Inhalation Therapy: Practical Considerations for Nebulisation Therapy

Many drugs may be administered either as a powder, a spray, or a nebulised aerosol. Even though the formulation is the same, the more common drugs are available in different inhaler device brands, or as a solution/suspension to aerosolise in a nebuliser system with unspecified characteristics. What formulation and type of inhalation device to choose is dependent upon factors such as type of drug, patient age, physical and mental capacities, and in what situation the drug is to be inhaled.1–3 Typically, the therapist is faced with a choice between a variety of alternatives. Optimally, a spray (pMDI) with a spacer should be used for delivering steroids to avoid a high bioavailability of drug deposited in the oropharynx, and to reduce simultaneously the occurrence of Candida spp. in the mouth.2 Otherwise, if drugs come