How to choose the right inhaler?

The treatment of bronchial asthma and chronic obstructive pulmonary disease is not an easy task requiring an integrated approach: maintaining a proper lifestyle and correct selection of therapy.
The most effective method of drug delivery for bronchopulmonary diseases is the inhalation route of administration, when the drug enters the patient’s body with the help of a special delivery device – an inhaler.
The therapeutic effect of drugs used in diseases of the respiratory tract, depends largely on the effectiveness of inhalation devices.
At the same time, inhalation devices available on the market can vary significantly in terms of the complexity of inhalation and the amount of the drug delivered to the lungs.
The most common means of drug delivery in pulmonology: metered-dose aerosol inhalers, powder inhalers, nebulizers and inhalers with “soft” aerosols.
At the same time, the number of medicines registered in Russia, including for the treatment of bronchopulmonary diseases, has been steadily growing lately. And not so easy to understand such a diversity. Despite the fact that a number of drugs have the same composition and dosage, there are important differences between the devices used by the patient for inhalation, i.e. for delivery of the drug to the lungs. For example, by the type of dosing of the drug, powder inhalers can be divided into multi-dose and single-dose inhalers.
Let’s see how they differ.
When using a single-dose capsular inhaler, the patient independently places a capsule with the drug in the device each time. As for multi-dose inhalers, in this case, the device is factory-charged with a certain number of doses of the drug1.
In single-dose powder inhalers, the medicine is inside a gelatin capsule, which is perforated with special needles before each inhalation. This can lead to technical problems: inadequate opening of the capsule, sticking of the capsule in the chamber of the inhaler, inhalation of the particles of the shell. In addition, single-dose powder inhalers require re-loading before each inhalation, which increases the risk of errors. For inhalation of each dose you need to take 2 breaths.
When using single-dose powder inhalers, as a rule, it is necessary to inhale sharply and strongly. It depends on how much medicine gets into the lower respiratory tract. At low speed, too slow inhalation, poor release of the dose or complete lack of release of the drug from the inhaler is possible. Studies have shown that young children of preschool age with asthma and people with chronic obstructive pulmonary disease may have difficulty using some powder inhalers, since they cannot breathe heavily.

Thus, the significant disadvantages of single-dose capsule powder inhalers are:
1. the need for frequent refueling inhaler;
2. the possibility of technical problems: inadequate opening of the capsule, sticking it in the chamber of the inhaler;
3. the difficulty of use in patients who need more than 2 inhalations per day;
4. sensitivity to the volume and speed of inhalation of the patient;
5. the risk of getting pieces of gelatin capsules in the patient’s mouth and throat.
In multi-dose reservoir powder inhalers, the drug is in a single container, and each inhalation dose is measured using a special dosing device. This type of powder inhaler is most convenient to use: the inhaler contains up to 60-200 doses, requires minimal preparation before use and can be used in the most emergency situations.
In the event that you use a multi-dose powder inhaler, the drug is already charged in the inhaler and does not require recharging.
Therefore, you can be sure that, if necessary, you can quickly activate the device and perform inhalation in any emergency conditions6 (for example, on the street, in transport, or in dim lighting).
Thus, multi-dose powder inhalers today are characterized by portability, compactness, convenience and ease of use.
In any case, the selection of therapy and device delivery of the drug is purely individual, and for effective treatment it is necessary, first of all, to follow the appointments of your doctor.
Moreover, if you are treated with inhaled drugs, it is very important to use the inhaler correctly and follow the regimen prescribed by your doctor. If you have questions about inhalation techniques, be sure to ask them to your doctor.
Compliance with the doctor’s prescriptions and proper use of the inhaler is the basis of the effectiveness of the treatment!
This article does not constitute or replace the advice of a doctor. Need to consult a doctor.

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