A dry powdered inhaler (DPI) is a type of inhaler which delivers medicines to the airways in the form of a powder compared to a metered dose inhaler (MDI) which delivers the medicine in the form of an aerosol. Dry powder inhalers (DPI) can contain different types of medicines which could be either in the form of bronchodilators like salbutamol, or inhaled corticosteroids or a combination of inhaled corticosteroids with a long acting beta agonist.
What are the advantages of using the dry powder inhaler?
There are many advantages of dry powder inhalers. Dry powder inhalers (DPI) are an efficient and effective way of depositing the medicine into the child’s airways. They are compact and easy to carry especially for medicines that need to be taken daily. Dry powder inhalers (DPI) also don’t require a spacer device which is necessary. Some dry powder inhalers are single dose while some are multi-dosed and can hold a large number of doses. Dry powder inhalers (DPI) are quite easy to use. They do not require the coordination between inhaling and pressing to spray the medicine as with Metered Dose Inhalers (MDI). Dry powder inhalers (DPI) are breath-actuated, where the medicine is released when the child inhales.
What are the disadvantages of using the dry powder inhaler?
Dry powder inhalers (DPI) are fraught with a few disadvantages as well. Dry powder inhalers (DPI) require a significant effort or inspiratory flow to disintegrate the medicine and deposit it into the airways of the lungs. This sometimes may not be possible in young children. The requirement for an effort or inspiratory flow may not be as much with newer dry powder inhalers such as turbhalers. Hence, Dry powder inhalers (DPI) should not be used in young children below 8 to 9 years of age. The second problem associated with dry powder inhalers is the higher amount of medicine getting deposited in the mouth of the child. This leads to a significant amount of. medicine being absorbed from the mouth into the body, which can lead to side effects.
What is the difference between various types of dry powder Inhalers available in the market?
Dry powder inhalers (DPI) are available in different types and models. The commonly available dry powder inhalers (DPI) are the Rotahalers, Lupihalers, Turbhalers, Revolizers, Acuhalers, etc. All these devices have their own pros and cons. Older devices like Rotahalers, Lupihalers although effective are single dose devices where the medicine is in the form of a capsule which needs to be broken/punctured. These devices are simple to use and quite cost effective. They require a higher inspiratory flow for proper disintegration and delivery of drugs. The newer generation devices like Turbhalers have a reservoir which contains the drug, hence they tend to be multidose. Upon effort of the patient a defined amount of medicine is released. The effort required compared to the older generation devices is significantly less. The deposition of medicine into the airway with different dry powder inhalers (DPI) is quite different. The amount of medicine which gets deposited. With Rotahalers the deposition ranges from 5 to 10% compared to turbhalers which might be somewhere between 15 and 20%. The new generation devices tend to be quite costly compared to older generation devices.
In conclusion, dry powder inhalers (DPI) are an effective way of giving medicines to children with respiratory problems like asthma. They are an option to Metered Dose Inhalers (MDIs) with spacers in older children. They are best avoided in young children where a Metered Dose Inhalers (MDIs) with spacers are preferred. The choice of device also depends on the patient’s comfort. Whatever device is used, the patient needs to master the technique to take the medicine to achieve maximum benefit.
In case your child is suffering from asthma, you need to get in touch with the pediatric pulmonologist for proper diagnosis, evaluation, treatment and choice of the best device for your child.
