Aerosol devices in the treatment of asthma. Technical and clinical factors

Inhaled medications are capable of producing the best bronchial effect with fewest systemic side effects. Proper inhalation technique is critical if these devices are to be effective. Specific aspects of both the system and the inhaler technique used are critical in achieving optimal performance. Observation of each patient's inhaler technique is advised--it is not enough to merely give instructions or to simply discuss the therapy. Both efficacy and side effects are dose dependent; high doses of topical bronchodilators and anti-inflammatory drugs are appropriate for some patients. Protection against side effects may be achieved by gargling mouth and throat after use, or by using a spacing (holding) chamber. Long-term compliance with medication will be best if the number of doses used, and the side effects, are minimised.