Inhaler Therapy

Inhaler Therapy

Inhalers and nebulizers are the two main ways in which inhaled medicines are used.

Inhaled medicines have quicker onset of action with enhanced safety profile and better efficacy than the oral route. Inhalers get your medicines into the lungs directly. Inhalers are small, handheld devices which deliver the medicines into the lungs during a puff. Metered dose inhalers [MDI], Dry powder inhalers (DPI), soft mist inhalers [SMI] are some of the types of inhalers. For asthma and chronic obstructive pulmonary disease (COPD) inhaler devices are used for the delivery of medications.

Major challenge in the use of inhalers is the incorrect technique which decreases the efficacy of inhalers significantly leading to poor control of disease. We advise correct technique of inhaled therapy during every visit. Using a spacer or valved holding chamber (VHC) with a pressurized metered dose inhaler (pMDI) decreases the amount of oropharyngeal deposition of drugs by holding the medicine aerosol for long period allowing the patient to inhale maximum as much as possible.

Valved holding chamber prevents the exhaled breath from entering the chamber and thus allowing for further inhalation of medicines retained in the chamber in subsequent inhalations. Proper technique is paramount important for obtaining optimal drug delivery to achieve good results.

DPIs are breath-actuated devices that deliver drug particles with a mass median aerodynamic diameter (MMAD) of less than 5 micrometers. DPI use depends on the inspiratory capacity of the patient. Soft mist inhalers derived aerosols have a low velocity and more sustained duration than a pMDI and dose delivery in SMI are independent of inspiratory flow.

Nebulisers [eg: jet, ultrasonic and mesh-type nebulisers] work on different principles to produce fine mist that can be easily inhaled and used during an acute exacerbation. Right inhaler device needs to be prescribed for the right patient. Inhaled medicines give quicker onset of action, greater safety and efficacy with fewer and less severe adverse effects.