5. Thinking a written prescription for a COPD inhaler means
the patient knows when to use it: The drug's purpose.
For treatment purposes all inhalers for COPD & asthma fall into one of
two broad categories:
a) to provide quick relief ('rescue inhalers') and
b) to improve chronic symptoms and prevent flareups ('maintenance inhalers'). Examples of rescue inhalers are albuterol (brand names Proventil HFA, ProAir HFA, Ventolin HFA) and ipratropium bromide (brand name Atrovent). Combivent contains a combination of albuterol and ipratropium bromide. Maintenance inhalers include any inhaled steroid (IS), either alone (brand names Azmacort, Qvar, Pulmicort, etc.) or in combination with a 'long acting bronchodilator' (LABD; brand names Symbicort, Advair). PROBLEM: The SAME type of delivery device (size, shape, mechanism of action) is commonly used for both rescue and maintenance inhalers. For example, as shown below, ProAir HFA (a rescue inhaler, on left) and Symbicort (a maintenance inhaler, on right) both come packaged as pressurized metered dose inhalers, and both are deep red in color. There is nothing intuitive about this. For a patient who may have both inhalers (quite common), and who becomes short of breath, it is all too easy to forget which is which.
The Analgizer was found to be safe, effective, and simple to administer in obstetric patients during childbirth, as well as for patients with bone fractures and joint dislocations ,  and for dressing changes on burn patients.  When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent adverse effect on Apgar scores .  All vital signs remain normal in obstetric patients, newborns, and injured patients.  The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient-controlled analgesia infusion pumps of today.     The Analgizer inhaler was withdrawn in 1974, but use of methoxyflurane as a sedative and analgesic continues in Australia and New Zealand in the form of the Penthrox inhaler .