November 5, 2018

Since my memory on this subject goes back several decades, I thought I might share the old and the new theory on which inhaler to use on any given patient.  Those of you with a lung disease that requires inhaler therapy (and most common ones like asthma and COPD do) know that there are many ways your medications can be delivered.  There are metered dose inhalers, dry powder breath actuated inhalers, respimat inhalers, and nebulizers, and within each of these groups there can be some variation on how the device is used.  You also may know that some of the commonly used medications can be administered by several different types of inhalers, and some are only available with one type of inhaler.

I just finished reading several articles which tried to determine which type of inhaler was preferred by most pulmonary physicians.  There were graphs, charts and percentages, along with some analysis of the data presented.  The conclusion in these studies was that physicians thought that the medication was more important than the delivery device.

The reality here is that most of the medications in a class have equivalent effectiveness.  The overriding reason patients are given one inhaler over another often has nothing to do with medicine, but rather economics.

The formulary system in place for most insurance guides the patient to one medication over another, not on the basis of effectiveness, but on cost.

Before prescribing an inhaler most physicians will ask “What will the patient’s insurance cover?” 

Lung Disease Center of Central Pennsylvania
"The Official Sponsor of Peace of Mind"


The Buzz by Dr. Z

George M. Zlupko, MD, FCCP

Timothy A. Lucas, MD, FCCP

Alan J. Kanouff, DO, FCCP

Dr. Michael C. Zlupko, MD

800 Chestnut Ave
Altoona, PA 16601




Monday through Friday
8:00 a.m. – 4:00 p.m.

Each of our physicians has office hours several days per week for patient visits. For an appointment, please call 814.946.2845 and our staff will schedule the next available day and time.

If you are not able to keep a scheduled appointment, please advise our office as soon as possible in order to provide another patient this time to meet with the physician and, if necessary, receive treatment.

If you have an emergency, please call 911.

For your complementary copy of Breathe Magazine, please click on "Health News" at the top of the page then "Breathe Magazine". You can view the entire publication on line or request a copy be mailed to you.

Are you a candidate for a Sleep Study? Click on "Sleep" at the top of page to learn more.