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The difference between the two is that one is a drug and the other isnt. Also their modes of action are different
AirPhysio is a drug-free handheld Oscillating Positive Expiratory OPEP device designed to assist in the clearance of secretions from the lungs. It assists in improving lung capacity by conditioning the lungs, helping to loosen mucus build-up and assisting to open up semi-closed airways.
Spiolto Respimat is an anticholinergic which relaxes the airways and helps keep them open