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The Asthma Section

Asthma Devices and How They Work

Diskus

A diskus is a device that resembles a hockey puck. Examples include Advair and the Ventolin diskus.

When this type of inhaler is opened, a mouthpiece and a lever appear. Pushing in the lever loads a dose and the medication is inhaled through the mouthpiece. If you need to inhale a second dose, the diskus has to be closed and re-opened to reposition the lever.

Spacers

Also known as an aerochamber, a spacer is a device that helps optimize the use of a Meter Dose Inhaler (MDI). It is a clear, plastic tube with a receptacle that holds the MDI in one end and a mouthpiece with a one-way valve. Spacers make the use of an MDI easier and also allow the medication to penetrate deeper into the lungs and minimize its deposition in the mouth and throat. Studies show that an aerochamber delivers anywhere from 3 to 5 times the amount of the dose into the lungs when compared with an MDI alone.

Masks

Masks are usually necessary for infants, children and those who cannot seal their lips around the mouthpiece of a spacer. However, they provide a surface that attracts the medication, and can cause some of the dose to be deposited on the mask. Although using a spacer with a mask is far superior than using the MDI alone, the mask can be looked at as “training wheels”; very useful when necessary, but removed when ready.

Nebulizers

A nebulizer is a machine that uses oxygen or ultrasonic power to break medications up into tiny aerosolized particles that are then inhaled through a mask or mouthpiece.

Benefits of Using a Nebulizer

-It’s a very passive way of inhaling the medication that doesn’t take a lot of skill or effort.
-If a child is too young for puffers or a person has difficulties manipulating inhalers, using a nebulizer may be the only way to deliver the medication to their lungs.
-A nebulizer can also deliver large quantity of medication at a time and different drugs can be mixed in the nebulizer cup and inhaled together.

Drawbacks of a Nebulizer
- Some of the dose gets trapped in the upper airway and the throat.
- Harder to transport than an inhaler
- More difficult to clean and maintain
- Take more time to deliver each dose (usually 10-15 minutes).
- May have to manually measure the dose.

Peak Flow Meters

A peak flow meter is a small, hand-held device that measures the person’s ability to breath out air. The peak flow meter measures the maximum speed of an exhalation, also known as peak respiratory flow rate (PRFR).

Peak flow meters are not used to diagnose asthma, because peak flows vary from person to person and are affected by height, weight, age, gender and even genetics. The do however provide a frame of reference to help you monitor how well your asthma is controlled.

A peak flow meter may be beneficial if:
•You have recently been diagnosed with asthma and need a visual reading to help you understand how your symptoms relate to your lung function.
•You have moderate or severe asthma and would like to use your peak flow reading as another sign to identify what zone of your asthma action plan you are in.
•You are a visual person who would like a tool to quantify your symptoms.
•You are taking care of someone who has a difficulty vocalizing when his or her symptoms are worsening.
•Your doctor advises that you use one so that he or she can monitor your symptoms easier.

Before purchasing a peak flow meter, ask your doctor or asthma educator how to use it and how to interpret the results. When using a peak flow meter, it is good to have a place where you can write down the results so that they can be reviewed with your doctor or asthma educator.

Image courtesy of Alberta Children’s Hospital.

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