Inhalers for asthma and COPD

Inhaled medications for the treatment of asthma and chronic obstructive pulmonary disease (COPD) are administered via inhalers. A large number of inhalers are available, and the general practitioner has to choose between a dry powder inhaler and an aerosol inhaler with or without a spacer, with the choice depending on the abilities and preference of the patient. It may help to assess the following four points: can the patient consciously inhale, can the patient forcefully inhale, can the patient hold his/her breath for 5 seconds, and does the patient have good hand-lung coordination. It makes sense for the patient to use one type of inhaler and not a combination of aerosol inhaler and dry powder inhaler. After the start of a (new) inhaler patients should be asked to visit to check how they use the inhaler after about 6 weeks. The inhaler technique of patients with asthma or COPD and inhaler maintenance should be monitored annually by the practice case manager or, if appropriate, the pharmacy assistant. Incorrect use of an inhaler has a much greater effect on the lung deposition of medication and on symptoms than the type of inhaler used. © 2014 Bohn, Stafleu van Loghum.