THE CONTINUED NEED FOR METERED-DOSE INHALERS

The metered dose inhaler (MDI) is currently the most widely used devic e in the treatment of adult asthma. It is the delivery system of choic e in general practice throughout the world where both MDIs and powder inhalers are available. UP to 70% of all UK adult asthma prescriptions are for an MDI and worldwide the figures are likely to be higher. The MDI can be used to dispense a variety of medications and is currently the most economical device available. The cost of converting all MDIs to equivalent powder inhalers would be prohibitive. Patients, who hav e difficulty coordinating the operation of an MDI, can use it with a s pacer device. This obviates the need for hand-lung coordination and th e requirement for more than minimal inspiratory effort. In acute attac ks, there is currently no alternative to an MDI with a spacer device f or effective, easily administered, emergency treatment outside the hos pital environment. In an emergency, an MDI with a spacer can act more rapidly than a nebulizer because it is quicker to set up and use. The MDI is inexpensive, requires no power source and is easily portable. I t is therefore important that the MDI continues to be available.