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Inhaler Devices 
Harindu Udapitiya, 
Temporary Lecturer, 
Division of Pharmacology.
Overview 
• What is inhaler? 
• Advantages Vs disadvantages 
• Types of inhalers 
– Properties 
– How to use 
– Advantages and disadvantages
1.What is inhaler? 
• An inhaler is a medical device used for 
delivering medication into the body via the 
lungs.
• Inhalant drugs 
1. Broncodilators 
2. Corticosteroids-Beclomethasone 
3. Mucolytic agents-Acetylcysteine 
4. Antimicrobials-Ribavirin, 
Tobramycin 
5. Immune modulators- 
Cyclosporine, Interferon α
6. Anesthetics-opiods
2.Advantages Vs Disadvantages 
• Advantages: 
1.Less systemic toxicity 
2.More rapid onset of medication 
3.Delivery to target of action 
4.Higher concentrations available in the lung
• Disadvantages: 
1.Time and effort consuming 
2.Limitation of delivery device
3.Devices 
1.Metered-dose inhalers
Properties 
A liquid propellant 
Inhalation technique is critical for optimal 
drug delivery
How to use 
Without chamber
1.Remove the cap from the MDI and shake well. 
2.Breathe out all the way. 
3.Place the mouthpiece of the inhaler between 
your teeth and seal your lips tightly around it. 
4.As you start to breathe in slowly, press down on 
the canister one time.
5. Keep breathing in as slowly and deeply 
as you can. (It should take about 5 to 7 
seconds for you to completely breathe in.) 
6. Hold your breath for 10 seconds (count to 
10 slowly) to allow the medication to reach 
the airways of the lung. 
7. Repeat the above steps for each puff 
ordered by your doctor. Wait about 1 minute 
between puffs.
8. Replace the cap on the MDI when 
finished. 
9. If you are using a corticosteroid MDI, you 
should use a valved holding chamber as 
described above.
With chamber
1.Remove the cap from the MDI and 
chamber. Shake well. 
2.Insert the MDI into the open end of the 
chamber (opposite the mouthpiece). 
3.Breathe out completely. 
4.Place the mouthpiece of the chamber 
between your teeth and seal your lips 
tightly around it.
5. Press the canister once. 
6. Breathe in slowly and completely through 
your mouth. If you hear a "horn-like" sound, 
you are breathing too quickly and need to 
slow down. 
7. Hold your breath for 10 seconds (count to 
10 slowly) to allow the medication to reach 
the airways of the lung.
8. Repeat the above steps for each puff 
ordered by your doctor. Wait about 1 minute 
in between puffs. 
9. Replace the cap on your MDI when 
finished. 
10. If you are using a corticosteroid MDI, 
rinse your mouth and gargle using water or 
mouthwash after each use. You should 
always use a chamber with a steroid MDI.
Advantages Vs Disadvantages 
Advantages 
•Rapid application 
•Handling 
•Multidose 
Disdvantages 
•Hand-breathe 
coordinations 
•İneffective use in poor 
ventilated patients 
•Oropharyngeal 
deposition and local 
side effects
2. Dry powder inhalers 
Single dose
Handihaler
Multi dose 
Discus inhaler 
Turbuhaler
Properties 
just dry-powder and no propulsion system. 
manual mechanism to insert one dose of 
dry-powder drug into the mouthpiece.
How to use 
1. To load a dose, hold the DPI with mouthpiece 
up to ensure proper loading of the medication. 
2.Twist the  grip fully in one direction as far as it 
will go and then fully back again. You will hear a 
click. The DPI is now loaded with a dose. 
3.Turn your head away from the inhaler and 
breathe out as much air as you comfortably can.
4. Place the device in your mouth and breathe in 
as forcefully and deeply as you can. 
5. Hold your breath for 10 seconds. 
6. Take the DPI away from your mouth and exhale 
slowly. 
7. If more than one dose is prescribed, repeat 
steps 1 through 5 for each dose. 
8. When your treatment is complete, replace the 
white cover and twist it completely to close
Advantages Vs Disadvantages 
Advantages 
•Less patient 
coordination required 
•Spacer not necessary 
•Compact Portable 
•No propellant 
•Usually higher lung 
deposition than a pMDI 
Disadvantages 
•Work poorly if inhalation is not 
forceful enough 
•Many patients cannot use them 
correctly (e.g.capsule handling 
problems for elderly 
•Most types are moisture 
sensitive. 
•Need to reload capsule each 
time
3. Nebulizer
Properties 
•The fundamental concept of nebulizer 
performance is the conversion of the 
medication solution into droplets in the 
respirable range of 1-5 micrometers
How to use
1. Place the compressor where it can safely reach its 
power source and where you can reach the ON/OFF 
switch. 
2. Wash your hands prior to preparing each treatment. 
3. Use a clean nebulizer. 
4. Measure the correct dose of medication and other 
solutions prescribed by your physician. Add these to the 
nebulizer. 
5. Connect the air tubing from the compressor to the 
nebulizer base. A finger valve may also be attached 
between the nebulizer base and tubing. Make sure all 
connections are snug. 
6. Attach a mouthpiece to the nebulizer.
Advantages Vs Disadvantages 
Advantages 
•Provide therapy for patients 
who cannot use other 
inhalation modalities (eg, MDI, 
DPI) 
•Allow administration of large 
doses of medicine 
•Patient coordination not 
required 
•Effective with tidal breathing 
•Dose modification possible 
•Can be used with 
supplemental oxygen 
Disadvantages 
•Decreased portability 
•Longer set-up and 
administration time 
•Higher cost 
•Electrical power source 
required 
•Contamination possible
Did you learn???
Few OSCE types 
questions….
Question 01 
1.1. What is this 
device? 
1.2. List 2 drugs use 
with the device? 
1.3. List 1 advantage 
of this device.
Question 02 
2.1. List 2 diseases 
that the given device 
use. 
2.2. List one advice 
that you give a patient 
who using the device. 
2.3. If a patient 
having difficulty in 
using the device give 
an option.
Question 03 
A 
B 
3.1. What is this 
instrument? 
3.2. identify A and B. 
3.3. Mention 2 conditions 
which uses given 
instrument.
Summery 
1. Introduction on inhalers 
What? 
Advantages Vs Disadvantages. 
Drugs.
• 2. Devices 
A.MDI 
B.DPI 
C.Nebulizer 
Properties 
How to use 
Advantages Vs 
Disadvantages
Inhaler devices
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Inhaler devices

  • 1. Inhaler Devices Harindu Udapitiya, Temporary Lecturer, Division of Pharmacology.
  • 2. Overview • What is inhaler? • Advantages Vs disadvantages • Types of inhalers – Properties – How to use – Advantages and disadvantages
  • 3. 1.What is inhaler? • An inhaler is a medical device used for delivering medication into the body via the lungs.
  • 4. • Inhalant drugs 1. Broncodilators 2. Corticosteroids-Beclomethasone 3. Mucolytic agents-Acetylcysteine 4. Antimicrobials-Ribavirin, Tobramycin 5. Immune modulators- Cyclosporine, Interferon α
  • 6. 2.Advantages Vs Disadvantages • Advantages: 1.Less systemic toxicity 2.More rapid onset of medication 3.Delivery to target of action 4.Higher concentrations available in the lung
  • 7. • Disadvantages: 1.Time and effort consuming 2.Limitation of delivery device
  • 9. Properties A liquid propellant Inhalation technique is critical for optimal drug delivery
  • 10.
  • 11. How to use Without chamber
  • 12. 1.Remove the cap from the MDI and shake well. 2.Breathe out all the way. 3.Place the mouthpiece of the inhaler between your teeth and seal your lips tightly around it. 4.As you start to breathe in slowly, press down on the canister one time.
  • 13. 5. Keep breathing in as slowly and deeply as you can. (It should take about 5 to 7 seconds for you to completely breathe in.) 6. Hold your breath for 10 seconds (count to 10 slowly) to allow the medication to reach the airways of the lung. 7. Repeat the above steps for each puff ordered by your doctor. Wait about 1 minute between puffs.
  • 14. 8. Replace the cap on the MDI when finished. 9. If you are using a corticosteroid MDI, you should use a valved holding chamber as described above.
  • 16. 1.Remove the cap from the MDI and chamber. Shake well. 2.Insert the MDI into the open end of the chamber (opposite the mouthpiece). 3.Breathe out completely. 4.Place the mouthpiece of the chamber between your teeth and seal your lips tightly around it.
  • 17. 5. Press the canister once. 6. Breathe in slowly and completely through your mouth. If you hear a "horn-like" sound, you are breathing too quickly and need to slow down. 7. Hold your breath for 10 seconds (count to 10 slowly) to allow the medication to reach the airways of the lung.
  • 18. 8. Repeat the above steps for each puff ordered by your doctor. Wait about 1 minute in between puffs. 9. Replace the cap on your MDI when finished. 10. If you are using a corticosteroid MDI, rinse your mouth and gargle using water or mouthwash after each use. You should always use a chamber with a steroid MDI.
  • 19. Advantages Vs Disadvantages Advantages •Rapid application •Handling •Multidose Disdvantages •Hand-breathe coordinations •İneffective use in poor ventilated patients •Oropharyngeal deposition and local side effects
  • 20. 2. Dry powder inhalers Single dose
  • 22. Multi dose Discus inhaler Turbuhaler
  • 23. Properties just dry-powder and no propulsion system. manual mechanism to insert one dose of dry-powder drug into the mouthpiece.
  • 24.
  • 25. How to use 1. To load a dose, hold the DPI with mouthpiece up to ensure proper loading of the medication. 2.Twist the grip fully in one direction as far as it will go and then fully back again. You will hear a click. The DPI is now loaded with a dose. 3.Turn your head away from the inhaler and breathe out as much air as you comfortably can.
  • 26.
  • 27. 4. Place the device in your mouth and breathe in as forcefully and deeply as you can. 5. Hold your breath for 10 seconds. 6. Take the DPI away from your mouth and exhale slowly. 7. If more than one dose is prescribed, repeat steps 1 through 5 for each dose. 8. When your treatment is complete, replace the white cover and twist it completely to close
  • 28. Advantages Vs Disadvantages Advantages •Less patient coordination required •Spacer not necessary •Compact Portable •No propellant •Usually higher lung deposition than a pMDI Disadvantages •Work poorly if inhalation is not forceful enough •Many patients cannot use them correctly (e.g.capsule handling problems for elderly •Most types are moisture sensitive. •Need to reload capsule each time
  • 30. Properties •The fundamental concept of nebulizer performance is the conversion of the medication solution into droplets in the respirable range of 1-5 micrometers
  • 31.
  • 33. 1. Place the compressor where it can safely reach its power source and where you can reach the ON/OFF switch. 2. Wash your hands prior to preparing each treatment. 3. Use a clean nebulizer. 4. Measure the correct dose of medication and other solutions prescribed by your physician. Add these to the nebulizer. 5. Connect the air tubing from the compressor to the nebulizer base. A finger valve may also be attached between the nebulizer base and tubing. Make sure all connections are snug. 6. Attach a mouthpiece to the nebulizer.
  • 34. Advantages Vs Disadvantages Advantages •Provide therapy for patients who cannot use other inhalation modalities (eg, MDI, DPI) •Allow administration of large doses of medicine •Patient coordination not required •Effective with tidal breathing •Dose modification possible •Can be used with supplemental oxygen Disadvantages •Decreased portability •Longer set-up and administration time •Higher cost •Electrical power source required •Contamination possible
  • 36. Few OSCE types questions….
  • 37. Question 01 1.1. What is this device? 1.2. List 2 drugs use with the device? 1.3. List 1 advantage of this device.
  • 38. Question 02 2.1. List 2 diseases that the given device use. 2.2. List one advice that you give a patient who using the device. 2.3. If a patient having difficulty in using the device give an option.
  • 39. Question 03 A B 3.1. What is this instrument? 3.2. identify A and B. 3.3. Mention 2 conditions which uses given instrument.
  • 40. Summery 1. Introduction on inhalers What? Advantages Vs Disadvantages. Drugs.
  • 41. • 2. Devices A.MDI B.DPI C.Nebulizer Properties How to use Advantages Vs Disadvantages