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Compared with other ways of administration, atomized inhalation of drugs can directly act on target organs, with the advantages of quick response, good curative effect, less systemic adverse reactions, and no need for deliberate cooperation of patients. It has been widely used in clinical practice.

1. Chronic Bronchitis

For chronic bronchitis patients with obvious symptoms and poor effect of conventional treatment, atomization inhalation of drugs is a good choice, such as inhaled glucocorticoid, bronchodilators, and expectorants.

2. Chronic Obstructive Pulmonary Disease (COPD)

Atomization inhalation can be applied to acute exacerbation of COPD.

1) Bronchodilator
Atomization inhalation of short-acting β2 agonist (SABA) should be used. A short-acting muscarinic antagonist (SAMA) should be added when the effect is not good.

2) Inhaled Glucocorticoid
Inhalation of budesonide (BUD) can partially replace systemic glucocorticoid. BUD 6 ~ 8 mg /d (2 mg, twice a day or 2 mg, once /6 h) has similar efficacy to methylprednisolone (40 mg/d). The dosage and course of treatment should be adjusted according to the severity of the acute exacerbation. The course of treatment is usually 10 ~ 14 days.

3. Asthma

1) Bronchodilator
A bronchodilator can be used for an acute attack of mild and moderate asthma. Repeated inhalation of SABA can quickly reverse airflow restriction. It is recommended to take intermittent (every 20min minutes) or continuous atomization at the first hour of onset, and then take intermittent (once /4h) as needed. When the treatment effect is not good, consider the combination of SAMA atomization inhalation.

2) Inhaled Glucocorticoid
When asthma attacks or worsens, the combination of inhaled bronchodilators and inhaled glucocorticoids (2-4 times the basic dose) can replace or partially replace systemic hormones, especially for patients with gastroduodenal ulcers and diabetes. Treatment with inhaled glucocorticoids can significantly reduce asthma-related death or hospitalization.

4. Hormone Sensitive Cough

1) Cough Variant Asthma
Combined inhalation of glucocorticoid and bronchodilator atomization therapy can effectively and quickly relieve cough symptoms. BUD suspension 1.0~2.0mg/ time, twice a day.

2) Eosinophilic Bronchitis
The first choice is the inhalation of glucocorticoids in a moderate dose. BUD suspension 2.0mg/ time, twice /d, continuous application for more than 8 weeks.

3) Allergic Cough
Inhaled glucocorticoid, BUD suspension 2.0mg/ time, treatment for more than 4 weeks

5. Post-Infection Cough

1) Inhaled Glucocorticoid
When severe persistent cough affects the quality of life, consider inhaled glucocorticoids by atomization. The dosage of BUD suspension is 2.0mg/ time, 2~3 times/day.

2) Bronchodilator
It can relieve cough symptoms.

6. Bronchiectasis

1) Antibiotics
In acute exacerbation of bronchiectasis, tobramycin, gentamicin, amikacin or polymyxin can be inhaled by atomization twice a day for 7 ~ 14 days.

2)Bronchodilators and inhaled glucocorticoids can be used as needed.

7. Ventilator-Associated Pneumonia (VAP)

For VAP infected by Pseudomonas aeruginosa, it has been reported that atomized tobramycin or amikacin can improve the cure rate and reduce the time of mechanical ventilation.

For VAP infected by Acinetobacter baumannii, intravenous atomization polymyxin has a good effect.

8.Pediatric Related Respiratory Diseases

1) Airway Inflammatory Diseases
Atomization of glucocorticoid can effectively improve the condition of patients. BUD suspension can be used for inhaled glucocorticoids in children under 4 years old.

2) Wheezing In Children
Short-acting β2 agonist (SABA) and short-acting muscarinic antagonist (SAMA) is the first choice to treat patients of any age. Medication for children needs special attention to safety.

9. Perioperative Period

Inhalation of glucocorticoid can alleviate airway inflammation. For high-risk patients with airway hyperresponsiveness and decreased lung function, it is recommended to take inhaled glucocorticoids from 1 week before the operation to 3 months after the operation.

Inhalation of bronchodilators can effectively prevent bronchospasm and other perioperative airway complications. Patients with asthma and COPD are recommended to inhale β2 agonists and anticholinergic drugs until the day of operation.