Dry powder inhalers are one of the most popular devices for delivering medication directly to the lungs of patients. Both for local action and when using the lungs as a portal of entry into the systemic circulation. Dry powder inhalers rely on the patient's inspiratory effort to supply the energy for the device to effectively deliver medication. In this respect they are limited by the airway pressures that a patient can generate with their respiratory muscles. In this review we focus on a simple model outlining the variables influencing respiratory pressure and review the literature on inspiratory flow rates in patients with respiratory disease. The main determinants of the capability to generate the pressure necessary to effectively use a dry powder inhaler are shown to be age and gender, not disease or disease severity.