Several aerosolized drugs are available for the management of reactive airway disease. Nebulized drugs are given directly into the airway, which minimizes the systemic effects of musculoskeletal tremor, anxiety, and cardiovascular stimulation in most patients. Although infants and young children can be given medication via a metered dose inhaler that has a spacer, these children may not generate enough inspiratory pressure to open the oneway valve on the spacer fully.