Changing delivery methods for obstructive lung diseases

There are three types of modalities for production of aerosolized medications, but numerous specific devices using these techniques are available. The recognition that children and adults need to use optimal methods to derive maximum therapeutic benefit with minimal side effects has resulted in recent developments such as spacers for pressurized metered-dose inhalers and breath-actuated dry powder inhalers and nebulizers. These methods provide finer aerosols that can be readily inhaled and deposited in the lung with improved efficiency. Delivery systems designed specifically for particular formulations have generally been well studied, but there is a paucity of information from manufactures characterizing the drug aerosols available from their devices. Clinicians are guided by data from drug trials, but must also be furnished with details of the delivery systems to allow them to compare devices and make intelligent choices for their patients. The material presented in this review provides an evaluation of some of the systems currently available for treating asthma and other lung diseases as well as a discussion of devices planned for the future.