What are HFA Inhalers?
HFA inhalers are known as hydrofluoroalkane inhalers. These type of inhalers were recently developed and switched from chlorofluorocarbon (CFC) inhalers.(1) Although HFA inhalers are thougth to be more expensive they are known to have a safer propellant, and are thought to be more effective than CFC inhalers.(3) Most HFA inhalers come as metered dose inhalers, which tells the patient how many number of sprays are in the canister.(3)
Albuterol sulfate, a common HFA inhaler is a beta2-adrenergic agonist.(2) The pharmacologic effects of albuterol sulfate include activation of beta2-adrenergic receptors on airway smooth muscle.(2) This causes dilation of the airway smooth muscle.
Who uses HFA Inhalers?
Patients that have an acute exacerbation due to an asthma attack.(3) This usually involves bronchoconstriction (constriction of the lung airway).(3)
What HFA Inhalers Are Currently Used?
There are three albuterol HFA inhalers that FDA has approved as safe and effective: ProAir (albuterol sulfate) HFA Inhalation Aerosol, Proventil HFA (albuterol sulfate) Inhalation Aerosol, and Ventolin (albuterol sulfate) HFA Inhalation Aerosol. Additionally, there are other HFA inhalers such as.
Patient Education on HFA Inhalers
It is important to shake the canister before each use.(2) Also important is to prime the inhaler (spraying about three sprays away from you into the air if the inhaler has not been used for greater than two weeks).(2) As an example inhaler, “Proair HFA has a dose counter attached to the actuator. When the patient receives the inhaler, a black dot will appear in the viewing window until it has been primed 3 times, at which point the number 200 will be displayed. The dose counter will count down each time a spray is released. When the dose counter reaches 20, the color of the numbers will change to red to remind the patient to contact their pharmacist for a refill of medication or consult their physician for a prescription refill.” (2)
For cleaning of ProAir HFA make sure to wash the red plastic actuator mouthpiece and dry thoroughly at least once a week.(2) Also, Patients should be instructed to never attach a canister of medicine from any other inhaler to the ProAir HFA actuator and never attach the PROAIR HFA canister to an actuator from any other inhaler.(2)
Side effects that you may experience with with albuterol HFA inhalers include palpitations, chest pain, rapid heart rate, tremor, or nervousness.(2) Drug interactions to keep in mind include beta blockers (since there are receptors in your lungs that are the same as in your heart), diuretics, digoxin, and monoamine tricyclic antidepressants (amitriptyline, doxepin, nortriptyline, etc…).(2)
1. Transition from CFC Propelled Albuterol Inhalers to HFA Propelled Albuterol Inhalers: Questions and Answers. https://www.fda.gov/Drugs/ResourcesForYou/Consumers/QuestionsAnswers/ucm077808.htm. Accessed October 25, 2018
2. ProAir. RxList. https://www.rxlist.com/proair-drug.htm#clinpharm. Accessed October 25, 2018
3. Velsor-friedrich B, Militello LK, Zinn KK, Dewolff DK. Switching from CFC to HFA Inhalers: What NPs and Their Patients Need to Know. Am J Nurse Pract.2009;13(10):45-50. Accessed October 25, 2018 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675349/.