Defining Severe Asthma In Childhood: A Descriptive Multicenter Study In Turkey

M O N D A Y 616 Medication Remaining In Discarded Metered Dose Inhalers Of Asthmatic Children Dr. Wantida Dampanrat, MD, Dr. Pasuree Sangsupawanich, MD, Dr. Araya Yuenyongviwat, MD; Prince Of Songkla University, Hatyai, Thailand, Prince Songkhlanagarind hospital, Hadyai, Thailand, Prince of Songkla University, Songkhla, Thailand. RATIONALE: Currently available metered dose inhalers (MDIs) do not track the remaining number of doses. Therefore, we assume that asthmatic children use their controller MDIs regularly and we estimate the time that MDIs should be discarded is the discard point labeled on the canister and box to prevent the use of empty MDIs. However, we hypothesized that some medication remained in the discarded MDIs. METHODS: Fluticasone propionate and budesonide were the controller MDIs used in this study. Children with asthma symptoms had a regular schedule to replace controllerMDIs according to the discard point labeled on the canister.We askedasthmatic childrenattending our clinic fromSeptember 2012 to June 2013 to collect their discarded controller MDIs. The remaining medication in each discarded MDI was calculated from the canister weight. RESULTS: Forty discarded MDIs were collected from 22 asthmatic children. Twenty one discarded MDIs belonged to controlled asthmatic children and all of them were used until nearly empty (>95% of labeled dose). Eight discarded MDIs(42%) which belonged to uncontrolled asthmatic children had remaining medication more than 30% of the labeled doses. Medication remaining in discarded MDIs of uncontrolled asthmatic children was unpredictable (median 15%, labeled dose range 0%-74%). CONCLUSIONS: Nearly half of discarded MDIs of uncontrolled asthmatic children had remaining medication more than 30% of the labeled doses. Canister weight is a useful and reliable method to track a patient’s medication supply. This procedure should be implemented into the health care system to prevent discard of unused medication.