However, all inhalers require careful attention to proper technique to ensure drug delivery. You should receive instruction when these are prescribed, and technique should be demonstrated at each regular physician visit. Use of an inhaled medication by a metered-dose inhaler with a spacer or an aerosol holding chamber Two types of assist devices can be used with pressurized metered dose inhalers in an attempt to improve delivery of medication. Simple spacers are simply extender tubes that result in reducing the amount of drug that settles out in the mouth and throat by having the larger particles settle in the extender tube. Some come with soft flexible face masks that when pressed firmly against the face of an infant or young child so that drug is delivered when they inhale without active cooperation on the part of the patient.
Some larger chambers allow rebreathing of medication in the chamber.
The Inspirease is such a device. It consists of a flexible plastic expandable chamber into which the medication is placed. Any child willing to breathe in and out through a mouthpiece can get adequate medication from a metered dose inhale with this device. For any of these devices, specific instructions and demonstration should be provided and reviewed at regular intervals. Use of an inhaled medication by a nebulizer system For patients who cannot adequately coordinate actuation of the inhaler with inhalation even with the use of an aerosol holding chamber, a nebulizer system permits delivery of the medication when active participation or even cooperation is not possible as with infants and toddlers.