[The best way to apply aerosol therapy. I--Methods].
The dimension of the particles delivered by a compressor-nebulizer system and therefore the ability to penetrate in the distal lung, varies according to different nebulizers. Moreover the aerosol is better in quality higher the flow furnished by the compressors is. The quantity of drug inhaled is greater as lower the residual amount of liquid left in the nebulizer is: the latter is less in glass nebulizers than in plastic nebulizers. The ultrasonic inhaler does not present any qualitative or quantitative advantages respect to the pneumatic inhaler. A very important point in the execution of an aerosol is oral respiration. The administration of the drug through a mouthpiece does not present substantial differences respect to the use of a face mask kept in a vertical position and adherent to the face. Metered-dose inhalers shorten the time of performance, but an active cooperation is needed; moreover the quantity of drug that resides in the oropharynx increases and consequently adverse effects, too. These two obstacles are overcome by the use of spacers which are chosen on the basis of the child's age. Aerosolic treatment has been simplified by the use of powders for inhalation, but we do not always obtain correct inhaling flows in children, especially when they are bronchoobstructed. Therefore compressor or ultrasonic aerosol is more useful in bronchoobstruction, while metered-dose inhalers with spacers are more useful in long-term treatment. Powder is usually used in children over 6-7 years of age and excludes the use of important drugs, such as cortisone, which may present relevant adverse effects.
Battistini
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Centro di Fisiopatologia Respiratoria Infantile, Università degli Studi di Parma.
D000280:Administration, Inhalation; D000336:Aerosols / Q000008:administration & dosage*; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D006801:Humans; D009330:Nebulizers and Vaporizers / Q000592:standards*; D011208:Powders / Q000008:administration & dosage / Q000009:adverse effects; D012140:Respiratory Tract Diseases / Q000188:drug therapy*
D000336:Aerosols; D011208:Powders