ReviewPrimary care respiratory journal : journal of the General Practice Airways Group2012
Clarifying the dilemmas about inhalation techniques for dry powder inhalers: integrating science with clinical practice.
Review in Primary care respiratory journal : journal of the General Practice Airways Group, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Novel inhalation therapy in pulmonary fibrosis: principles, applications and prospects.Journal of nanobiotechnology · 2024Review
- Towards More Precise Targeting of Inhaled Aerosols to Different Areas of the Respiratory System.Pharmaceutics · 2024Review
- Identifying critical inhalation technique errors in Dry Powder Inhaler use in patients with COPD based on the association with health status and exacerbations: findings from the multi-country cross-sectional observational PIFotal study.BMC pulmonary medicine · 2023Observational
- Advancements in the Design and Development of Dry Powder Inhalers and Potential Implications for Generic Development.Pharmaceutics · 2022Review
- State of the Art in Capsule-Based Dry Powder Inhalers: Deagglomeration Techniques and the Consequences for Formulation Aerosolization.Pharmaceutics · 2022Article
- FIDEPOC: Consensus on Inspiratory Flow and Lung Deposition as Key Decision Factors in COPD Inhaled Therapy.International journal of chronic obstructive pulmonary disease · 2022Article
- A Predictive Machine Learning Tool for Asthma Exacerbations: Results from a 12-Week, Open-Label Study Using an Electronic Multi-Dose Dry Powder Inhaler with Integrated Sensors.Journal of asthma and allergy · 2022Article
- Understanding the Importance of Capsules in Dry Powder Inhalers.Pharmaceutics · 2021Review
- A path to successful patient outcomes through aerosol drug delivery to children: a narrative review.Annals of translational medicine · 2021Review
- Prevalence and Associated Factors of Suboptimal Daily Peak Inspiratory Flow and Technique Misuse of Dry Powder Inhalers in Outpatients with Stable Chronic Airway Diseases.International journal of chronic obstructive pulmonary disease · 2021Article
- Patient Inspiratory Maneuver Performance; Peak Lungpower, Acceleration and Volume.Journal of aerosol medicine and pulmonary drug delivery · 2020Article
- Medication Tracking: Design and Fabrication of a Dry Powder Inhaler with Integrated Acoustic Element by 3D Printing.Pharmaceutical research · 2020Article
- The effect of inspiratory parameters after two separate inhalations on the dose emission of theophylline from low and high resistance dry powder inhalers.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2020Article
- Understanding Dry Powder Inhalers: Key Technical and Patient Preference Attributes.Advances in therapy · 2019Review
- Role of the pharmacist in improving inhaler technique and asthma management in rural areas in Jordan.Clinical pharmacology : advances and applications · 2019Article
- EasyhalerDrugs in context · 2019Review
- Estimation of inhalation flow profile using audio-based methods to assess inhaler medication adherence.PloS one · 2018Article
- Peak Inspiratory Flow Rate in Chronic Obstructive Pulmonary Disease: Implications for Dry Powder Inhalers.Journal of aerosol medicine and pulmonary drug delivery · 2017Review
- Recent advances in capsule-based dry powder inhaler technology.Multidisciplinary respiratory medicine · 2017Review
- Optimising Inhaled Pharmacotherapy for Elderly Patients with Chronic Obstructive Pulmonary Disease: The Importance of Delivery Devices.Drugs & aging · 2016Review
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This review integrates pharmaceutical science with routine clinical practice to explain why inhalation manoeuvres through a dry powder inhaler (DPI) should start with a gentle exhalation, away from the inhaler. Place the inhaler in the mouth and ensure the lips form a tight seal. This should be followed by an immediate forceful inhalation that is as fast as possible and continued for as long as the patient can comfortably achieve. Although this is universally accepted, there has been a lot of attention on inhalation flow as an indicator of adequate inspiratory effort. This has led to the wrong assumption that inhalation flows through each DPI should be the same, and that low flows through some DPIs suggest that dose delivery is impaired. Most miss the concept that inhalation flow together with the resistance of the DPI combine to create a turbulent energy which de-aggregates the formulation and provides an effective emitted dose. A low flow through a DPI with high resistance generates the same turbulent energy as fast flow with low resistance. Therefore, depending on the device, different inhalation flows are compatible with potentially effective use. Flow measurements should be a guide to train patients to inhale faster. The focus of inhaler technique training should be the use of the above generic inhalation manoeuvre.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.