Inhalers
Inhalers are small, handheld devices that allow you to breathe
medicine in through your mouth, directly to your lungs. An
inhaler uses pressure to deliver medication through a
mouthpiece.
They usually treat asthma and COPD.
Bronchodilators and corticosteroids are common inhaled
medications.
Inhalers require coordination and correct
technique in order to deliver the right
amount of medication.
With practice, inhalers can be just as
effective as nebulizers.
1. Metered dose inhalers (MDI)
• Metered dose inhalers are also called puffers, they are
pressurized sprayers.
• The medicine is in a small canister, inside a plastic case.
When the inhaler is pressed, a measured dose of medicine
comes through the mouthpiece.
• It utilizes the energy of
compressed propellant
for aerosol generation,
the drug is in solution in
the propellant.
• MDIs deliver one dose at
a time from a canister that
holds multiple doses.
• MDIs require good technique and coordination by pressing
down on the inhaler and breathing in at the same time.
• Because using the inhaler correctly can be difficult, spacer
devices are recommended for use with MDIs. The spacer is
attached to the MDI to make it easier to use the inhaler and get
more medicine into the lungs.
Advantages
• Widely available for most inhaled
medicines.
• Small, easy to carry
Disadvantages
• Requires good co-ordination
technique – have to press down and
down andinbreathe
breathe in attime.
at the same the same time.
• Recommended to be used with a
spacer.
on• and
Has a propellant that can sometimes
affects the amount that reaches the lungs.
cause throat irritation and affects the
amount that reaches the lungs.
dication to the lungs and airways as you inhale through it,
2-Breath-actuated metered dose inhalers
(bMDIs)
❑It is a lightweight, breath-actuated multi-dose inhaler
equipped with a dose indicator.
❑It aims to enhance patient compliance and adherence.
❑Automatically triggered by the patient's inspiratory effort
❑Breath actuated devices are useful for older children and
adults who have difficulty co-ordinating triggering with
inhalation
3-Dry powder inhalers
❑Dry powder inhalers (DPIs) store medicine
as a powder inside capsules or other
containers that you activate when you’re
ready to use the inhaler.
❑Unlike MDIs, a propellant doesn’t push the
medicine out of a DPI. Instead, you use a
quick, deep breath to pull the powder out
and into your lungs.
❑DPIs are usually tube- or disk-shaped,
with a mouthpiece. Some have a place to
load in medicine. Different styles and
brands have different instructions on how
to activate and use them.
Advantages
• Does not contain a propellant.
• Does not require co-ordination of breathing in and pressing
down.
Disadvantages
• Not suitable for young children.
• Not recommended in people who cannot breathe in strongly
enough to inhale the powder.
4-Soft mist inhalers
❑Soft mist inhalers turn liquid medicine into a fine mist. You
breathe the mist in through your mouth to get the medicine
to your lungs.
❑Using the soft mist inhaler needs some co-ordination, to
press down slowly and breath in at the same time.
❑The soft mist inhaler has been shown to leave less
medication in the throat with more reaching the lungs, as
compared with the metered dose inhaler.
Advantages
• Compact and easy to carry around.
• Does not require as much co-ordination of breathing in and
releasing the dose, as an MDI.
• Does not require a spacer.
• More medication reaches the lung, compared with an MDI.
Disadvantages
• Every new inhaler must be loaded with a new medicine
cartridge.
• Does need some strength and coordination to assemble the
inhaler.
