How Many Puffs Of An Inhaler Can Kill You?

How Many Puffs Of An Inhaler Can Kill You

Most inhalers would take at least 10,000 puffs to kill you, and these inhalers usually contain 200 doses. However, overdosing on an inhaler of Ventolin can also be deadly.

Ventolin is a medication used in inhalers to help with asthma. However, it can also have unfortunate side effects like an inhaler overdose and death if taken too much.

One may experience dry mouth, chest pain, nausea, rapid heartbeats, seizure, and fainting symptoms.

In 2006, four out of five U.S. asthma-related deaths per year were due to common asthma inhalers containing salmeterol or formoterol. The meta-analysis studies concluded patients using salmeterol or formoterol inhalers were 3.5 times more likely to die.

Also, these patients were 2.5 times more likely to be hospitalized. The said drugs may relieve asthma symptoms and promote bronchial inflammation and sensitivity.

Types Of Inhaler For Asthma And COPD

The most common treatments for asthma and chronic obstructive pulmonary disease (COPD) are pocket-size inhalers or nebulizers. Inhalers usually contain corticosteroids, beta-agonists, and anticholinergics that reduce inflammation, open the airways, and clear up mucus build-up in the lungs.

Below are the types of inhaler devices designed differently and how they’re commonly used.

Metered-Dose Inhalers (MDIs)

MDIs contain the medications in a small aerosol canister where the person needs to activate the propellant and inhale the released medication. This type of inhaler provides a “metered” or a measured amount of medicine.

Dry Powder Inhalers (DPIs)

DPIs don’t have propellant, as their contained medication is breathed directly into the lungs. This inhaler device is the most preferred treatment option for kids and teens.

Soft Mist Inhalers (SMIs)

Soft Mist Inhalers use a fine mist and have more particles than DPIs and MDIs. This type of inhaler releases the medicine slowly and gets more medicine into the lungs.

Medications Inside Inhalers

Inhalers contain medicines for the treatment of asthma and COPD. The following are some medications with their physiological effects that mainly affect the lungs and airflow.

Asthma Inhaler Medications

Asthma inhalers are used during an asthma attack whenever there’s a restriction of the air passage in the respiratory tract. The following medications manage such asthma symptoms and provide relief.

Corticosteroids

Inhaled corticosteroids regulate target genes and reduce vascular inflammation in the airway. As a result, it influences the airway passage in the lungs.

Some common corticosteroid inhalers:

  • Beclomethasone (Qvar)
  • Budesonide (Pulmicort)
  • Mometasone (Asmanex)

Long-Acting Beta-Agonists (LABAs)

LABAs help in relaxing the muscles lining the lungs. This medication is mostly combined with a corticosteroid, as the American Academy of Allergy, Asthma, & Immunology (AAAAI) recommends.

Some common LABAs combined with corticosteroids inhalers:

  • Budesonide And Formoterol (Symbicort)
  • Mometasone And Formoterol (Dulera)

Anticholinergics

Anticholinergics block the effects of the neurotransmitter acetylcholine. The anticholinergic counteracts the activity of the acetylcholine both on its following receptors:

  • Muscarinic receptors (functions in the peripheral and central nervous systems)
  • Nicotinic receptors (functions in the central nervous system and neuromuscular junction)

Commonly prescribed anticholinergic for asthma is the Tiotropium bromide (Spiriva Respimat). The anticholinergics’ effects reduce mucus production and relax lung muscles.

COPD Inhaler Medications

Asthma is under the condition of COPD, together with chronic conditions such as emphysema and bronchitis. It has similar medications used in asthma inhalers, such as corticosteroids, beta-agonists (LABAs), and the combination of corticosteroids and LABAs.

For COPD’s anticholinergic, some of the inhalers are the following:

  • Umeclidinium (Incruse Ellipta)
  • Ipratropium (Atrovent)
  • Aclidinium (Tudorza Pressair)

How to Use a Respimat Inhaler

In this video, you’ll learn what a Respimat inhaler is, its parts, and how to use it. A Respimat inhaler is a soft mist inhaler that simultaneously gives two medicines (Ipratropium and Albuterol).

The combined medicine in the inhalers is usually used to treat COPD, which helps in opening the airways to stop symptoms such as wheezing, coughing, and shortness of breath.

Step by Step

The medication is inserted in the Respimat inhaler and should be primed first. Follow these steps in setting up your Respimat inhaler and how to use it:

  1. Hold the Respimat Inhaler with the transparent base at the bottom. While the cap is closed, press the safety catch on the side of the inhaler and pull the transparent base.
  1. The cartridge where the medication is contained is pierced inside the inhaler. 1/8 of the cartridge should be exposed after inserting it into the inhaler.
  1. Then, put the transparent base back in its place.
  1. The inhaler must be primed when using it for the first time. For priming, turn the transparent base to the direction of the arrows indicated in the device until you hear a clicking sound.
  1. Open the cap and point the mouthpiece away from your face and press the dose-release button. Repeat these priming steps until a spray is visible.
  1. Once the spray is visible, repeat the steps three more times. Such priming won’t affect the number of doses.
  1. For daily intake, turn the transparent base to the direction of the arrows indicated in the device until you hear a clicking sound, and then open the cap.
  1. Put the mouthpiece in your mouth but do not cover the air vents.
  1. While taking a slow deep breath, press the dose-release button and continue to breathe in slowly for as long as you can.

Causes of Asthma Due To Environmental Triggers

Asthma – causes, symptoms, diagnosis, treatment, pathology

The causes of asthma are often triggered by environmental factors such as allergens from cigarette smoke. Your dendritic cells will pick up the allergens and present these allergens to TH2 (T-Helper 2) cells, which will release cytokines Interleukin 4 and 5 (IL-4 and IL-5).

IL-4 will release IgE antibodies. These IgE antibodies coat the mast cells and release their granules containing histamines, leukotrienes, and prostaglandins. For the IL-5, it reacts with eosinophils to release more cytokines and leukotrienes.

The release of IgE antibodies is referred to as a type 1 hypersensitivity reaction that leads to two events that block the airways within minutes:

  • The smooth muscle in the bronchioles will have spasms
  • Increase mucus secretion

Frequently Asked Questions

Is there a treatment for overdosing on inhalers?

Yes, there’s a treatment for overdosing on inhalers. Adrenergic bronchodilators, whether they’re ingested or inhaled, can cause overdose:

  • Epinephrine
  • Isoetharine
  • Albuterol
  • Bitolterol
  • Ritodrine

Adrenergic bronchodilator overdose is treated in emergency rooms. The doctor will provide the necessary treatment for the severe manifestation of the symptoms.

Such treatment may include:

  • Putting you on a ventilator to control how much air you should get
  • Let you ingest activated charcoal to remove the excess drugs in the stomach, as activated charcoal will only absorb toxins in their dissolved liquid phase
  • Placing a tube to your mouth to remove the food, including the drugs
  • Monitoring your potassium and blood sugar levels through blood tests

Is it OK to drink water after using an inhaler?

Yes, for corticosteroid inhalers, you should rinse your mouth and drink a sip of water after using the inhaler. But some would also suggest that you shouldn’t drink water after using a corticosteroid inhaler, as it may transfer the medication into the bloodstream and cause side effects.

What if the asthma inhaler is not helping?

Your asthma condition may have progressed and become more persistent, so the doctor might need to adjust the dosage or add a new medication, depending on the doctor’s findings. Also, if kids grow into teens, they might need to take higher doses to change their medication.

What are spacers for?

Spacers hold the medicine from inhalers, as it’s attached to inhalers. This helps in inhaling the medicine as many breaths as you need.

Doctors mostly recommend using spacers in MDIs that contain corticosteroids.

How to use spacers?

Follow these steps in using the spacers to the inhaler properly:

  1. Place the inhaler’s mouthpiece into the spacer and check if it needs priming.
  2. Then remove the cap from the spacer.
  3. Hold the inhaler upright where the mouthpiece is at the bottom.
  4. Tilt your head backward (like drinking a glass of water) and breathe out slowly.
  5. Place the spacer’s mouthpiece into your mouth and press the inhaler to spray a puff of medicine onto the spacer.
  6. Then breathe in slowly and inhale the medicine coming from the spacer.
  7. Hold your breath for 10 seconds to let the medicine settle in your lungs.
  8. Wait 30 to 60 seconds to allow the inhaler valve to refill for the second dose.

Do I need to shake the inhaler?

Yes, especially MDIs where you need to shake it before using it. This ensures that the medicine is mixed properly with the propellant for optimal use.

Other inhalers may not need shaking but look at its instructions first.

Does breathing in too early affect medicine’s effectiveness?

Yes, because when you breathe in too early, you won’t be able to inhale all the medicine, as your lungs are full and at capacity to breathe in more air. The remaining medicine will then stick in your mouth or the back of your throat.

Are inhalers more effective than nebulizers?

Both devices are equally effective and have their pros and cons in using them. Inhalers may be incorrectly used but are portable.

Nebulizers are easier to use since you can inhale the medicine directly into your lungs without spraying for the puff. Although nebulizers are not easily accessed, especially when you’re on the go.

Can I buy inhalers without a prescription?

There are OTC inhalers available at the drugstores, so no prescription is required. In severe cases of asthma, a prescription is required for such inhalers.

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