Asthma is a chronic lung disease that causes narrowing of the airways. It affects millions of people worldwide and proper management is crucial to prevent symptoms and exacerbations. One important component of asthma management is taking prescribed inhaled medications correctly. Inhaled medications work directly in the lungs to open up the airways and provide relief. Their proper delivery is important for maximum effectiveness. This is where asthma spacers play a crucial role.

What are asthma spacers?
Asthma spacers, also known as aerochambers or valved holding chambers, are plastic tube-like devices used with metered-dose inhalers (MDIs). They have an open end that fits over the mouthpiece of the MDI and a mouthpiece on the other end through which the patient inhales. Spacers work by holding the medication released from the inhaler in its chamber temporarily before the patient inhales. This allows more medication to reach the lungs as compared to inhaling directly from the inhaler alone.

How do asthma spacers help medication delivery?
When a metered-dose inhaler is pressed without a spacer, much of the medication stays in the mouth and throat rather than reaching deep down into the lungs where it is needed. This is because the propellant that carries the medication out of the inhaler moves at a very high speed. With a spacer, the propellant and medication are held briefly in the chamber before being inhaled slowly. This allows tiny particles in the medication mist to settle so they can be inhaled deep into the lungs. Studies show 60-70% more medication reaches the lungs with a spacer compared to inhaling straight from an MDI.

Reasons why spacers improve medication delivery include:
- Slowing down the speed at which medication is inhaled, allowing more time for it to settle in the lungs rather than remaining in the mouth/throat.
- Forming a reservoir that holds medication temporarily instead of it going straight into the mouth.
- Enhancing coordination as the patient does not need to time inhalation with actuation of the inhaler.

Spacers also reduce incidence of side effects like oral thrush that occur due to local effects of inhaled corticosteroids in the mouth. They are especially beneficial for young children and elderly patients who may have difficulty coordinating inhalation with device actuation. Overall, spacers offer a tangible improvement in medication delivery to the airways compared to inhalers alone.


Types of Asthma Spacers
There are different types of Asthma Spacers available to choose from depending on a patient’s needs and preferences. Some common types are:

- Single-dose spacers- These are smaller disposable spacers meant for single use with one inhaler. They are inexpensive and portable but create more waste.

- Multi-dose spacers- Larger reusable spacers that can be used with the same or different inhalers over weeks/months. They hold more medication but require cleaning as per the schedule. Popular brands include Volumatic and Nebuhaler.

- Breath-actuated spacers- Have one-way valves that open only during inhalation and prevent loss of medication during exhalation and between breaths. Examples include AeroChamber Plus Flow-Vu and OptiChamber.

- Mask spacers- Have a silicone face mask attached instead of a mouthpiece, making them more suitable for young children and persons with disabilities who cannot use standard spacers.

The choice depends on factors like age of patient, ability to clean multi-dose spacers properly, cost, and portability needs. Physicians usually recommend the best suited type.

Correct Spacer Technique is Important
While spacers improve medication delivery significantly, it is crucial patients learn the proper technique for using them effectively:

- Shake the inhaler well before use

- Attach spacer securely to inhaler mouthpiece

- Exhale fully before placing mouthpiece in mouth and pressing inhaler

- Inhale deeply and slowly over 3-5 seconds through spacer

- Hold breath for 10 seconds before exhaling

- Rinse spacer mouthpiece and air chambers daily with water

Benefits of Using Asthma Spacers
When used correctly alongside prescribed inhalers, asthma spacers provide considerable benefits for managing the condition:

- Improve medication deposition in lungs by 60-70%

- Enhance asthma symptom control through better delivery of reliever and preventer medications

- Reduce use of rescue inhalers through more effective control with preventers

- Lower risk of side effects like oral thrush especially in young children

- Improve adherence as technique is easier than direct inhalation

- May be cost-effective in the long-run through better management of asthma

Asthma spacers are a simple, low-cost tool that offers a significantly improved method for inhaled medication delivery. When prescribed and used properly in conjunction with inhalers, they can have a meaningful positive impact on asthma management and control.

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