Proper use of a soft mist inhaler requires that the patient be able to do which of the following?

a. Generate inspiratory flows of 60 L/min or higher.
b. Exhale forcibly through the device before drug delivery.
c. Requires hand-breath coordination on the part of the patient.
d. Connect the device to the proper gas source.

ANS: C
To operate the device, patients twist the body of the device to load an internal spring, place the mouthpiece of the Respimat between the lips, and press a button to release the drug through a uniblock to create the aerosol, which is released over 1.1 to 1.4 sec, depending on the formulation configuration. The Respimat requires hand-breath coordination on the part of the patient, as does a pMDI, but because of the longer aerosolization time, it seems more likely that the patient will get a greater percent of emitted dose despite coordination issues.