Respir Care 2005 Oct;50(10):1376-83
Department of Respiratory Care, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts 02114, USA.
Respir Care 2005 Oct;50(10):1313-21; discussion 1321-2
The Nemours Children's Clinic, Orlando, Florida 32806, USA.
Topically inhaled bronchodilators and corticosteroids are the mainstay of treatment for asthma and chronic obstructive pulmonary disease. These medications are delivered via jet or ultrasonic nebulizer, metered-dose inhaler (MDI), or dry powder inhaler (DPI). While the number of devices may be confusing to patients and clinicians, each device has distinct advantages and disadvantages. Read More
Acta Biomed 2007 Dec;78(3):233-45
Respiratory Physiopathology and Rehabilitation, Cardiothoracic Department, Polyclinic Le Scotte, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Patients with asthma and COPD commonly use inhaled drugs. The 3 types of currently available devices for inhaled therapy (Metered-dose inhaler, dry powder inhaler, and nebulizer) are clinically equivalent. However, since many different inhalers are available for inhaled therapy, the choice of the delivery device is important for optimizing the results of aerosol therapy. Read More
Respir Care 2005 Oct;50(10):1331-4; discussion 1344-5
Division of Pulmonary, Critical Care, and Environmental Medicine, Department of Internal Medicine, University of Missouri-Columbia, 65212, USA.
Pressurized metered-dose inhalers (pMDIs) are commonly employed for administering bronchodilator aerosols to mechanically ventilated patients. Although it is feasible to employ dry powder inhalers in ventilator circuits, the presence of humidity in the ventilator circuit could reduce their efficiency. A complex array of factors influence drug delivery from pMDIs during mechanical ventilation, and subtle differences in the method of administration can markedly alter aerosol deposition in the lower respiratory tract. Read More
Respir Care 2005 Oct;50(10):1360-74; discussion 1374-5
Aerogen, Mountain View, California 94943, USA.
Patient education is a critical factor in the use and misuse of medication inhalers. Inhalers represent advanced technology that is considered so easy to use that many patients and clinicians do not receive adequate training in their use. Between 28% and 68% of patients do not use metered-dose inhalers or powder inhalers well enough to benefit from the prescribed medication, and 39-67% of nurses, doctors, and respiratory therapists are unable to adequately describe or perform critical steps for using inhalers. Read More