II. Efficacy

  1. MDIs require spacers for adequate efficacy
  2. Without a spacer device, more drug deposits on pharynx
  3. Spacer increases efficacy and decreases side effects
    1. Significantly improves dose delivery to Bronchi
    2. Less systemic absorption with spacer use
  4. Some Inhalers have spacer attached
    1. Aerospan (Flunisolide)

III. Types

  1. Open tube spacers (e.g. microspacer)
    1. Open tube (non-valved) that extends the distance between the mouth and the Inhaler
    2. Inhalant is less likely to deposit on the back of the throat with risk of adverse effects (e.g. oral Thrush, voice Hoarseness)
  2. Valved holding chamber (e.g. Aerochamber, optichamber)
    1. Valved chamber that holds the medication longer in the chamber to allow for maximal absorption
    2. Also extends the distance between mouth and Inhaler (as with open tube spacers)
  3. References
    1. (2014) Presc Lett, 21(5):27

IV. Preparations

  1. Commercially available spacer
    1. Price varies widely ($4 to >$30)
    2. Low cost spacers are as effective as expensive ones
      1. See Homemade spacers below
  2. Homemade spacer
    1. Plastic water bottle (500 cc) sealed
      1. As effective as commercial spacer
    2. Polystyrene cup (200 cc)
      1. Not as effective as plastic water bottle
    3. References
      1. Zar (1999) Lancet 354(9183):979-82 [PubMed]
  3. Improvised Aerochamber with Mask for young children
    1. lungAsthmaPedsMask.png

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Related Studies

Ontology: OPTIHALER (C0727300)

Concepts Medical Device (T074)
English OPTIHALER, Optihaler

Ontology: Spacer Inhaler (C0991876)

Definition (MSH) Inhalation devices with INHALATION SPACERS. They are generally used for dry powder medications.
Concepts Medical Device (T074)
MSH D036501
Portuguese Inaladores com Espaçadores
Spanish Inhaladores con Espaciadores
German Spacer-Inhalatoren, Pulverinhalatoren, Spinhaler
English spacer inhaler, inhaler spacer, Spacer-Inhaler, Spacer-Inhalers, Spacer Inhalers, Spacer Inhaler, SPACER-INHALER, Spacer
French Aérosols-doseurs avec chambre d'inhalation, Pompes avec tube d'espacement, Aérosols-doseurs avec chambre de retenue, Aérosols-doseurs avec tube d'espacement, Aérosols-doseurs avec dispositif d'espacement, Pompes avec dispositif d'espacement
Dutch Spacer inhalers