Nebulizer

Dear Dr. Mahler: My pulmonary doctor has recommended that I try medicines in a nebulizer machine to help my breathing.  Over the past few years my primary doctor and his PA have prescribed every possible inhaler for my COPD, but none of them seem to work very well. His nurse has shown me how to use these different inhalers, but it is confusing.  I have used the machine once when I had to go to the emergency room for my breathing and the medicine helped me a lot. Please tell me more about use of a nebulizer. Fran from Little Rock, AR Dear Fran: A nebulizer is a machine that mixes air or oxygen with a liquid bronchodilator medicine (called an aerosol) that is inhaled to dilate, or open, the breathing tubes (airways). Nebulized therapy is used widely when someone with asthma or COPD comes to the Emergency Department or is admitted to the hospital with a breathing problem. The picture shows one type of nebulizer.
One type of nebulizer

One type of nebulizer

If your doctor orders the nebulizer and medicines from a durable medical equipment (abbreviated DME) company, someone, usually a respiratory therapist, will deliver the nebulizer and medicines to your home and show you how to use the system. Both short-acting (last 4 hours) and long-acting (last 12 hours) bronchodilator medicines are available to relax the breathing tubes (airways) and allow you to breathe easier. The person who delivers the equipment and liquid medicines will write down a schedule of how often you should take the prescribed medicine. Depending on your condition, your doctor may also order a liquid corticosteroid medicine to use in the nebulizer machine twice a day. This is usually prescribed if you experience frequent chest infections that cause breathing difficulty and increased coughing (called an exacerbation).
Woman inhaling aerosol from nebulizer

Woman inhaling aerosol from nebulizer

Remember, you should breathe in and out normally from the mouthpiece of the system when inhaling the aerosol. The  person who delivers the machine to your home will also show you how to clean the system. I suggest that you give this approach a try as it will likely help your breathing. Sincerely, Donald A. Mahler, M.D.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.