title: How to match the optimal currently available inhaler device to an individual child with asthma or recurrent wheeze.
abstract: Inhaled medications are the cornerstone of treatment in early childhood wheezing and paediatric asthma. A match between patient and device and a correct inhalation technique are crucial for good asthma control. The aim of this paper is to propose an inhaler strategy that will facilitate an inhaler choice most likely to benefit different groups of children. The main focus will be on pressurised metered dose inhalers and dry powder inhalers. In this paper we will discuss (1) practical difficulties with the devices and with inhaled therapy and (2) the optimal location for deposition of medicines in the lungs, and (3) we will propose a practical and easy way to make the best match between the inhaler device and the individual patient. We hope that this paper will contribute to an increased likelihood of treatment success and improved adherence to therapy.
authors.affiliation: Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital AMC, Amsterdam, The Netherlands.
authors.forename: Wim M
authors.initials: WM
authors.lastname: van Aalderen
authors.affiliation: Area de Pediatria, Pabellon Docente Universitario Ctra., Murcia, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Garcia-Marcos
authors.affiliation: Department of Pediatrics, Marine Hospital gGmbH Wesel, Wesel, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Gappa
authors.affiliation: University Hospital of North Staffordshire, Stoke-on-Trent, UK.
authors.forename: Warren
authors.initials: W
authors.lastname: Lenney
authors.affiliation: University of Southern Denmark, Paediatric Research Unit, Kolding Hospital, Kolding, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Pedersen
authors.affiliation: Department of Pulmonary Diseases (454), Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Dekhuijzen
authors.affiliation: Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: David
authors.initials: D
authors.lastname: Price
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage; D000465:Algorithms; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D058995:Dry Powder Inhalers; D004867:Equipment Design; D006801:Humans; D036501:Metered Dose Inhalers; D011320:Primary Health Care; D012008:Recurrence; D012135:Respiratory Sounds / Q000187:drug effects*
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents