Table 1 Advantages and disadvantages of breath-triggered inhalers (BTIs)
From: Asthma management with breath-triggered inhalers: innovation through design
| Main advantage over pressurized metered dose inhalers (pMDIs) | |
| There is no need to coordinate inhalation and actuation, since the device is self-triggered by the patient’s inspiratory flow. | |
| Main advantage over dry powder inhalers (DPIs) | |
| BTIs release the drug at low inspiratory flow. Therefore, patients do not need to inhale forcibly. Furthermore, drugs’ impact on upper airways is reduced. | |
| Further advantages of k-haler BTIs | |
| The device is small, light and portable. | |
| The device allows multiple doses, without any charging. | |
| It has got a dose counter, so that patients know how many doses are left. | |
| Few steps are needed to prime and operate the device, making it simple to use. | |
| Audible “clicks” when priming and closing allow feedback that the device is ready to use or store, respectively. | |
| The automatic release of a dose when the mouthpiece cap is closed prevents double or multiple doses if a primed dose is not taken. | |
| The closed canister avoids contents’ contamination. | |
| The cap is connected to the device, therefore it cannot be lost. | |
| There is high reproducibility in the amount of drug delivered. | |
| Main disadvantages | |
| BTIs are available for a limited range of drugs. | |
| If there is a suspension enclosed, patients need to remember to shake the device before each use. | |
| BTIs need priming before first use, in case of cold environment or if not used for some time. |