COPD Patients: Take a Deep Breath
December 10, 2009
By Johns Hopkins Health Alerts; www.johnshopkinshealthalerts.com
Proper technique is the key to benefiting from dry powder inhalers (DPIs) that treat chronic obstructive pulmonary disease (COPD) and asthma. But data presented at the annual meeting of the American College of Chest Physicians suggest that many patients with COPD can’t or don’t know how to use their inhalers properly.
Compared with aerosol metered dose inhalers, DPIs are considered “user-friendly.” They don’t require coordination between breathing in and squeezing the inhaler to release medication, and DPIs rely on your breath rather than chemical propellants to get the COPD medicine into your lungs.
But using DPIs requires a measured, forceful inhalation to ensure that the powdered COPD medication gets from the inhaler to deep in your lungs. If you inhale too quickly, the powder ends up at the back of your throat; if you breathe too slowly or too gently, it doesn’t go anywhere; and if you accidentally exhale, the powder might get blown away.
Aerosol metered dose inhalers, such as albuterol and ipratropium, give fast relief during acute respiratory attacks, but most DPIs are prescribed to control COPD symptoms. If you are not using your DPI properly, your COPD can progress, or you may frequently experience acute COPD episodes that require hospitalization.
Researchers from Offenburg Hospital in Germany reported that 32% of 224 patients made mistakes using their DPIs that prevented them from getting the right dose of medication. Errors were most common in patients who were over 60 and in people with severe lung obstruction.
Each of the various DPIs works differently. Diskus models contain several weeks’ worth of individual doses. Other DPIs look more like traditional tube inhalers and might contain individual doses or need to be loaded with a medication capsule before each use.
If you’re prescribed a DPI for your COPD, ask your doctor both to show you how to use it and then to watch as you use the DPI yourself. Bring your inhaler to each doctor ‘s visit to double-check your technique. If you are having trouble, your doctor can prescribe a traditional metered dose inhaler. Combining this type of pressurized inhaler with a spacer — a device that attaches to the inhaler and holds the medication for a few seconds before releasing it into your airways — can reduce problems with hand-breath coordination.
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