ABSTRACT
Slow mist inhalers (SMIs) have been part of the spectrum of inhalation devices since 2003. SMIs deliver the drug solution using mechanical energy produced by a spring, generating a fine, slow-moving mist over a longer period compared to other devices. The only SMI currently available is the Soft Mist Inhaler Respimat, developed by Boehringer Ingelheim. This device contains different bronchodilators as separate entities and in combinations. Recently, an improved second-generation Respimat reusable inhaler was released. In more detail, this second-generation Respimat inhaler is characterized by an easier device assembly, a larger dose indicator window, and, more importantly, it is reusable, with up to six cartridges with an intuitive cartridge-exchange mechanism. The SMIs containing long-acting beta-2-agonists and/or long-acting anticholinergics can be used as maintenance therapy. Some characteristics of the Respimat device may support its ease of use. Patients only need to generate a low inspiratory flow rate through the device to get the medication into the airways.
