Bronchodilator or 'mucokinetic' aerosols play an important role in the management of airway obstruction. Inhaled aerosolized medications are often preferable to oral or parental routes of administration because topical delivery gives direct benefits with limited toxic reactions. Aerosols are generated from a nebulizer solution, directly with a metered-dose inhaler, or with a dry powder inhaler. These devices deliver aerosols of pharmacologically active molecules to the lower airways.

The nebulizer and the metered-dose inhaler have identical efficacy when the patient is intubated. The metered-dose inhaler is the standard method for patients who are not intubated.

This technique is combined with physiotherapy in order to increase its effectiveness. It is used to relieve bronchospasm (b 2-agonists, anticholinergic agents) and also to optimize mucociliary clearance. ^-Acetylcysteine may be useful for short-term treatment in lung diseases associated with mucous plugging.

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