What Is A Diskus? Is It The Same As A DPI?

Yes, the Diskus is one type of DPI device used in asthma treatment. Other DPI devices that allow for inhalation of asthma medicines include the Aerolizer, the Flex-haler (previously called the Turbuhaler), and the Twisthaler. Some devices such as the Diskhaler and the Clickhaler are not available in the United States but are used abroad.

DPIs are devices that permit a person with asthma to self-administer precise, predetermined doses of inhaled corticosteroids or long-acting bronchodilator medicine, either individually or in combination. DPIs were developed as an alternative delivery device to CFC-containing MDIs. From a technical point of view, patients usually find it easier to use a DPI than an MDI.

Using a DPI requires you to take a controlled, deep breath from the DPI mouthpiece in such a manner that the medication, which is in the form of a very fine powder, penetrates deeply into the bronchial passageways. Although DPIs and MDIs both dispense very precise doses of medication, DPIs are fundamentally different from MDIs. The DPI device automatically releases medicine as you generate an inward flow of air with your lips around the mouthpiece.

The DPI is thus breath activated or patient activated; it requires less coordination compared to an MDI. You must be able to generate sufficient airflow through the mouthpiece in order to benefit from a dry-powder inhaler. As a rule, DPIs can be prescribed for persons over 5 years of age, as younger children do not have the ability to generate the required airflow to trigger the release of medicine from the device.

One type of DPI (such as the Diskus, the Twisthaler, and the Flexhaler) has a month’s supply of asthma medicine already contained in the device. You bring up each dose, as it is needed, usually by clicking a lever or by rotating the base of the DPI unit immediately before use. The second type of DPI requires that you open the

DPI before the time of use and place a capsule that contains a single dose of medicine in powdered form into a groove or chamber before snapping the DPI back into place. Medicines provided through the Diskus, the Flexhaler (previously known as a Turbuhaler), and the Twisthaler are preloaded with a month’s supply of medicine. The Aerolizer requires that you place a capsule containing the medicine into the device right before each use. A Handihaler similarly needs to be loaded immediately prior to each dose, but it delivers a medication (tiotropium) that is currently FDA approved for the treatment of lung conditions other than asthma (COPD and emphysema).

The design of the Diskus is distinctive—it looks like a small disc—and features a small counter that displays how many doses remain in the device, which is a very useful and practical feature. The Flexhaler and

Twisthaler have a more tubelike shape and have incorporated dose counters as well, to let you know when it is time to obtain a refill from the pharmacy. Several different types of asthma medicines come in DPI form, including long-acting β2 agonists (LABAs such as salmeterol and formoterol), inhaled corticosteroids (such as budesonide, fluticasone, and mometasone), and combination DPIs containing different potency inhaled corticosteroids, directly combined with long-acting β2 agonists (such as mixtures of salmeterol with fluticasone and, outside of the United States, budesonide with formoterol DPI).

Trade names include the Serevent Diskus, Foradil Aerolizer, Pulmicort Flexhaler, Flovent Diskus, Flovent Rotadisk Diskhaler, Asmanex Twisthaler, and Advair Diskus.