The Accuhaler

Right. Now to start the page again, after having written tonnes, and then closing the page like an idiot. An hours work. Guys, make sure you save regularly.

Anyway. *Sigh*. The Accuhaler is a dispenser for the dry powder form of the drug combination fluticasone/salmeterol (fluticasone propionate and salmeterol xinafoate). In contrast, the Evohaler is the 'standard' inhlaer that you see, which delivers a measured dose in aerosol form.

It is marketed by GlaxoSmithKline (who also designed the Accuhaler) under the trade name Advair in the US/Canada and Seretide in the UK. Even though the US Patent for the drug ran out in 2010 and the UK drug will in 2013, no competitors have a version on the market, so the Seretide Accuhaler is still by far the most widely used.

In the US and France, the Accuhaler goes by the name Diskus. For much more detailed information on the drug please see this website: http://www.medicines.org.uk/EMC/medicine/2317/SPC/Seretide+100%2c+250%2c+500+Accuhaler/ or this safety data sheet on dropbox: https://www.dropbox.com/s/tooldsreea6j3qv/Drug%20Safety%20Data%20Sheet.pdf?m.

(All information above from http://en.wikipedia.org/wiki/Fluticasone/salmeterol. May not want to reference that in the report...)

History
(from http://productdesignhub.com/2009/04/every-breath-you-take-dissecting-the-diskus/)

"Designed by Gregor Anderson, leader of the Device Technology Group (DTG) at GlaxoSmithKline, the Diskus® [Accuhaler] is the result of his training in the design field, as well as the fields of polymer science & engineering and marketing. Being head at the DTG, he has worked on several devices, all of them concerning healthcare and more specifically, inhaler devices. Recently these experiences led him to develop a device focused on the importance of patient driven future inhaler attributes, which we can see displayed on the Diskus®."

Basic Operation
(For more detailed information abou the mechanism, please see the Mechanisms page)

The internal workings of the Accuhaler are complicated and compact, and basically work like clockwork.

When the user pushes the dispensing lever down, the contracting wheel and index wheel rotate in opposite directions, pulling the protective film and main drug strip away from each other. This exposes the drug at the drug exit port, allowing the user to inhale it.

In addition, every time the user pushes the lever, a countdown mechanically decreases, indicating the amount of Seretide left in the device.

For instructions on how to use the device please see here: http://www.pamf.org/asthma/medications/inhalers/diskus.html or here: https://www.dropbox.com/s/whzjn57hdw9vray/Using%20an%20Accuhaler%20NHS%20Instructions.pdf?m

Popular Reception
(Reviews taken from http://www.viewpoints.com/Advair-Diskus-reviews)

Cost

 * "The retail price tag, however, is prohibitive for the uninsured. According to Target, the retail price on Advair 500/50 is $379.99. I don't pay that because I have very good insurance but this product would be way out of the reach of those with asthma who don't have a prescription plan." - njchicaa
 * "My doc filled out a script for the Advair. I dropped it off at the pharmacy and they later called to let me know it would cost me over $200! I can not afford that every month!" - bytheyes
 * "Advair is very expensive. Unless you have excellent insurance and reasonable co-pays, you may want to ask your doctor for samples. My doctor (who also has asthma and knows the territory) keeps me well supplied and is happy to do so. In these days of out-of-control medical prices, it's worth pushing for samples no matter what your doctor's disposition!" - TunefulGal
 * For the Australian user covered by medicare (Every citizen/resident) the out of pocket cost for the medication is approximately $40 AUD. - Fercol

Side effects

 * "I do not get jittery from Advair, but I have read some reviews that indicate it can cause the jitters... I would caution those with dental issues. It appears that because Advair is a steriod, it does inflame gums and any other mucous membrane. I noticed that my gums were unusually sore and when I spoke to my dentist about it, he told me that the use of Advair was the culprit." - Meerkats
 * "After doing your Advair inhalation, be sure and rinse out your mouth very thoroughly. The chemicals left in the mouth are, to quote my doc, "very nasty stuff"." - TunefulGal
 * "This powder you inhale can leave you with mouth sores if you forget to rinse your mouth or if you don't rinse it well enough. I am sticking to my inhalor and nebulizer machine if I need them." - cwilder

Usability

 * "The one thing they recommend for me though is to take this Advair and use it 4 times a day. Thats a lot of medicine a day if you think about it. You can't tip this when you use it and you can't exhale into it... Well, I for one, hate it. I used it to start with but it can be a pain to have to use it, get up and rinse your mouth, then drink a glass of water to help wash it down. And 4 times a day? Not for me." - cwilder
 * "I have got to say this medicine has helped me deal with everyday life. I have been taking it for about 1.5 years now and i have gone down to taking it once every few days with no use of my inhaler. Although taking medicine for the rest of my life isn't what i hoped for, this medicine isn't horrible. (just make sure to rinse your mouth after taking it or just do it before you brush your teeth)." - polly2990

In general, reviews are very positive, with most people saying that the medicine works as it is meant to. On the above site the product is rated as 86/100 based on 42 reviews.

Materials
For full details on the material, please see the Materials page. It's made of POM, or Acetal, btw.

Problems

 * Wasted drug when you fiddle with the lever
 * Confusing to know how to reinitialise product
 * No feedback on whether you have breathed in correctly, or when to stop
 * Can't tip the product
 * Difficult for young children
 * Non Reusable
 * Expensive!
 * Far too many parts, therefore assembly could be needlessly hard
 * Designed for assembly and disassembly

Good Points

 * No Coordination neccessary
 * Looks good
 * Ergonomic Shape
 * Drug secured by sheath