1785 EVALUATION OF INHALATION AIDS OF METERED DOSE INHALERS IN ASTHMATIC CHILDREN

Abstract

Many patients have incorrect aerosol inhalation technique with metered dose inhalers (MDI) and fail to benefit fully from this form of therapy. Several inhalation aids have been developed and marketed recently for those cases. However such aids may benefit even those with proper technique. We compared bronchodilator efficacy of 2 puffs of albuterol aerosol administered either directly from a MDI or from an Inspirease (Key Pharm, Miami, Fla), an Aerochamber (Monaghan, Plattsburgh, NY), or our own Aerosol Bag (Pediatrics 1984) in 20 patients with stable asthma aged 8-15. All had been instructed in inhalation technique in the past and were receiving beta agonists from MDI. They were taught the use of the 3 inhalation aids and were studied with a double blind, randomized cross-over protocol in 4 days. After the baseline pulmonary function was tested the patient inhaled 2 puffs of aerosol from each of two of 4 modalities each day. One contained albuterol and the other placebo. The patient inhaled from a MDI unsupervised but was supervised by the examiner with the 3 inhalation aids. FEV1 increased similarly after all 4 modes of administration at 15, 30, 60, 120 and 180 minutes (maximum increases at 60 minutes were 33, 33, 34, 39% over the baseline for MDI, Inspirease, Aerochamber and aerosol bag). Six patients who had suboptimal inhalation technique benefitted from 3 aids equally. Those with proper technique did not benefit from any of the inhalation aids. The 3 new inhalation aids are helpful to those with difficulties in using MDI.