Asthma medication delivery devices*1

Abstract

In pediatrics, asthma is the most prevalent chronic condition. Asthma affects approximately 5 million children under the age of 18 ( National Heart, Lung, and Blood Institute, 2004 National Heart, Lung, and Blood Institute (NHLBI) (2004). National Asthma Education and Prevention Program description. http://www.nhlbi.nih.gov/about/naepp/naep_pd.htm Google Scholar ). Medical management of asthma involves the use of medications that either prevent or reduce airway inflammation or promote bronchodilation of the respiratory smooth musculature. The mainstays of treatment are beta2 agonist, inhaled corticosteroids, and leukotriene modifiers. Improvements in asthma pharmacology have resulted in a variety of ways to deliver the medications. The manner in which a medication is delivered may influence how well it works and the number of side effects experienced. The purpose of this article is to review the most common asthma medication delivery devices prescribed by pediatric nurse practitioners (PNPs) including nebulizers, metered dose inhalers (MDI) with spacer, and dry powder inhalers. An additional aim is to update providers on the recently announced joint evidenced-based guidelines for the selection of aerosol delivery devices developed by the American College of Chest Physicians (ACCP) and the American College of Allergy, Asthma, & Immunology (ACAAI).