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J R Soc Med. 1980 November; 73(11): 776–779.
PMCID: PMC1437930

Simple instructions for using pressurized aerosol bronchodilators1


Although the manufacturers of pressurized aerosol bonchodilators issue instructions for using the inhalers, little or no experimental verification exists. Bronchodilatation has been measured after controlled inhalations of 500 μg terbutaline sulphate given in a systematic series of investigations to 8 patients with reversible airways obstruction at 2 different inhalation flow rates (25 1/min and 80 1/min), 3 different lung volumes (20%, 50% and 80% vital capacity) and followed by 2 different breath-holding pauses (4 and 10 seconds). The results indicate that patients may release the aerosol at any time during the course of a slow deep inhalation which should be followed by 10 seconds of breath-holding. This will ensure an optimal bronchodilator response.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Coady TJ, Davies HJ, Barnes P. Evaluation of a breath actuated pressurized aerosol. Clin Allergy. 1976 Jan;6(1):1–6. [PubMed]
  • Earis JE, Bernstein A. Misuse of pressurised nebulisers. Br Med J. 1978 Jun 10;1(6126):1554–1554. [PMC free article] [PubMed]
  • Goldberg IS, Lourenço RV. Deposition of aerosols in pulmonary disease. Arch Intern Med. 1973 Jan;131(1):88–91. [PubMed]
  • Grainger JR. Correct use of aerosol inhalers. Can Med Assoc J. 1977 Mar 19;116(6):584–586. [PMC free article] [PubMed]
  • Hensley MJ, O'Cain CF, McFadden ER, Jr, Ingram RH., Jr Distribution of bronchodilatation in normal subjects: beta agonist versus atropine. J Appl Physiol Respir Environ Exerc Physiol. 1978 Nov;45(5):778–782. [PubMed]
  • Miller WF. Aerosol therapy in acute and chronic respiratory disease. Arch Intern Med. 1973 Jan;131(1):148–155. [PubMed]
  • Paterson IC, Crompton GK. Use of pressurised aerosols by asthmatic patients. Br Med J. 1976 Jan 10;1(6001):76–77. [PMC free article] [PubMed]
  • Pavia D, Thomson ML, Clarke SW, Shannon HS. Effect of lung function and mode of inhalation on penetration of aerosol into the human lung. Thorax. 1977 Apr;32(2):194–197. [PMC free article] [PubMed]
  • Riley DJ, Weitz BW, Edelman NH. The response of asthmatic subjects to isoproterenol inhaled at differing lung volumes. Am Rev Respir Dis. 1976 Sep;114(3):509–515. [PubMed]
  • Riley DJ, Liu RT, Edelman NH. Enhanced responses to aerosolized bronchodilator therapy in asthma using respiratory maneuvers. Chest. 1979 Nov;76(5):501–507. [PubMed]
  • Sterling GM. Diseases of the respiratory system. Asthma. Br Med J. 1978 May 13;1(6122):1259–1262. [PMC free article] [PubMed]

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