Page 187 - COMMUNITY PHARMACY PRACTICE

02/04/2024

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New types of nebulisers

New generation of nebulizers: (A) AERx
(Aradigm), (B) Respimat (Boehringer), (C)
AeroDose (AeroGen Inc).

378

Summary of inhaler devices 379

Type Device Advantages Disadvantages
Aerosols Metered dose inhaler with or Inexpensive Difficult for patients to co-ordinate
without integral spacer actuation and inspiration. Inefficient

drug delivery as a result of poor
technique. Some still contain CFCs.*
Local side effects because of drug

deposition in the mouth

Breath actuated metered dose No requirement for co-ordination. Click on actuation may be off-putting.
inhaler. Small volume spacer Portable. Simple to use with Some devices may be expensive

available for some devices minimal effort

Dry powder Turbohaler Simple to use with minimal Devices may be expensive. Not
Clickhaler inspiratory effort. Indicator of refillable

Accuhaler number of doses remaining.
Portable. Robust devices

Nebuliser Diskhaler Simple to use. Can deliver high Difficult for some patients to load or
Spinhaler doses prime.
Rotahaler
Aerochamber Requirement to protect the capsules
against extremes of temperature and
Compressor humidity
Over-reliance may be a problem.
Inefficient drug delivery. Steroids require

a mouthpiece rather than a mask.
Expensive

* Some metered dose inhalers are now available as CFC-free inhalers. Patients may experience a change in taste, sound
and feel of the inhaler. When changing to a CFC-free inhaler the manufacturer's literature must be consulted for dose
equivalence

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