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Generic prescribing of inhalers should be avoided as this might lead to patients 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. Different 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. Patient preference should be considered when prescribing treatments. 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. Adherence to treatment regimens should also be checked.

They should be washed in detergent and allowed to dry in air. Plastic spacers should be replaced at least every 12 months but some may need changing at six months. Metered Dose Inhaled MDI corticosteroid inhalers should be used with a spacer to reduce the incidence of oral thrush and optimise drug delivery. CUHFT is commissioned as a specialist centre. After disucssion at specialist MDT and regional asthma network. Intention is for first 3 doses to be administered in clinic 2a of CUHFT supply from central pharmacy with subsequent doses to be given by local hospital. Asthma UK: What to do when your medicine changes.

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Wholesale switches across a patient cohort may reduce the carbon impact on paper but risks loss of disease control and increased exacerbation rates that could quickly offset any initial CO 2 savings. While there are incentives to switch patients from pMDIs to lower carbon devices e. DPIs and SMIs it is important to note that, above all, the priority for healthcare professionals is to make the best decision for each patient to improve their health. However, there are opportunities to change treatment for individuals and cohorts of patients when treatment has not been optimised. This may result in the dual benefit of improving disease control alongside reducing the carbon impact of inhaler prescribing. This includes those with poor disease control, poor inhaler technique, poor adherence, excessive SABA use and those prescribed mixed types of inhaler device.

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Prescribe by brand as different brands may not be bioequivalent. Dry powder inhalers DPI - has dose counter. Dry powder inhalers - has dose counter. Dry powder inhaler DPI - has dose counter. Treatment of severe asthma with type 2 inflammation that is inadequately controlled in people 12 years and over.

Asthma is a salbutamol nhs cost long-term condition that can cause coughing, wheezing, chest tightness and breathlessness. The severity of these symptoms varies from person to person. Asthma can be controlled well in most people most of the time, although some people may have more persistent problems. Occasionally, asthma symptoms can get gradually or suddenly worse. This is known as an 'asthma attack', although doctors sometimes use the term 'exacerbation'.

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Patients with asthma need to be managed according to their disease severity. All patients with asthma should be treated with an inhaled corticosteroid and the practice of using short acting bronchodilator monotherapy is now outdated. In those with well controlled symptoms appropriate management includes having their therapy stepped down. Given the evidence linking high inhaled steroid use to potentially severe adverse effects, in recent years there has been a concerted effort to increase patient safety and reduce the dose of inhaled corticosteroids used by patients on a daily basis in controlling their asthma. As well as having a significant impact on patient safety this can also enable the achievement of cost efficiencies. Where appropriate, newly available inhaler options have also been incorporated.

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Maintenance dose is 12mcg once or twice daily. It costs times per dose more than an Easyhaler. Licensed over age of 6 years. Avoid in patients with nut allergy as contains lecithin. Accuhaler licensed from 4 years as is Serevent MDI inhaler. This is a cost neutral alternative to established treatments and may be appropriate for patients for whom once-daily administration is appropriate, especially those not requiring inhaled corticosteroids.

Specialist initiation and monitoring for the first three months before GP referral. Device to place over pressurised aerosol inhalers to aid when strength in hands is impaired e. Selective Beta 2 agonists. For use in existing patients cheap ventolin inhaler. For continuation of existing patients only.