How does use of a spacer with aerosolized orticosteroids reduce the likelihood of oral candidiasis, as well as

Answer 1

Well, when you inhale steroids (or anything else) not all of the drug goes to your lungs, in fact most of it settles out in your mouth and airways before getting to the lungs, even if you do the technique right (and more so if you do it incorrectly). It's this steroid dose to your mouth that makes you more susceptible to thrush, one of the effects of steroids (and this is actually their therapeutic affect for asthma, but in the lungs, not your mouth) is to decrease inflammation and immune response, and if this happens in your mouth, it makes it easier for candida and other fungi (which are the cause of thrush) to grow there.
A space allows some of the larger particles to settle out in the spacer rather than your mouth and when you inhale, smaller particles that are more likely to get to your lungs are a higher percentage of the medicine delivered. It's not foolproof, of course, and it's still a good idea to rinse your mouth out after using the inhaler, whether you use a spacer or not.

Answer 2

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