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Letter

Inhaler blues?

Andrew R. McIvor
CMAJ March 08, 2011 183 (4) 464; DOI: https://doi.org/10.1503/cmaj.111-2025
Andrew R. McIvor
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Patients frequently refer to inhalers by colour rather than by trade or generic names.1 Indeed, many physicians use colour-coded wall charts to help both them and their patients identify inhalers.

Although there is no formal agreement between pharmaceutical companies, both brand and generic drug manufacturers traditionally provide rapid- acting β-agonist bronchodilators (for rescue or reliever therapy) in blue, and inhaled corticosteroid (ICS) inhalers (controller) in shades of orange, brown or red.

One of the major improvements in asthma therapy is the move from symptom relief and overuse of the blue rescue inhalers to regular use of anti-inflammatory controller ICS combination inhalers.

However, inconsistency in the colour of inhalers can create a lot of confusion.2,3

Guidelines are based on striving for control, and physicians are encouraged to assess control during all patient visits. Physicians commonly determine a patient’s use of a rescue bronchodilator by asking, “How often have you used your blue inhaler in the past week?”4 During telephone conversations, physicians or other health care providers, for worsening symptoms, may tell a patient to “increase significantly their blue inhaler.”1

Why would Health Canada recently approve Zenhale, a new combination inhaler, in the colour blue? Surely this is a risk management issue for patients and physicians and may lead to serious consequences of overdose during exacerbation?

References

  1. ↵
    1. Hodder R,
    2. Lougheed MD,
    3. Rowe BH,
    4. et al
    . Management of acute asthma in adults in the emergency department: nonventilatory management. CMAJ 2010;182:55–67.
    OpenUrl
  2. ↵
    1. Horn CR,
    2. Cochrane GM
    . Colour coding for bronchodilator inhalers. Lancet 1986;18:1843
    OpenUrl
  3. ↵
    1. Partridge M
    . Coloured inhalers. BMJ 1992;305: 890.
    OpenUrlFREE Full Text
  4. ↵
    1. Balter MS,
    2. Bell AD,
    3. Kaplan AG,
    4. et al
    . Management of asthma in adults. CMAJ 2009;181:915–22.
    OpenUrlFREE Full Text
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Canadian Medical Association Journal: 183 (4)
CMAJ
Vol. 183, Issue 4
8 Mar 2011
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Inhaler blues?
Andrew R. McIvor
CMAJ Mar 2011, 183 (4) 464; DOI: 10.1503/cmaj.111-2025

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Inhaler blues?
Andrew R. McIvor
CMAJ Mar 2011, 183 (4) 464; DOI: 10.1503/cmaj.111-2025
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  • Absolute risk reduction a must
  • Evidence-based sustainability
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