Asthma and COPD. Inhalation therapy--clarity or confusion?

BACKGROUND: Inhalation therapy is the most effective drug administration route for the treatment of asthma and chronic obstructive pulmonary disease (COPD). The range of available inhaler devices is wide and choosing the right one for your patient can be difficult.
OBJECTIVE: This article reviews the available evidence on the pros and cons of various inhaler devices, in order to encourage a more tailored choice. DISCUSSION: Of the currently available devices, we believe the Autohaler is probably the most clinically effective and user friendly. Although nebulisers are also clinically effective, they are costly and less easily portable. For most situations, the acceptable alternative to a nebuliser is an aerosolised metered dose inhaler attached to a spacer. Regardless of inhaler device choice, your patient must be able to use the device easily, maintain it, and derive clinical benefit. The cornerstone of good asthma and COPD management is continual clinical reassessment, including inhaler technique.