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Inhalation therapy: practical considerations for nebulisation therapy

Abstract Inhalation therapy is a term which is used to describe a variety of treatment techniques, including the delivery of a variety of drugs that may be administered via inhalation, targeting lung tissue, airway secretion and micro-organisms in upper, central and/or peripheral airways. However, studies to date have typically been carried out on drugs targeting systemic effects which are administered through inhalation, aiming at deposition in the alveoli where the drug can be rapidly absorbed and distributed. There are three different kinds of inhalation device – dry powder inhaler (DPI), spray (pressurised metered dose inhaler, pMDI), or nebuliser systems. Each kind of device comes in several different models and brands, and the market is growing rapidly. A nebuliser system can be based on one of three different techniques – jet, ultrasonic and vibrating membrane; all are available as different models. Choosing the optimal device for a patient is essential to ensure the effectiveness of the therapy. However, the choice is dependent on several different factors and there is no single device that is best for all patients in all situations: individual solutions are necessary. Inhalation technique and handling of the device is essential for the effective treatment. Patients must be carefully instructed and taught how to use and take care of their device. The instructions must be reinforced on a regular basis, and the choice of device must be similarly re-assessed. To achieve effective inhalation therapy for patients, personnel must be aware of current developments.