The Challenge of Delivering Therapeutic Aerosols to Asthma Patients

Abstract

The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.

Patients’ perspectives and preferences in the choice of inhalers: the case for Respimat^®or HandiHaler^®

“…Aerosolizing by pMDIs and the SMI is less dependent on patient inspiratory effort than for DPIs that require a high inspiratory flow rate to ensure correct inhalation and deposition of the drug into the lungs 22. This has advantages for patients with impaired lung function.…”

Kurzdarstellung

“…Helfen Sie Asthmatikern mit akuten Atemproblemen bei der Einnahme ihrer bronchienerweiternden Therapie. Jeder Ersthelfer muss mit deren verschiedenen Anwendungsmethoden vertraut sein [824][825][826].…”

Inhaler Characteristics in Asthma

“…It should also be independent of the patient's airflow, if possible, and all this should be achieved at a reasonable cost. 9,10 Delivering a sufficient dose of drug to the lungs is not easy, as the lungs have evolved to repel inhaled foreign substances in order to keep the airways clear for its primary purpose of gas exchange. The patient must first overcome the unnatural sensation of drawing a solid or liquid aerosol into their lungs.…”