Aerosolized medications for the treatment of asthma are now considered to be the delivery system of choice. Despite their popularity, traditional pressurized metered dose inhalers are associated with a variety of drawbacks. This article reviews the aerosolized drug delivery systems currently available, along with their advantages and disadvantages. Patient technique in the use of these agents is addressed. Special considerations in children and the elderly are discussed, with specific recommendations tailored to these age groups, followed by practical suggestions for general inhaler use.
Asthma medications, including controller and reliever medicines as defined by the second Expert Panel Report [1], are available in oral and inhalational formulations. For a variety of reasons, the inhaled route is preferred. Compared with oral medications for asthma, inhalational therapy has several advantages, including rapid delivery and onset of action, excellent therapeutic efficacy, and reduced risk for side effects. Disadvantages of aerosolized drug delivery include inefficient penetration to the lower airway and the need for hand-mouth coordination and proper technique. These issues are especially pertinent for the very young and the elderly. This article reviews recent investigations and recommendations for the proper use of inhaled agents for the treatment of asthma.