Why is correct inhaler technique important?
It maximises drug delivery to the lungs and improves patient outcomes
What are the consequences of poor inhaler technique?
Reduced lung deposition, wasted medication, poor disease control, lower quality of life, more emergency admissions, higher costs
What does pMDI stand for?
Pressurised Metered Dose Inhaler
Why do approximately 90% of patients use pMDIs incorrectly?
They require good coordination and timing, which many patients struggle to achieve
When should a spacer be considered for a patient using a pMDI?
When the patient cannot achieve correct pMDI technique
What does priming a pMDI involve?
Spraying the inhaler into the air to mix the propellant and medication
How should a new or unused pMDI be primed?
Spray four times with a 5‑second shake between each spray
Why should patients breathe out fully before inhaling medication?
To clear the lungs and allow drug particles to reach alveolar and bronchial spaces
Why should patients hold their breath for about 10 seconds after inhaling from a pMDI?
To prevent exhalation of medication and ensure full therapeutic effect
What is the purpose of a spacer?
To improve drug delivery by reducing coordination requirements and lowering oropharyngeal deposition
Why are spacers essential for infants and children?
They ensure accurate dosing and require age‑appropriate spacer designs
What does DPI stand for?
Dry Powder Inhaler
How should a patient inhale when using a DPI?
With a fast, deep, forceful breath through the mouth
Why should patients rinse and spit after using an inhaled corticosteroid via DPI?
To remove deposited powder and reduce risk of buccal infections from local immunosuppression
How should DPIs be stored?
In a cool, dry place to prevent powder caking
What does SMI stand for?
Soft Mist Inhaler
Why do SMIs not require strong inspiration?
They use a mechanical spring to generate a slow‑moving mist
What is the first step when setting up an SMI for initial use?
Insert the medicine cartridge into the base until it clicks
How is an SMI primed on first use?
Point downward, press the dose‑release button, and repeat until visible mist appears
When must an SMI be re‑primed?
If unused for 21 days or longer
What inhalation pattern is recommended between multiple doses for DPIs and SMIs?
A 1‑minute waiting period between doses
What is the main difference in inhalation technique between pMDIs and DPIs?
pMDIs require slow, steady inhalation; DPIs require fast, forceful inhalation
What is the main advantage of SMIs regarding buccal deposition?
They produce low buccal deposition, allowing lower doses
What is the purpose of breathing out slowly after inhalation?
To avoid exhaling medication as visible white mist
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Genetic testing: cystic fibrosis30
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Pulmonary surfactants29
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Altitude physiology24
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COPD38
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Lung cancer39
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Controlled Drugs34
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Spirometry38
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Inhaler technique30
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Investigating patient safety incidents29
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Environmental pollution48
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Smoking and vaping50
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Chemistry of large molecule therapeutics44
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Introduction to antimicrobial resistance67
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Pseudomonas42
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Mycoplasma32
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Legionella45
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Tuberculosis44
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Obstructive Sleep Apnoea38
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Medical gases18
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Altitude sickness35
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Pneumothorax22
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Cystic fibrosis43
