Treatment of COPD requires regular use of inhaled medication. As such, choosing an appropriate inhaler device is crucial for successful patient outcomes.

Portable inhalers are categorized as pressurized metered-dose inhalers (MDIs), dry powder inhalers, and soft mist inhalers. Pressurized MDIs use a propellant to atomize the drug, which is then ideally inhaled into the lungs. Patients must coordinate inhalation with inhaler actuation; otherwise, the drug is deposited in the oropharynx (where subsequent ingestion may cause systemic adverse events) instead of the lungs. Breath-actuated, pressurized MDIs bypass the need for coordination by releasing the drug in response to inhalation, but patients may still inhale too quickly, struggle to inhale deeply enough, fail to hold their breath long enough for effective drug delivery, or a combination of these concerns.

Dry powder inhalers rely on the patient’s inhalation to atomize the drug. However, many patients with COPD cannot inhale forcefully enough to achieve effective drug delivery. Furthermore, these types of inhalers are susceptible to heat and moisture, thereby limiting their use in hot and humid ambient environments.

Soft mist inhalers overcome limitations of pressurized MDIs and dry powder inhalers by reducing the need for coordination, avoiding propellants, and decreasing the required inspiratory effort. A compressed spring inside the inhaler delivers the drug as a slow-moving, longer-lasting aerosol mist that requires less coordination to inhale, whereas the small size of the drug particles facilitates deposition in smaller airways. Together, these characteristics provide consistent drug delivery to the lungs and reduced oropharyngeal deposition.

Do you consider inhaler characteristics when selecting a treatment option for your patients with COPD?