For which of the following patient groups is use of a dry powder inhaler (DPI) for bronchodilator administration recommended?

1. Infants and children younger than 5 years
2. Patients with an acute bronchospastic episode
3. Patients requiring maintenance therapy
a. 1 and 2 only
b. 3 only
c. 2 and 3 only
d. 1, 2, and 3

ANS: B
Because infants, small children (younger than 5 years) (Figure 39-17), and those not able to fol-low instructions cannot develop flow this high, these patient groups cannot use DPIs. Patients with severe airway obstruction also may not be able to achieve the required flow; therefore, DPIs should not be used in the management of acute bronchospasm.