Metered-dose inhalers and dry powder inhalers in aerosol therapy.

Inhaled drug delivery is an important part of the armamentarium of clinicians caring for patients with pulmonary disease. An increasing variety of metered-dose inhalers and dry powder inhalers are becoming available. This has been driven by the development of new formulations and the impending ban on chlorofluorocarbon propellants. The result is a proliferation of devices, resulting in a confusing number of choices for the clinician, as well as confusion for patients trying to use these devices correctly. The presenters at this conference included many of the world's authorities on metered-dose inhalers and dry powder inhalers, and were an appropriate mix of academic aerosol scientists, clinician researchers with an interest in aerosol therapy, and aerosol scientists working for industry. Improper inhaler technique is common among patients. One of the important take-home messages of this conference is the importance of clinicians knowledgeable in the use of aerosol delivery devices and clinicians' ability to teach patients how to use these devices correctly. Respiratory therapists are uniquely positioned to provide this service, and there is evidence that respiratory therapists may do this better than others. The proceedings of this conference provide the current state of the art of metered-dose inhalers and dry powder inhalers.