INHALATION DEVICES IN

CHILDREN
MAGDALENA SIDHARTANI

DEPT OF CHILD HEALTH

FACULTY OF MEDICINE
DIPONEGORO UNIVERSITY
Asthma in children  adults
• Pattern, anatomy
• Natural history
• Drug delivery mechanism
• Potential side effects
Children fail to respond because
• Non-adherence
• Poor technique

Choice of device depends on

• Efficacy of drug delivery
• Convenience
– Portable
– Require no power
– Technically simple
– Minimal maintenance
• Cost effectiveness
• Safety
Inhalation Devices
1. Pressurized : MDI
2. Breath activated : autohaler
3. Dry powder : rotahaler, turbohaler
INHALER
Use of inhaler :
• Open mouth
• Closed mouth

Type of medication :
• Reliever
• Controller
PENGGUNAAN
AUTOHALER
PENGGUNAAN
EASYHALER
DISKHALER
PENGGUNAAN
TURBUHALER
PENGGUNAAN
BABYHALER
 Devices in children
Type <2 yr 2-4 yr 5-7 yr >8 yr

MDI, spacer & mask  

MDI & spacer   
Dry powder device ± 
Breath-activated device ± 
MDI (alone) 
INDIVIDUAL / TAILORED
 Goals for the successful
Management of Asthma
1. Achieve and maintain control of symptoms
2. Prevent asthma exacerbations
3. Maintain pulmonary function as close to
normal levels as possible
4. Maintain normal activity levels, including
medications
5. Prevent development or irreversible airflow
limitation
6. Prevent asthma mortality
Remember :
• Review regularly
• Assess adherence
• Assess inhaler technique
• Monitor control
• Adjust therapy to minimum dose required
to maintain control
Interrelated Asthma Management
1. Guided self-management education &
communication
– Written
– Problem review
– Coordination & support
2. Asses & monitor asthma (PEFR)
3. Environmental control measures
4. Medication plan (accommodate variability
among & within patients)
5. Plan for acute management
6. Regular follow-up care