mPDI
This technique error leads to increased oropharyngeal deposition and reduced lung delivery in pMDIs.
What is poor hand-breath coordination?
This type of inhalation maneuver is required for proper DPI use.
What is a deep, fast inhalation?
This breathing pattern is sufficient for effective nebulizer drug delivery.
What is normal tidal breathing?
This branded inhaler is a classic example of a soft mist inhaler.
What is Respimat®?
This measurement describes how fast a patient inhales and determines device suitability.
What is inspiratory flow rate?
This add-on device reduces coordination requirements and increases lung deposition while decreasing throat deposition.
What is a spacer (holding chamber)?
This environmental factor can render a DPI ineffective by causing powder clumping.
What is moisture/humidity?
This is the main advantage of nebulizers in acute exacerbations or severe patients
What is minimal coordination/inspiratory effort required?
This key feature reduces the need for precise hand-breath coordination compared to pMDIs.
What is low-velocity mist release?
This tool can be used clinically to assess whether a patient can properly use certain inhalers.
What is the In-Check DIAL?
This step is required after first use or prolonged non-use to ensure proper dose delivery.
What is priming the inhaler?
This excipient commonly found in DPIs may pose issues in certain patients.
What is lactose?
This type of nebulizer uses compressed air to aerosolize medication and is typically loud and bulky.
What is a jet nebulizer?
This preparation step must be completed before first use of an SMI.
What is loading the canister into the device?
This patient population is most appropriate for nebulizer therapy.
Who are patients with low coordination (young, elderly, or severely ill)?
This inhaler type is an exception to traditional pMDIs because it is breath-actuated and should NOT be shaken or primed.
What is the RediHaler?
This is the primary physiologic limitation that makes DPIs inappropriate for some COPD or exacerbating patients.
What is insufficient inspiratory flow rate/effort?
This advanced nebulizer uses a piezoelectric mechanism to generate smaller particles and faster delivery.
What is a mesh (ultrasonic) nebulizer?
This mnemonic helps patients remember SMI use steps.
What is “TOP” (Twist, Open, Press)?
This factor is MOST important when selecting between DPI vs pMDI vs SMI in clinical practice.
What is patient ability (inspiratory flow + coordination)?
This pharmacokinetic disadvantage of pMDIs results from high-velocity aerosol particles failing to navigate the airway turn effectively.
What is increased oropharyngeal deposition due to particle inertia?
This specialized DPI technology produces low-density porous particles to enhance deep lung deposition and reduce oropharyngeal loss.
What is Pulmosphere® technology (e.g., TOBI Podhaler)?
This limitation of nebulizers makes them less practical for chronic ambulatory patients despite ease of use.
What are long administration times and poor portability?
This pharmacologic/device advantage makes SMIs preferable in patients with low inspiratory flow compared to DPIs.
What is reduced inspiratory effort requirement due to propellant-free mist delivery?
This device type requires the highest inspiratory effort and is therefore most likely to fail in acute asthma exacerbations.
What is a Dry Powder Inhaler (DPI)?