Autohaler
Autohaler
Autohaler
DRUG or DEVICEorPATIENT
Or
Is it all of them ?
Under-diagnosis
Non-adherence with medication
Sub-optimal levels of ICS
Choice of inhaler device
Design of the device and its characteristics
Technique of usage
6
p<0.0001
5
4
3
2
1
0
Number
of errors
>7
Change in FEV1
%
30
Good technique
Bad technique
20
10
15
30
60
90 Min
Hence
Poor inhalation technique
Inhaled Drug
Delivery System
Metered Dose
Inhaler (MDI)
Add on devices
(spacer + mask)
Nebulizer
Breath Actuated
Metered dose
inhaler (BAI)
pMDIs
(Pressurized Metered Dose Inhalers)
Zerostat VT
DPIs
(Dry Powder Inhalers)
Breath activated device
Classification of DPIs
Unit dose
Rotahaler
Revolizer
Lupihaler
Reddyhaler
Myhaler
Turbospin
Machaler
Adhaler
Aphaler
Octahaler
Multi dose
Discrete
Reservoir
Multihaler
Accuhaler
Sunhaler
Turbohaler
Novolizer
REVOLIZER
MULTIHALER
ROTAHALER
Many inhalers, both pMDIs and DPIs, are complicated to use, some
requiring up to eight steps for a correctly usage1
Reduced compliance
Poor control of disease
BAIs
Breath Actuated Inhalers
BAIs
(Breath Actuated Inhalers)
BAIs sense the patients inhalation through the actuator and actuate
the inhaler automatically in synchrony
These devices emit a dose when a sufficient inspiratory flow
The Autohaler
(Breath actuated pressurized metered dose inhaler)
Lever
Top Cap
Sleeve
Body
Aerosol
Valve
Mouthpiece
Mouthpiece
Cover
Trigger
Assembly
Slide
Advantages
Simple to learn, use and teach
Disadvantages
Patients has to inhale to
trigger the device
No need to coordinate actuation
Patients need to be
and inhalation
instructed to inhale slowly.
Works effectively at low inspiratory Patients sometimes stop
flow rate of 20-30 l/min
inhaling once actuation
occurs
Releases the drug at a low
velocity of 20 m/sec
Indicated for all age groups adults, elderly and children
Spacer or valved holding chamber
is not required
cap
Failure to lift the lever
Device unrelated
Failure to exhale completely
before breathing in
Failure to breathe in slowly
and deeply
Failure to hold breath for 10
seconds
Autohaler Vs pMDIs
18 patients with asthma
Patients inhaled 100 g salbutamol through
pMDI (own technique)
pMDI (taught technique)
Autohaler
120
100
80
60
40
20
0
Breath-Actuated
Inhaler
Autohaler
Multi-dose DPI
Multi-dose DPI
pMDI
Reservoir DPI
pMDI+spacer
75%
70%
60%
50%
40%
30%
25%
20%
10%
0%
Autohaler
pMDI
Use of Autohaler in
difficult situations
Children
11 were < 6with
years acute wheezy condition could
Autohaler 99% of times
Results actuate
:
Rotahaler was actuated 74/100 times
Autohaler was actuated in 99/100 times
Indias
st
1
BAI - Autohaler
Autohaler
Just breathe in& well deliver