Aerosol Delivery Devices for Obstructive Lung Disease:
Focus on Nebulizer Systems

By Matt Hegewald, MD

Aerosol therapy is the cornerstone for treating asthma and Chronic Obstructive Pulmonary Disease (COPD).  Many aerosol devices are available, including the pressurized metered dose inhaler, the dry powder inhaler, the slow/soft mist inhaler, and the nebulizer. Each device has its particular advantages and disadvantages. The asthma and COPD guidelines stress the importance of matching the patient to the aerosol delivery device. Providers need to be aware of the advantages and disadvantages of the available devices. Given the absence of evidence that one aerosol delivery system is superior to another, as long as they are used correctly, patient preference, convenience, available drug formulations and cost will be the determining factors in choosing a device. For those patients not capable of using handheld delivery devices adequately, nebulizers are the preferred aerosol delivery devices.

Panel Discussion: New Directions in Aerosol Therapy

Moderator:  Arzu Ari, PhD, RRT, PT, CPFT, FAARC

There has been a growing interest in the development of new aerosol technologies over the years. New directions and technical innovations in aerosol medicine give clinicians access to new devices. However, adopting new aerosol technologies for the treatment of patients with pulmonary diseases brings many challenges and strategic barriers such as unfamiliarity, confusion and misuse of the device by patients due to device dementia as well as lack of knowledge and experience with the novel device in clinical practice. It is important to overcome these barriers for successful implementation of new technologies in aerosol medicine.  In this issue of Clinical Foundations, Drs. Bruce Rubin, James B. Fink and Sandra Adams, who have a wealth of experience and knowledge in aerosol medicine, provide valuable suggestions to clinicians who want to adopt new technologies in their clinical practice. They also provide detailed and comprehensive information on new directions in aerosol medicine, the importance of patient education and adherence, the risks with concomitant therapy and the factors that need to be considered for the selection of a nebulizer. This is your opportunity to improve your knowledge and expertise that will empower you as a clinician for the benefit of your patients.

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