The ADMIT series — Issues in Inhalation Therapy. 5) Inhaler selection in children with asthma

Pedersen, Søren; Dubus, J.-C.; Crompton, G.K.

doi:10.4104/pcrj.2010.00043

Cited by 56 publications

(41 citation statements)

References 45 publications

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“…14 However, some young children 6,14,16,21 and patients with severe COPD 6,14 may have problems. When checking their inhalation technique, if these patients cannot make a determined forceful inhalation through their DPI, they should be prescribed a DPI with lower resistance or an MDI, with or without a spacer.…”

Section: Inhale As Fast As You Can Through a Dpimentioning

confidence: 99%

Clarifying the dilemmas about inhalation techniques for dry powder inhalers: integrating science with clinical practice

Azouz

Chrystyn

2012

Primary Care Respiratory Journal

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This review integrates pharmaceutical science with routine clinical practice to explain why inhalation manoeuvres through a dry powder inhaler (DPI) should start with a gentle exhalation, away from the inhaler. Place the inhaler in the mouth and ensure the lips form a tight seal. This should be followed by an immediate forceful inhalation that is as fast as possible and continued for as long as the patient can comfortably achieve. Although this is universally accepted, there has been a lot of attention on inhalation flow as an indicator of adequate inspiratory effort. This has led to the wrong assumption that inhalation flows through each DPI should be the same, and that low flows through some DPIs suggest that dose delivery is impaired. Most miss the concept that inhalation flow together with the resistance of the DPI combine to create a turbulent energy which de-aggregates the formulation and provides an effective emitted dose. A low flow through a DPI with high resistance generates the same turbulent energy as fast flow with low resistance. Therefore, depending on the device, different inhalation flows are compatible with potentially effective use. Flow measurements should be a guide to train patients to inhale faster. The focus of inhaler technique training should be the use of the above generic inhalation manoeuvre.

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Section: Inhale As Fast As You Can Through a Dpimentioning

confidence: 99%

Clarifying the dilemmas about inhalation techniques for dry powder inhalers: integrating science with clinical practice

Azouz

Chrystyn

2012

Primary Care Respiratory Journal

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“…In 2011, GINA is focused on patient education about asthma (2). Inhaled treatment has many advantages such as direct fast onset of action due to local delivery high concentration of the drug to the airways with minimal systematic side effects however, use of these medications with improper technique leads to the inefficacy of treatment (5)(6)(7)(8). Inefficient inhaler treatment results in poor asthma outcomes, frequent exacerbations, increased hospitalization rates and medication cost (3,5,(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…Spacers that require breathing at tidal volume, have high clinical efficacy with low oropharyngeal deposition. These devices eradicate the problem of cooperation that exists with MDIs due to the one way valve system that open with inspiration and close with expiration (6,9). Younger children may need the use of a mask tightly sealing to the face (6,9).…”

Section: Introductionmentioning

confidence: 99%

“…These devices eradicate the problem of cooperation that exists with MDIs due to the one way valve system that open with inspiration and close with expiration (6,9). Younger children may need the use of a mask tightly sealing to the face (6,9). Although, use of spacers increases the clinical MDI therapy in young children, improper technique may eliminate this advantage.…”

Section: Introductionmentioning

confidence: 99%

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Metered dose inhaler-spacer use education effects on achieve asthma control in children

Türkeli¹,

Yılmaz²,

Yüksel

2016

Tuberk Toraks

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“…It has been observed that, in adults, breath-holding only improves lung deposition after an extremely slow inhalation, which may be difficult for children to perform. 5 Information on comparative efficacy of either method is limited.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of 2 Inhalation Methods When Using a Pressurized Metered Dose Inhaler With Valved Holding Chamber

Stephen¹,

Vatsa²,

Lodha

et al. 2015

Respir Care

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The ADMIT series — Issues in Inhalation Therapy. 5) Inhaler selection in children with asthma

Cited by 56 publications

References 45 publications

Clarifying the dilemmas about inhalation techniques for dry powder inhalers: integrating science with clinical practice

Clarifying the dilemmas about inhalation techniques for dry powder inhalers: integrating science with clinical practice

Metered dose inhaler-spacer use education effects on achieve asthma control in children

A Randomized Controlled Trial of 2 Inhalation Methods When Using a Pressurized Metered Dose Inhaler With Valved Holding Chamber

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