The convenience and apparent simplicity of the pressurised metered dose inhalers (pMDIs) makes them attractive.
The patient needs to coordinate inhalation and actuation of the MDI to ensure adequate topical delivery of the drug. Even with optimal technique 90% of the drug is deposited in the oropharynx.
Less than optimal inhaling technique is seen in around 50% of pMDI users (2). Periodic checking of inhaler technique should be performed, particularly if there are problems with control.
If there are significant problems with technique a spacer device or breath actuated pMDI may be indicated (1).
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