title: Asthma control: the right inhaler for the right patient.
abstract: Inhaled therapy is the cornerstone of asthma management in that it optimizes the delivery of the medication to the site of action. The effectiveness of inhaled therapy is affected by the correct choice of the device and proper inhalation technique. In fact, this influences the drug delivery and distribution along the bronchial tree, including the most peripheral airways. In this context, accumulating evidence supports the contribution of small airways in asthma, and these have become an important target of treatment. In reality, the "ideal inhaler" does not exist, and not all inhalers are the same. Advances in technology has highlighted these differences, and have led to the design of new devices and the development of formulations characterized by extrafine particles that facilitate the distribution and deposition of the drug particles along the respiratory tract. In addition, efforts have been made to implement adherence to chronic treatment, which translates into clinical benefit. Taken together, the optimal control of asthma depends on the drug that is selected, the device that is employed and the removal of factors that reduce patient's adherence to therapy.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.MIS), University of Palermo, Palermo, Italy, nicola.scichilone@unipa.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Scichilone
mesh_terms: D000280:Administration, Inhalation; D001249:Asthma / Q000188:drug therapy*; D002626:Chemistry, Pharmaceutical; D002908:Chronic Disease; D006801:Humans; D009330:Nebulizers and Vaporizers; D010349:Patient Compliance; D010353:Patient Education as Topic
references.citation: J Allergy Clin Immunol. 2007 Mar;119(3):583-90
references.pmid: 17204317
references.citation: Eur Respir J. 2005 Jun;25(6):986-91
references.pmid: 15929952
references.citation: Respiration. 2014;88(1):3-15
references.pmid: 24902629
references.citation: BMC Pulm Med. 2011;11:40
references.pmid: 21762500
references.citation: Eur J Respir Dis. 1987 Feb;70(2):93-8
references.pmid: 3817076
references.citation: Respir Med. 2009 Jan;103(1):41-9
references.pmid: 18977646
references.citation: Arch Intern Med. 1977 Mar;137(3):318-321
references.pmid: 843149
references.citation: BMC Pulm Med. 2009;9:1
references.pmid: 19121204
references.citation: Br J Clin Pharmacol. 2003 Dec;56(6):600-12
references.pmid: 14616419
references.citation: Allergy. 2010 Jul;65(7):897-902
references.pmid: 20121764
references.citation: Int J Clin Pract Suppl. 2005 Dec;(149):30-2
references.pmid: 16280001
references.citation: Eur Respir J. 2011 Jun;37(6):1308-31
references.pmid: 21310878
references.citation: Respir Med. 1990 Jan;84(1):67-70
references.pmid: 2371425
references.citation: Respiration. 2008;75(1):18-25
references.pmid: 17911976
references.citation: Am J Respir Crit Care Med. 2005 Dec 15;172(12):1497-504
references.pmid: 16192448
references.citation: Respiration. 2014;88(4):346-52
references.pmid: 25195762
references.citation: J Bras Pneumol. 2009 Sep;35(9):824-31
references.pmid: 19820807
references.citation: Respir Med. 2006 May;100(5):841-5
references.pmid: 16216485
references.citation: Expert Opin Drug Deliv. 2014 Sep;11(9):1497-506
references.pmid: 24921434
references.citation: J Allergy Clin Immunol. 2014 Dec;134(6):1269-70
references.pmid: 25258141
references.citation: Soc Sci Med. 1997 Nov;45(9):1423-31
references.pmid: 9351159
references.citation: Arch Dis Child. 1998 Feb;78(2):143-7
references.pmid: 9579156
references.citation: Eur Respir Rev. 2012 Mar 1;21(123):66-74
references.pmid: 22379176
references.citation: NPJ Prim Care Respir Med. 2014;24:14081
references.pmid: 25297072
references.citation: Respir Med. 2012 Feb;106(2):205-14
references.pmid: 22035853
references.citation: J Aerosol Med Pulm Drug Deliv. 2014 Dec;27(6):414-8
references.pmid: 25238005
references.citation: Curr Med Res Opin. 2009 Sep;25(9):2303-10
references.pmid: 19635045
references.citation: Arch Dis Child. 1992 Mar;67(3):332-3
references.pmid: 1575560
references.citation: Can Respir J. 2009 Mar-Apr;16(2):49-54
references.pmid: 19399308
references.citation: J Appl Physiol (1985). 2008 Feb;104(2):394-403
references.pmid: 17991792
references.citation: Respir Med. 2011 Jun;105(6):930-8
references.pmid: 21367593
references.citation: Ther Clin Risk Manag. 2008 Oct;4(5):855-64
references.pmid: 19209268
references.citation: Expert Opin Pharmacother. 2008 Feb;9(3):479-90
references.pmid: 18220498
references.citation: Respir Med. 2013 Jul;107(7):987-1000
references.pmid: 23643486
references.citation: Clin Exp Allergy. 2011 Nov;41(11):1521-32
references.pmid: 21752116
references.citation: J Asthma Allergy. 2013;6:11-21
references.pmid: 23378776
references.citation: Eur Respir J. 2002 Feb;19(2):246-51
references.pmid: 11866004
references.citation: Chest. 1994 Jan;105(1):111-6
references.pmid: 8275720
references.citation: J Asthma. 2014 May;51(4):440-5
references.pmid: 24393080
references.citation: J Allergy Clin Immunol. 2009 Aug;124(2):390-3
references.pmid: 19541361
references.citation: Respir Res. 2012;13:112
references.pmid: 23216798