerosol inhalers to an extreme degree is reported. When he was six years old, he and his family moved to England from India. He was physically and mentally stable until age 19 when his parents arranged a marriage for him. Two months later he had his first severe asthma attack. After treatment with salbutamol (an adrenergic bronchodilator) inhalers, his asthmatic symptoms abated. Over the years, asthma attacks were continually treated with adrenergic bronchodilators. Abuse of inhalers also steadily increased over the years. He would demand inhalers and become verbally and physically aggressive if they were not available. At age 22, the patient was admitted to a psychiatric hospital. He seemed to be psychotic, and his behavior was odd. He had delusions of grandeur in which he felt he could cure his family members of all their ailments. In the hospital, aerosol use was reduced and he was treated with antipsychotic medication. All symptoms resolved within a few days. During the next year he became addicted to aerosol bronchodilators again, and required further hospitalization due to his aggressive behavior. A third admission occurred because he punched and kicked his sister and permanently damaged his brother's eye. Inhaler treatment was stopped and replaced with theophylline, a bronchodilator that can be administered intravenously or orally. He recuperated and was discharged. It is believed that fluorinated hydrocarbons, rather than the active agents in the inhalers, may be responsible for the stimulating and addictive effects of aerosol inhalers. It is suggested that conversion to a dry powder system of medication can prevent addiction and allow for more careful dose monitoring. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Complications and side effects, Substance abuse, Bronchodilator agents, Solvent abuse

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Montelukast for persistent asthma

Article Abstract:

The FDA has approved montelukast for the treatment of asthma. Sold under the trade name Singulair, the drug belongs to a class of drugs called leukotriene receptor antagonists. It blocks the action of leukotrienes, which are chemicals produced by the body during inflammation. It is effective in children but as always, more evidence of its long-term effectiveness is needed. It does not appear to be as beneficial as inhaled corticosteroids, but may be easier to take because it comes in tablet form.

Product/Service Evaluation, Singulair (Medication)

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Metered-dose inhaler accessory devices in acute asthma

Article Abstract:

Metered-dose inhalers and accessory devices (MDI/AD) seem to be the best first choice for treatment of children with acute asthma. This is in comparison with small-volume nebulizers (SVN). An analysis of 17 clinical trials concluded that MDI/ADs provide better relief of symptoms and are safer. In addition, they are less expensive, require less attention from medical staff, and are easier to use.

Drug delivery systems, Dosage and administration, Antiasthmatic agents, Nebulizers and vaporizers, Nebulizers (Medicine), Vaporizers

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