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Recent discussion about the place of sodium cromoglycate in the management of childhood asthma1 2 has not mentioned problems of device maintenance for users of this medication. Since the introduction of chlorofluorocarbon (CFC) free sodium cromoglycate delivered by metered dose inhalers (MDIs) in Australia, there has been a change in the manufacturer's instructions about care of the plastic MDI holder. This change in instructions has been triggered by significant problems with blockage of the device nozzle.
The new instructions for CFC free sodium cromoglycate inhalers (Aventis Pharma) recommend that the plastic holder should be washed every night. The protocol includes running hot water through the plastic holder for 1 minute, then a further 1 minute in the opposite direction, tapping the holder to remove water droplets, and allowing it to dry overnight before re-use.
These daily requirements place a considerable burden on patients or their carers. When prescribing medications for the treatment of asthma, physicians must take into account both the efficacy of each medication and the ability and willingness of the patient or carer adequately to maintain the delivery device.
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