LS 4.2: Dosage Forms and Devices Used in Treatment of Respiratory Disorders

Type of Inhaled Products and Devices

Aerochambers

Type of Inhaled Products and Devices

MDIs - have smallest particle size

Type of Inhaled Products and Devices

DPIs - aerolizer caps, breezhaler, diskhaler, diskus, ellipta, genuair, handihaler, twisthaler, respimat, turbuhaler, inhub, respiclick, lupinhaler

Type of Inhaled Products and Devices

Soft mist inhaler

Type of Inhaled Products and Devices

Nebules ("nebs")

Type of Inhaled Products and Devices

Respirator solutions

Aerochambers "Spacers"

• A valved holding chamber that attaches to the mouthpiece of the inhaler

• Holds the spray inside the chamber until it's inhales- More medication enters the lungs rather than the mouth, throat or stomach

Aerochambers "Spacers"

Various sizes:

• Infant with mask (0-18 months)

• Child (1-5 years)

• Youth (5+ years)

• Adult

Aerochambers "Spacers"

Suggest replacing device every 2 years

Metered Dose Inhalers (MDIs)

• "Puffers", usually require "Shake well"

• Care - wash the plastic casing periodically with warm, soapy water

• They will freeze and will overheat

• Most require priming

Metered Dose Inhalers (MDIs)

Disadvantages:

• Requires hand-breath co-ordination

• For most difficult to assess number of doses left (some have dose counters)

Metered Dose Inhalers (MDIs)

• Patients may request their inhaler by the color, classification, or use (Ex: request blue, rescue, orange, steroid,…inhaler)

• Contain hydrofluoroalkane (HFA) Ex: Flovent HFA

• Some are CFC-free

Dry Powder Inhalers (DPIs)

• Generally easier to use

• Are breath-actuated

• Decrease need for hand-breath coordination

• One inhalation is required to deliver dose

• Dry powder contained in a blister, a capsule or a reservoir

• For most, need to inhale quickly and deeply

• Hold level, do not shake

DPI: Inhub

Ex: Wixela

DPI: Breezhaler caps in foil blister

Ex: Seebri, Onbrez, Ultibro

DPI: Diskus

Ex: Advair, Flovent, Ventolin, Serevent

DPI: Ellipta

Ex: Arnuity, Breo, Anoro, Incruse

DPI: Genuair

Ex: Tudorza

DPI: Handihaler

Ex: Spiriva

DPI: Twisthaler

Ex: Asmanex

DPI: Respiclick

Ex: Aermony

DPI: Turbuhaler

Ex: Bricanyl, Pulmicort, Oxeze

Hand-Halers

• Do not swallow capsules

• Supplies as: Capsules with handihaler, refill packs (capsules only)

Respimat (Soft-Mist)

• Inhalation solution - small particle size in a mist (soft mist inhaler)

• Requires assembly

• Spacer device not required- Once daily at the same time

• When there are no more doses left, it will lock

• Discard 3 months after the first use, or if locked

Nebules

Dispensed into nebulizer machine by the patient, and then breathed in via mask ("nebulized")

Nebules

Used over a period of 10-15 minutes for a specified number of times per day

Nebules

Sometimes used to rinse nasal cavities (Ex: Use steroid nebules in sinus-rinse kit)