Inhalers?

The most obvious one in inhalers is asthma medication

Yup, I'd go with asthma medication too.

As for stealing them...

They are kept in a pharmacy, but cases of asthma are growing, in the UK, at least. Lot's of children have them, and they are pretty careless about looking after their inhalers (trust me, I know) Your character could pick one up in a park, a swimming pool, in school... lots of places where there is no need of a distraction, unless it's important to the story?

Is there a common mistake a child would make if he/she tried to use an inhaler without supervision or instructions?

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Firstly, there is a difference between adult inhalers and children's inhalers. I can only speak for the UK but here children start off with... I'm not sure what it's called, we call it the spacer - a huge clear plastic container that fits together in two parts. The inhaler, itself, slots into one end. you press the amount of times prescribed, suck until you hear the valves click and then exhale.

It's a teaching aid, so if your char stole only the inhaler then that could be a mistake.

Hope this helps.

quixotic!fantastic! said:

What medication is usually used for inhalers?

Are they kept in a pharmacy?

I'm trying to help my 8 year old character steal some inhalers, probably from a clinic or pharmacy. Any idea how he could do this? I can get him a distraction.

Is there a common mistake a child would make if he/she tried to use an inhaler without supervision or instructions?

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They come in two pieces that have to be assembled--the plastic inhaler part, and the medication container. The container has to be snapped into place. I'm guessing the most common mistake he might make is not figuring out how to use it. It isn't obvious you have to push down on the medicine container. If he does figure that out, he might not push it hard enough.

I had an asthma inhaler when I was a child. I vaguely recall it tasting like licking a stamp. Wasn't hard to use once I was shown how, but would not have been intuitive without a lesson. I'm not really sure why anyone would steal one, but the easiest place to steal one would be from a classmate.

An asthma inhaler usually has some kind of stimulant, at least that's the effect it has when you use it. Mine is albuterol.

http://asthma.about.com/od/treatmentoptions/a/tx_medguide_albuterol.htm

I'm not sure it's actually a stimulant, but the side effects I get include an increased heart rate, tremors, an upset stomach and a hyper feeling, like too much caffeine.

My husband worked as a counselor at a cub scout camp one year, and one of the kids used his entire inhaler at once. He was bouncing off the walls. (They did get him medical attention.)

Hope this helps.

I don't know about your pharmacies, but the ones I've been to have no less than 2 people. And the pharmacists (where I worked) are trained to never, ever, ever leave the pharmacy unattended. Ever.

My inhalers (for asthma) no longer need to be assembled upon receipt. They have to be shaken before use or you don't really get anything from them. If you're not prepared for the puff of meds & propellant, it can be quite unpleasant in the back of the throat. There are albuteral inhalers, but also long-acting controller meds in inhalers. My experience with the latter is that they have less powerful propellant.

My insurance company makes me order mine through the mail, and the Dr always writes a 3 month supply. This could be a way for your character to score some-- maybe they raid a mailbox or something. They might think there's something neat in the package when really, it's just meds (but in funny looking containers.)

Clair Dickson said:

My inhalers (for asthma) no longer need to be assembled upon receipt. They have to be shaken before use or you don't really get anything from them. If you're not prepared for the puff of meds & propellant, it can be quite unpleasant in the back of the throat. There are albuteral inhalers, but also long-acting controller meds in inhalers. My experience with the latter is that they have less powerful propellant.

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That's true. Advair is another medicine that's inhaler, but it's not like the asthma emergency relief. The device comes in a purple circular container with 30 compartments. You have to pull a lever to open the compartment. The compartment contains a powder, which needs to be inhaled. It's not propelled at all, except by inhaling. Very easy to breathe into the powder and puff it in your face or to not inhale enough and get all the powder. Of course, figuring out how just to open it is tricky, too.

quixotic!fantastic! said:

One more question - Do people "grow out" of asthma? Like, is it like lactose intolerance in that you could have it as a kid but not as an adult? Or would it more be something that just didn't tend to trouble you as an adult, but still potentially could?

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Some people do-- and some people can grow INTO asthma as well. Also, some people with asthma who take controller medication may have their asthma well enough controlled that they no longer experience symptoms of asthma (the wheezing, coughing, etc.) The condition is more than likely still there, but controlled to the point of being hidden. (I'm like that.) Now, for example, if said person goes off the controller medicine for a certain period of time (depends) then the symptoms may return.

Here's a link for some more reading that might be of great use to you. (I love Google!)

http://www.webmd.com/asthma/guide/asthma_inhalers_bronchodilators
It talks about the different types and the drugs used, etc.

quixotic!fantastic! said:

One more question - Do people "grow out" of asthma? Like, is it like lactose intolerance in that you could have it as a kid but not as an adult? Or would it more be something that just didn't tend to trouble you as an adult, but still potentially could?

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You might get it just by changing locations. It can be caused by allergies, especially if the place you go to has a lot of allergy pollutants. If you get control of the allergies, you can come off the asthma medication.

Had asthma all my life and my medication is albuterol, and yes it makes my heart race and my hands tremble. If I'm drinking coffee while using it, the effect is magnified. So a child drinking a cola would have the same effect.

The easiest way for a child to get hold of an inhaler is to take it off someone else, and not from a pharmacy. Older people who don't have children around tend to be more careless than parents with younger kids. Also, as a teacher, I often saw kids just leave their inhalers on a desk while they went to get lab materials, or paper or something. I was always after a few of them to put the darn thing away. Anyone walking by could have nabbed it.

(And we had the rule that medication had to be kept with the nurse, but being asthmatic myself I didn't push it. I knew that when you need your inhaler, you need it and you really shouldn't have to walk a mile (my school was huge) to get to the nurse to use it. There could be be a delay of five minutes or more.)

Anyhow, have your character find an inhaler or raid his grandparent's medicine cabinet.

As for asthma going away, mine sort of dwindled in my 20's and 30's. I went for many years with only 'emergency inhalers' and got to the point I didn't use them for months at a time. Now that I am 'older' I use it on a daily basis.

My asthma was mainly a problem as a child due to mandatory gym classes with the requirement to run laps and play high-exertion sports like soccer. I quit using an inhaler when I was around 13. The only time I had an attack in the last several years was when I got very emotionally stressed by a fight with a friend.

jaksen said:

The easiest way for a child to get hold of an inhaler is to take it off someone else, and not from a pharmacy. Older people who don't have children around tend to be more careless than parents with younger kids. Also, as a teacher, I often saw kids just leave their inhalers on a desk while they went to get lab materials, or paper or something. I was always after a few of them to put the darn thing away. Anyone walking by could have nabbed it.

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Yes, that's much easier than raiding a pharmacy. My wife is a school nurse and they keep all inhalers locked in a file drawer in the nurse's office. Some schools allow them to be locked in the teacher's desk. And sometimes older kids are allowed to carry them on their persons.

Also anyone who uses rescue inhalers almost always has more than one--one for home, one for purse, etc. And extras stored in the house somewhere.

If there is an asthmatic teacher or secretary at the school, she'd have hers in her purse or he'd have his in a coat pocket or desk drawer. Unless school policy is to lock that sort of thing up.

DW says that the most common mistakes kids make when she's teaching them how to use their albuterol or atrovent (another asthma drug) inhalers is not holding your breath after the puff. They puff/inhale/puff/inhale instead of breathe out, puff/inhale and then hold your breath for 10 to 20 seconds. Then repeat a minute later.

Also, as mentioned above, not shaking before puffing.

I was prescribed albuterol nebulizer treatments when I had the flu a few years ago and I thought I'd scream and climb a wall. I was jittery and my heart was pounding. ARGH! I'd almost rather be gasping and wheezing.

DW says that the most common mistakes kids make when she's teaching them how to use their albuterol or atrovent (another asthma drug) inhalers is not holding your breath after the puff.

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THIS!!! I cannot tell you how many times my asthmatic friends and I have screamed at a TV or movie character for not holding their breath after taking a puff. If you don't hold your breath, it is USELESS! And anyone who "learns" to use an inhaler by watching TV will make this mistake.

Ditto what other people say about stealing from a person, not the pharmacy. I have at least a dozen inhalers scattered around my purse, car, backpack, apartment, parents' house, soccer bag....

You can grow out of asthma (or into it) but I think it's far more common for people to simply get their asthma under control to the point where they don't need medication. They are still asthmatics - this is often evidenced by decreased lung capacity compared to a normal person - but they don't bother treating the condition anymore. It very much depends on your trigger. Off the top of my head, I know it can be induced by allergies (moving to a new area often helps, though sometimes it gets worse again after a few months when your body's accustomed to the new environment), exercise, and stress/emotion.

Kitti said:

You can grow out of asthma (or into it) but I think it's far more common for people to simply get their asthma under control to the point where they don't need medication. They are still asthmatics - this is often evidenced by decreased lung capacity compared to a normal person - but they don't bother treating the condition anymore. It very much depends on your trigger. Off the top of my head, I know it can be induced by allergies (moving to a new area often helps, though sometimes it gets worse again after a few months when your body's accustomed to the new environment), exercise, and stress/emotion.

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This. I saw a doctor a couple of years ago for a checkup, and I casually mentioned that I used to have asthma when I was a kid, but I didn't have it anymore--and she tore into me. According to her, you can definitely have more control over it as you get older (or it can get worse), but you never really lose it. It's under control now, but I still have a rescue inhaler and I have to be very careful around specific allergens, especially cats.

Back to the original question--I was the opposite of careful with my inhaler when I was a kid. If somebody had wanted one, it would have been much easier to take mine out of my backpack than to steal one from a pharmacy.

Kitti said:

THIS!!! I cannot tell you how many times my asthmatic friends and I have screamed at a TV or movie character for not holding their breath after taking a puff. If you don't hold your breath, it is USELESS! And anyone who "learns" to use an inhaler by watching TV will make this mistake.

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I have a character who uses an inhaler, and while I have two brothers with asthma, I'd never seen them use their inhaler. So I learned by TV *duck* During a critique session of my novel, someone noted that I needed to read up on that. I did and rewrote the scene so my character will properly hold her breath

Albuterol is a bronchodilator. What it does is relax the smooth muscle that winds around the bronchial tubes. Increased heart rate is a side effect for a small percentage of people, but many others feel shaky/jittery even without increased heart rate.

The spacer device someone mentioned is the best way to achieve maximum dosing of the med. Without one, the speed of the medication coming out of the inhaler makes it almost impossible to inhale it fast enough to get most of it into the lungs where it's needed--that's even if the patient has perfect technique--which isn't too often. So, instead, the medication hits their tongue, back of the throat, goes into the stomach and only a small percentage in the lungs. Using a spacer increases the percentage by 70-80%.

I'm a respiratory therapist with 25 years experience and do MDI intructions all the time. I don't understand why doctors don't write a script for spacers at the time they write the script for the medication. Also, many patients don't think they get as much medication because they can't taste it anymore. Well, yeah, they don't taste it because there are no taste buds in the lungs. I try to reason with them and ask them how they would react if the pharmacy dispensed their inhaler with only 30% of the medication it was supposed to hold. Of course, they'd be angry and feel cheated. I tell them they are doing the same thing when not using a spacer.

Another thing you may want to consider is the epi-pens that a lot of anaphalaxis kids need these days. Perhaps you could have some fun with that?

As asthma medication is designed to "open" the bronchioles, I would imagine someone who didn't need the medication would have dizzyness, light-headedness, and those type of symptoms. Some wicked people I've heard about like to have a puff of their ventolator and then smoke something they shouldn't.

There are also a couple of over-the-counter asthma inhalers on the market. I think their basic medication is epinephrine. This would certainly be easy enough for a kid to get hold of.

Ten years ago I purchased an over-the-counter inhaler for my little brother. He was having a mild asthma attack, my parents were out of town and I drove him to the emergency room. The receptionist just told us to go to the pharmacy and buy an inhaler. I was 17 at the time. I did have to ask the pharmacist for the inhaler, but we didn't need a prescription. Sorry I don't remember the name of the medication. It might have been albuterol...

I've been diagnosed with asthma but it's pretty well controlled with my allergy meds. I only bring an inhaler if I'm going to be exercising at high altitudes (skiing or hiking). It was worse when I was a kid, before I took Allegra and living with a parent who smoked.

There's an inhalable epinephrine that's sold OTC - the most common trade name is Primatene. Although the inhalers are due to be pulled off the market due to CFC concerns.

It's pretty unlikely the kid would be able to still behind the counter medications - he'd have to look through a buttload of other stuff without being noticed. Not to mention the Advair disks are about $250 retail, so it's not exactly a petty theft.