Inhalation Devices: MDIs

• Most bronchodilators and anti-inflammatory medications can be administered via inhalation.
• Inhalation allows medication to directly reach the bronchioles.
• It minimizes systemic effects.
• Inhalation provides faster relief of bronchoconstriction.
• Inhalation devices deliver Beta2-adrenergic agonists, anticholinergics, glucocorticoids, or combinations of these.
• There are four types of inhalation devices: metered-dose inhalers (MDIs), dry powder inhalers (DPIs), soft mist inhalers, and nebulizers.

Metered-Dose Inhalers (MDIs)

• MDIs are multi-dose, portable devices that deliver a measured dose of medication via a pressurized canister.
• Usual dosing is one to two inhalations with a one-minute interval.
• The client must exhale first and then inhale while pressing the canister.
• The client should subsequently hold their breath for 10 seconds.
• MDIs necessitate hand-breath coordination.
• Spacers can be attached to MDIs to hold medication temporarily.
• Spacers provide more time to inhale the medication.
• Spacers reduce medication contact with mouth and oropharynx tissues.

Dry Powder Inhalers (DPIs)

• DPIs are portable devices preloaded with medication in powder form.
• Some DPIs have pre-set doses in blister packs, while others require manual capsule insertion.
• DPIs are breath-activated.
• The client must take a fast, deep, forceful breath to draw medication into their airways.
• The client should hold their breath for 10 seconds after inhalation.

Soft Mist Inhalers

• Soft mist inhalers are multi-dose portable devices preloaded with liquid medication.
• These inhalers do not use propellants.
• They release a fine mist slowly that lasts longer in the air compared to MDIs.
• The client must exhale first and then inhale while pressing the canister.
• The client should hold their breath for 10 seconds after inhalation.
• Soft mist inhalers require hand-breath coordination.
• Spacers are not to be used with soft mist inhalers.

Nebulizers

• Nebulizers transform liquid medication into a mist for inhalation.
• The client breathes in the medication through a mask or mouthpiece.
• Nebulizers come in portable, handheld, and tabletop versions.
• Once set up, the client inhales and exhales until all medication is gone.
• Nebulizers take longer to administer medication compared to other inhalation devices.

Most bronchodilators and anti-inflammatory medications can be administered via inhalation. Inhalation allows medication to directly reach the bronchioles and minimizes systemic effects. There are four types of inhalation devices: metered-dose inhalers (MDIs), dry powder inhalers (DPIs), soft mist inhalers, and nebulizers.