Soft Mist Inhalers

The medication from these devices is released as a mist into the air.  There is no propellant in the system, though benzalkonium chloride and EDTA are present as preservatives.  The drug is stored in a liquid form which is expressed as a mist when mechanically forced through a nozzle array.  SMIs are a low-velocity system which results in less oropharyngeal deposition of drug.  The particles are suspended in air for 6 times longer than a MDI; thus, coordination between actuation and inhalation is easier.,  Examples of a SMIs are Combivent© Respimat and Spiriva© Respimat.  SMIs result in 2-3x lung deposition vs. an MDI.  Advantages of the SMI are increased lung deposition of drugs and ease of coordination with breathing.  Disadvantages are cost and ease of setup.

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