Inhalers... do you have a pMDI inhale... - Asthma Community ...
Inhalers... do you have a pMDI inhaler or a dry powder inhaler? You can select more than 1 option.
Do you know how to use your pMDI or dry powder inhaler correctly?
Getting your technique right can help you manage your symptoms better. Head to our website to watch the full videos.
What is a pmdi inhaler?
Pressurised Metered dose inhaler
Terrible side effects from all inhalers that they cannot overcome. 😕
To clarify my comment, it was for me that side effects couldn't be overcome. I haven't seen any scientific studies either. The list of possible side effects is huge and I encountered many of them, including severe palpitations to the extent I couldn't work. This was Fostair, both powder and aerosol and then later Simbicort too. I stopped taking them and Montelukast with a plan to reintroduce them slowly. Montelukast first with minimal problems, then Simbicort just on an odd occasion. This has been easier but still not without side effects, and was done with medical agreement. I still keep the inhaler to minimum because side effects are still a huge problem for me. Fortunately my asthma is quite mild but I do feel that these medications, especially Fostair need more ongoing investigation of side effects. I feel really sorry for anyone suffering as I am who really has to take them.
what is a pMDI inhaler? Can’t work out what it stands for.
Pressurised Metered dose inhaler
Thank you. So glad my nurse put me back on a prdi which I feel confident with and also with a child ish inhaler. Back to Fostair and better breathing
I had been on powder inhalers for years but my asthma became worse. They try to get you on powder inhalers as part of NHS net zero targets. Our health and lives are more important!
I had to Google it, we're not all doctors or health nuts
Have never found a spacer effective, but then I and my asthma nurse know I have good technique without one. If I use a spacer (also with good technique) my asthma gets worse.
Spacers were I believe originally for children and anyone else who can't get the hang of correct breathing, timing, posture, etc. and they appear to have spread to being "accepted wisdom" now. But there's a well-respected doctor in Aberdeen, Dr David Price, who has published a trial of adults who have good technique and has said, perhaps controversially in today's thinking, that spacers are not necessarily better. PM me for a link, if you're interested.
I am also an engineer with specialist knowledge of particle dynamics, and I can't get past the fact that droplets will hit the walls and outlet valve of the spacer, be trapped there, and not be inhaled, thereafter you're depending on the medication evaporating in order to be inhaled. I don't know how much that happens.
I think each person has to test both methods and see what works best for them.
I’m using a spacer for my preventer but not using one with my blue inhaler as I am usually out and about when I need it. This is interesting and have wondered about particles getting trapped in the spacer. Thank you.
I do use one out and about as I have a compact one that my inhaler can fit inside. (Able spacer). Collapsible ones are also available. If you want to use one of course - I just find it more convenient to still use one but I don't want a massive one.
This is interesting. I have also wondered whether I get the full dose when using Trixeo through an Airflow spacer. I have been told to do tidal breathing.
Would be grateful for more information but don’t know how to pm you for a link
Hello Cliff - are you aware of any work done on the different manufactures of inhalers, specifically on comparing performance and particle size? My wife began, some years ago, with Fostair, but was then arbitrarily [by GP] to another brand, which seems to irritate more, as well as accumulating on the inside of the spacer [which the GP is reluctant to replace], although recommended - I'd be interested to hear more
Yetti1 and Alith2,
The study was only for corticosteroids, i.e. the preventer (brown in the UK at least), but I guess it can be generalised. I've never heard of Trixeo and am not sure about Fostair, so I don't know how relevant the study is. However, if you search Medline or Google Scholar for David B Price and asthma, you'll find he's pretty prolific. The study I mentioned is titled "Real-Life Outcomes for Patients with Asthma Prescribed Spacers for Use with Either Extrafine- or Fine-Particle Inhaled Corticosteroids." They basically say they didn't find a difference which was a surprise, so larger trials are needed.
I can't remember the link, but I found a study which suggested better lung deposition with a spacer than without. I think that may have included reliever inhalers though, and didn't differentiate by technique.
I have a fine particle Fostair dry inhaler for a preventer. This seems to work fine and is also easier to take than my Symbicort was. I had good technique when breathing was ok with that one but not if I was struggling at all, which turned into a vicious cycle of not getting enough in and getting worse. I'm still not fully controlled but definitely better on Fostair (plus Spiriva and two tablet medications).
For reliever inhalers, and possibly for some people for preventers, I think it is still important to use a spacer.
My experience is that even though I have good inhaler technique when well, and I am very good at breath holding where needed, that goes downhill if I'm struggling, and tidal breathing through a spacer is easier then (also I'm lazy and I prefer tidal breathing normally even though I can do it breath hold if I need to.)
It's especially easier if I'm coughing. In an asthma attack, the recommendation is to use a spacer.
I think anything that reduces the cognitive load as well as breathing effort is also good, especially in an attack. I don't panic when I have attacks (happens too much) but my brain is not functioning well at that point. For someone who is also panicking because they can't breathe, good technique is probably the last thing on their mind.
Same for waking up at night. It can take me a while to even remember what an inhaler is and how it can help me to deal with the whole breathing thing that just woke me up. (Not even joking. My sleep brain is totally away with the fairies!)
Yes, other papers by the same author stress that technique is key, and as everyone is different then what works best for each person is what counts.
I know when I was first given a spacer many years ago, when the only spacer was the large volumatic one, the studies showed 17% more lung deposition. I always use it for salbutamol now and just starting with a Symbicort pMDI MART. I wonder if I have ever inhaled the full dose of a powder inhaler. And I am interested to see if I can actually get full control of my asthma and rely on lower doses...
I have the Fostair 200, very strong with very small particles. I’ve been told my technique is very good but I get thrush immediately if I use it without a spacer. I do sometimes have a problem with inhaler thrush anyway, but recently improved it by holding it in for just 5 seconds instead of 10. I found this advice on a video about Fostair. Also found this comment on spacers on the Able spacer website:
By providing a space between the inhaler and mouth this reduces the speed that the medication particles enter the mouth. Resulting in a larger proportion of the medication particles being inhaled.
Makes sense to me. Without a spacer, it seems to hit the back of my throat and cause thrush. With a spacer, at least the wasted particles are on the plastic surface and not my throat!
Interesting. I may have to try again. My asthma is improving a bit so it might give me wiggle room to try.
Is there any evidence for any preference in inhalers used in the management of idiopathic bronchiectasis?
why use technical terms? pMDI? Waste of time.
Do you realise this is a charity, not a business, They are actually on our side and it takes seconds to look it up online. Not sure why the negativity??
. You should always define abbreviations in science. Standard practice.
Hi
I have a breath actuated blue (reliever) inhaler so don’t need a spacer..
I prefer this as it’s really easy and I don’t need to lug a spacer around when out and about.
You also don’t need to worry about coordination if you are feeling poorly or in the middle of the night when half asleep!
😊👍
What to you classify Spiriva Respimat as? It's not a powder and it's not pressurised in the normal sense
