Bronchodilator Responses to Salbutamol Using Diskhaler Versus Metered-Dose Inhaler

Abstract

In adults inhaling salbutamol via metered-dose inhalers (MDIs) 200 μ.g doses are recommended, but with diskhalers the manufacturer advocates 400 rather than 200 µg doses. To assess this advice, a partially double-blind, placebo-controlled salbutamol dose response, crossover study (also incorporating MDI doses) was conducted in 12 mild/moderate asthmatics. After active treatment, mean peak expiratory flow rate (PEFR) increments yielded no clinically or statistically significant differences; compared to placebo, respective median differences in PEFR increments (95% CIs) were 10 (-10, 50), 20 (0, 50), and 15 (0, 30) following 400 and 200 µg via diskhalers and 200 u.g via MDIs. Diskhalers are a suitable alternative for patients with poor MDI technique, but the use of 400 rather than 200 µg salbutamol doses is not supported by evidence.

Key Words:

• Salbutamol
• MDI
• Diskhaler
• Dose response
• Controlled comparison