Source: Annual Congress 2002 - Asthma - Therapy and management -2
Disease area: Airway diseases

Abstract

It is well known that when inhaling through inhalers flowrates are dependent on several factors including severity of the pulmonary disease, age and aptitude. Futhermore the flowrate is dependent on the resistance of the inhaler. The aim of this study was to compare two commercial inhalers with regard to the effort required when generating a variety of flow.
Method: Ninety subjects inhaled through a resistance equivalent to Turbuhaler or Diskhaler/Diskus. Inspiratory pressure was measured with an esophageal catheter and flow by a pneumothacograph.
In total we studied 30 healthy volunteers, 30 patients with asthma and 30 patients with COPD.
Results: Mean FEV1 (SD) was 3.23 (0.90) for the healthy volunteers, 2.71 (0.80) for the asthmatics and 1.21 (0.33) for COPD patients. With the same effort all subjects produced higher flowrates with the Diskhaler compared to the Turbuhaler. Asthmatics and the healthy volunteers generated higher inspiratory pressures and greater maximal flowrates compared to the COPD patients. Fourteen patients with COPD, 2 asthmatics and 4 healthy volunteers did not reach 60 L/min when inhaling through the high resistance equivalent to Turbuhaler.
Conclusion: The inhalationeffort determines the flowrates when inhaling through a dry powder inhaler. Patients with COPD have a less good ability to inhale which could lead to reduced flowrates especially when inhaling via inhalers with high resistance.

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C. H. Hamnegard, T. Pullerits, M. Berkefeld, P. Arvidsson, B. Bake, M. Palmqvist, J. Lotvall (Gothenburg, Sweden). Different inhalers require different levels of effort for the same flow. Eur Respir J 2002; 20: Suppl. 38, 402

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