BRONCHODILATOR RESPONSES TO SALBUTAMOL USING DISKHALER VERSUS METERED-DOSE INHALER

In adults inhaling salbutamol via metered-dose inhalers (MDIs) 200 mu g doses are recommended, but with diskhalers the manufacturer advocate s 400 rather than 200 mu g doses. To assess this advice, a partially d ouble-blind, placebo-controlled salbutamol dose response, crossover st udy (also incorporating MDI doses) was conducted in 12 mild/moderate a sthmatics. After active treatment, mean peak expiratory flow rate (PEF R) increments yielded no clinically or statistically significant diffe rences; compared to placebo, respective median differences in PEFR inc rements (95% CIs) were 10(-10, 50), 20 (0, 50), and 15 (0, 30) followi ng 400 and 200 mu g via diskhalers and 200 mu g via MDIs. Diskhalers a re a suitable alternative for patients with poor MDI technique, but th e use of 400 rather than 200 mu g salbutamol doses is not supported by evidence.