Discussion
dyspnea, overdose, CHD, overdosed, COPD
COPD, ADVERSE EFFECTS, CHRONIC HEART FAILURE
The present study shows that ADR symptoms associated with the use of inhaled therapy are prominent in patients that are overdosed compared to non-overdosed patients with COPD. This effect is seen irrespective of the reason leading to the presentation in the hospital ED. Thereby, 16% of all prescribed inhaled therapies showed an overdose. In particular, the occurrence of malaise, local (dysphagia-like), and sympathomimetic-like symptoms were frequently associated with an overdose of inhaled medication.The majority of the ADRs were not attributed to inhaled therapy, neither by patients nor by healthcare professionals. This is a well-known phenomenon, as the systemic effects associated with inhaled therapy have long been underestimated due to the form of application [The reason for an increased use of inhaled therapy in the sense of off-label use cannot be identified by our data. However, the data show that an overdose of inhaled therapy did not lead to a statistically measurable reduction in dyspnea, so that the benefit appears to be reduced compared to adverse effects. In this context, the use and indication of inhaled therapy must be critically discussed. Common comorbidities of COPD are, e.g., chronic heart failure and CHD, which may also be causative for dyspnea [Similar larger studies on ADRs in emergency departments focused on classical substance groups such as anticoagulants, antibiotics, antidiabetics, or opioids as causally suspected substances — associations with inhaled medication as suspected medications for the presentations are not found there [