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By metering the release of a given volume of propellant, a metered dose of drug is delivered in the propellant volume.
Today, many patients wear pumps to deliver a steady metered dose of insulin, but Judge Sotomayor does not; her friends say she prefers to inject insulin the old-fashioned way.
The device functions by forcing a metered dose of drug solution through a unique and precisely engineered nozzle (the uniblock), producing two fine jets of liquid that converge at a pre-set angle.
That occurred in China in 2003, but the word's first known usage came 20 years before, when an author named Rob Stepney, writing in the pages of the now defunct UK magazine New Society, described a hypothetical device being explored at the time: "an inhaler or 'non-combustible' cigarette, looking much like the real thing, but… delivering a metered dose of nicotine vapour.
Delivering a metered dose of medication to a site of interest is achieved through a novel mechanism utilising a cam, a needle funnel, two opposing ratchets, a needle, and a single micromotor manufactured by Namiki.
With a DPI, the act of inhalation de-aggregates ('breaks up') and releases the metered dose of drug, thereby removing the need for a patient to coordinate actuation with inhalation.
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We also assessed device specific administration rules such as sufficient number of breaths in case of using a spacer, air-tight fit of mask/mouthpiece, and proper shaking of metered dose inhaler (MDI).
Emergency treatment of acute asthma or severe wheezing episodes in children ≤5 years focuses on urgent treatment of hypoxaemia (now aiming for a target oxygen saturation of 94 98%), and frequent administration of SABA by pressurised metered dose inhaler plus spacer, addition of ipratropium bromide for the first hour if needed, and frequent re-assessment.
Consideration of metered dose inhalers, a relatively recent concern, has led to the design of new equipment for administering this unique dosage form.
Factors like viscosity, spray pattern, spray angle, volume of actuation, droplet size distribution of the metered dose spray formulation and drying time, flexibility and wash-ability of the film formed after spraying were assessed.
We calculated the average daily dose of salbutamol (mg/day) while in the ICU as the sum of total metered dose inhaler and nebulization dose (in mg) divided by the number of days in the ICU.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com