Volume 19 Issue 3 September 2010Review
The ADMIT series – Issues in Inhalation Therapy.
5) Inhaler selection in children with asthma
Pages 209-216
*Søren Pedersena, Jean Christophe Dubusb, Graham K Cromptonc, on behalf of the ADMIT Working Groupd
a
Pediatric Research Unit, University of Southern Denmark, Kolding Hospital, Dk6000, Kolding, Denmark
b
Department of Pediatric Pulmonology, University Hospital of La Timone, 13385 Marseille Cedex5, France
c
4 Midmar Drive, Edinburgh, EH10 6BU
d
Members of the Aerosol Drug Management Improvement Team (ADMIT): Peter J Barnes, London, UK; Mariëlle Broeders, Nijmegen,
The Netherlands; Chris Corrigan, London, UK; Lorenzo Corbetta, Firenze, Italy; Richard Dekhuijzen, Nijmegen, The Netherlands;
Jean Christophe Dubus, Marseille, France; Thomas Hausen, Essen, Germany; Meinhard Kneussl, Vienna, Austria; Federico Lavorini,
Firenze, Italy; Mark L Levy, Edinburgh, UK; Søren Pedersen, Kolding, Denmark; Antonio Ramalho de Almeida, Porto, Portugal;
Joaquin Sanchis, Barcelona, Spain; Jose L. Viejo, Hospital General Yagüe de Burgos, Spain; Walter Vincken, Brussels, Belgium;
Thomas Voshaar, Moers, Germany.
Received 6 May 2010 • Accepted 12 May 2010 • Online 18 July 2010
Abstract
Many children with asthma do not use their inhalers correctly and consequently gain little or no therapeutic benefit from the treatment.
The focus of inhalation therapy should be on those inhalers which are easiest to use correctly by various groups of children and the
amount of tuition and training required to obtain a correct technique. It is recommended that clinicians focus on a limited number of
inhalers. Most children can be taught effective inhalation therapy by using a pMDI, a pMDI with a spacer ,or a DPI.
Most preschool children can be taught effective use of a pMDI and spacer with a valve system and a face mask. Therefore, this is the
preferred mode of delivery in these age groups. When the child is capable of using the spacer without a face mask this administration
technique should be adopted.
In older children pMDIs are more difficult to use correctly than a pMDI with a spacer, a DPI ,or a breath-actuated pMDI. Because DPIs and
breath-actuated pMDIs are more convenient to use these devices are normally considered the preferred inhalation devices in these age
groups except for administration of beclometasone dipropionate, which for safety reasons should be delivered by a spacer.
Keywords
Inhalation therapy, children, asthma, inhalation technique, inhaler selection
* Corresponding author. Søren Pedersen Tel: +45 7636 2223 Fax: +45 7636 3479 Email: spconsult@post1.tele.dk | |
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