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Long-acting reliever/preventer inhalers.

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VOL: 101, ISSUE: 25, PAGE NO: 31

Generic/proprietary names

- Seretide: Evohaler 50; 125; 250.

- Seretide: Accuhaler 100; 250; 500.

- Symbicort Turbohaler 100/6; 200/6 400/12.


- This inhaler contains two active ingredients: inhaled corticosteroids, either fluticasone propionate or budesonide; and a long-acting beta2 agonist, which is either salmeterol or formoterol fumarate.

- The inhaled corticosteroids act to decrease inflammation in airways.

- The long-acting beta2 agonist causes brochodilation.


- Respiratory system drugs.


- Used in the treatment of asthma and chronic obstructive pulmonary disease.


- Known sensitivity or allergy to any ingredient.


- Active tuberculosis.

- Hyperthyroidism.

- Cardiovascular disease.

- Arrhythmias.

- Diabetes.


- Hoarseness.

- Candidiasis of mouth or throat.

- Tremor.

- Palpitations.

- Headache.

- Muscle cramps.

- Tachycardia.

- Sleep disturbance.

- Cataracts.

- High doses have the potential to cause adrenal suppression.

- Small increased risk of glaucoma with prolonged use at high dosage.


- Potential for hypokalaemia can be increased by theophylline corticosteroids and diuretics.


- Metered dose aerosol inhaler.

- Metered dose dry powder inhaler.

Nursing considerations

- The use of long-acting reliever/preventer inhalers should be informed by evidence-based guidelines such as those produced by SIGN (2004) and NICE (2004).

- Assess respiratory function.

- Assess ability to use the inhaler device and reassess technique at regular appointments, giving coaching where appropriate.

- No significant growth retardation has been noted. However, it is recommended that the height of all children on regular therapy is monitored.

Patient teaching

- Ensure the patient can self-manage appropriately.

- Advise patients not to stop this medication without speaking to the prescribing health care professional.

- Give smoking cessation advice if appropriate.

- Ensure patients know never to use this medication to treat an acute attack. They should have an appropriate short-acting reliever inhaler for this purpose.

- Give appropriate advice about maintaining the device.

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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