Abstract
Airway response to inhalation therapy depends on the volume and particle size of the drug being delivered. Factors affecting the particle size of nebulized drugs include driving gas flow rate and pressure, inhalation rate, temperature, and humidity. Inhalation of nebulized saline solutions may cause bronchoconstriction by airway cooling; this may be the mechanism underlying "suggestion-induced" asthma.Comparative dose-response and direct deposition studies indicate that drug delivery efficiency of a nebulizer is similar to that of a metered dose inhaler and, in consequence, the relatively large recommended dose of nebulized beta-agonist should be reassessed.

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