Site of action of commonly nebulized drug aerosol therapies and the droplet size thought ideal for maximum clinical benefit
Drug | Target airway site | Special considerations |
β2-agonists acute | Central-peripheral | Use O2 as driving gas unless there are concerns about CO2 retention |
Adults and children | ||
β2-agonists chronic | Central-peripheral | Reduce nebulization time for treatment compliance |
Adults and Children | ||
Anti-cholinergic | Central | Mouth piece (preferable) or tight sealing face mask |
Adults and Children | (Mouth piece for glaucoma patients) | |
Corticosteroid | Central-peripheral | Minimize skin and eye exposure |
Children and adults | Mouthpiece (preferably) (or tightly sealed face mask) | |
Amino-glycosides or Colomycin | Central-peripheral | Mouth piece |
Adults | Filter or exhaust exhaled gases | |
Pre-treat with β-agonist when necessary | ||
Pentamidine | Peripheral | Mouth piece |
Adults | Pretreat with nebulized β-agonist | |
Filter or exhaust exhaled gases | ||
Amphotericin | Central | Dilute with water not saline |
Adults | Filter or exhaust exhaled gases | |
RhDNase | Central | Mouthpiece |
O2: Oxygen
CO2: carbon dioxide
RhDNase: recombinant human deoxyribonuclease