Dry-powder inhalers or DPIs do not use propellants like MDIs. Instead, DPIs, which are also called breath-activated devices, deliver medicine to your child's airways using a dry powder. Children generally over the age of five can use DPIs, but they will require some new skills. Most of these devices have counters.

With a DPI, your child will need to take a quick, deep breath to inhale the medicine — rather than a slow breath as with the MDI and spacer. Because of the lack of propellant, this deeper breath will help the medicine move into your his airways better.

Types of DPIs

Four types of DPIs are on the market for treating asthma symptoms. One is the Diskus that is marketed under the brand names Serevent or Advair. The others are the Turbuhaler used by Pulmicort; the Twisthaler for Asmanex; and the Aerolizer inhaler for Foradil.

Using a DPI

Each of the DPIs varies in how it is used. With the Diskus, the device is twisted and a lever is pulled in order to use it. With the Turbuhaler, it is twisted in two different directions. The Aerolizer uses capsules so it's easy to see how much medicine has been used. Spacers are not used for DPIs.

The devices require that your child exhale first, and then bring the mouthpiece to her lips. She should use a fast, quick breath when the medicine is released, and then hold her breath for ten seconds. It's probably a good idea for your child to rinse her mouth when she is finished, and to clean off the device for the next use.