Table 2.

Different kinds of ICS inhalers.

Type of Inhaler	Subtype	Characteristics	Advantages	Limitations	References
Nebulizers	Jet (or pneumatic)	Use compressed air or oxygen to convert liquid medication into a fine mist for inhalation.	Versatile and suitable for all ages.	Longer administration times, produce noise and vibration, require power sources, and need regular maintenance.	[76]
	Ultrasonic	Use high-frequency vibrations to convert liquid medication into a fine mist for inhalation.	Portable and compact, have faster administration times, operate quietly.	Not suitable for medications that are heat-sensitive or contain suspensions.	[77]
	Mesh	Use a vibrating mesh or perforated plate to generate a fine aerosol mist from liquid medication.	Portable, lightweight, and operate silently with faster administration times.	Have limitations in delivering higher viscosity medications or large medication volumes.	[78]
Dry powder inhalers (DPIs)	Single- and multi-unit doses	Deliver medication directly to the lungs in a powdered form.	Breath-activated, portable, and do not require coordination between inhalation and device activation.	Require adequate inspiratory flow for optimal drug delivery, and can be used only with specific types of dry powder medications.	[79]
Pressurized metered-dose inhalers (pMDIs)	Single and combined drugs	Deliver medication in a pressurized aerosol form using propellants.	Deliver a consistent dose, require minimal preparation time.	The presence of propellants and the inability to assess remaining medication levels easily.	[80]
Soft mist inhalers (SMIs)	None	Deliver medication as a slow-moving aerosol mist.	Provide consistent and precise dosing, generate a slow-moving mist suitable for patients with diverse inspiratory abilities, and are equipped with dose counters to monitor medication levels.	Potential clogging if not used properly, higher cost compared with other inhalers, and limited availability of medications in soft mist formulation.	[81]