Because high inspiratory flows are required when using dry powder inhalers (DPIs), older patients, patients with chronic obstructive pulmonary disease (COPD) exacerbations, young children, and patients who are experiencing bronchospasms are not good candidates for DPI use.undefined#ref2">2
Take steps to eliminate interruptions and distractions during medication preparation.
DPIs, which deliver medications to the lungs in a dry powder form, are alternatives to aerosol-based delivery systems for inhaled respiratory medications. DPIs are more portable and may be easier to use than metered-dose inhalers (MDIs). Therefore, DPIs may improve patient compliance. Patients with respiratory disorders, such as asthma, bronchitis, and emphysema, may benefit from medication delivery with a DPI. Most older children are able to produce the inspiratory flow rate needed to use a DPI.
Because most DPIs use the force of inhalation to deliver the dry powder medication, insufficient flow rates or an ineffective inspiratory hold time can reduce the dosage delivered. DPIs are breath activated (they do not use a propellant to deliver the medication), which makes coordinating inspiration and actuation of the delivery device less necessary. The correct use of DPIs depends on the type of delivery system used. Two types of devices are available: the single-dose and the multidose (Figure 1).
The disadvantages of DPIs are that fewer drugs are available in this form and the patient must generate a sufficient inspiratory flow rate to acquire the correct dose. DPIs must be kept dry because moisture and humidity can cause the powder to clump. The dose may be lost if the patient inadvertently exhales into the DPI.
If the patient expresses concern regarding the accuracy of a medication, do not give the medication. Explore the patient’s concern, notify the practitioner, and verify the order.
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