Aerosol Therapy of Obstructive and Parenchymal Pulmonary Disease: Principles and Clinical Aspects

Abstract

ABSTRACT Aerosols are the mainstay of the pharmacotherapy of reversible airflow obstruction (RAO). They are available as a variety of bronchodilators and anti-inflammatory/anti-allergic drugs provided by several aerosol delivery systems, making ingested therapy almost unnecessary for control of asthma and COPD. Oral steroids are however, frequently required during exacerbations and in a minority of patients with very severe asthma. Metered dose inhalers (MDI) are the most convenient, efficient and inexpensive way to deliver therapeutic aerosols, however, many patients, particularly children, the elderly and handicapped are unable to manipulate these effectively, even after repeated instruction. Such patients benefit from powder inhalers or MDI add-on devices such as valved holding chambers that assure aerosol delivery and minimize local and systemic side effects. Future promising developments include sympathomimetic and anticholinergic bronchodilators with a 12 hour or greater duration of action, topicall...