[How best to perform aerosol therapy. 2. Drugs]

The individuation of a 5:1 ratio for the posology of beta 2-agonist drugs administered respectively by nebulizer or as a spray plus a spacer, allows the use of these drugs by the latter way also during an acute attack of bronchospasm. Other qualifying aspects of beta 2-agonist are the possibility of increasing the dose up to a continuous administration in case of a severe attack of bronchoconstriction and the demonstrated clinical efficacy of these drugs during the first year of life. The question of the correct dose to administer according to the age of the patient appears to be rather complex: in fact if on the one hand during the first months of life the low tidal volume (VT) can reduce the quantity of drug inhaled, on the other the low pulmonary volumes (FRC) of the first years of life determine a lesser dilution of the inhaled drug and therefore a greater pulmonary concentrations. Among corticosteroids for inhalation, the ones with the fewer side effects should be chosen: these may appear although in a subclinical fashion at relatively low doses of about 400 micrograms/day of beclomethasone. The most frequent indication for an antibiotic treatment by inhalation is represented by chronic pulmonary infection caused by bacteria sensible only to parenteral antibiotics (for ex. Pseudomonas infection in cystic fibrosis). The extremely high cost of these treatments requires the use of devices with a very high efficiency, in other words capable of nebulizing very large percentages of drug into small particles (< 6 microns).(ABSTRACT TRUNCATED AT 250 WORDS)