A nebulizer is a medical device which converts liquid medicine into vapour, mist or aerosol so that it can be inhaled directly into the air tubes or lungs. It uses electricity to generate compressed air which converts liquid form of medicine into vapours; much in the same way as an old style ” Flit ” sprayer does.

It has a power lead, a compressor, tubing and an operable plastic chamber into which the medicine solution is put. On turning it on, the aerosol comes out, which can be inhaled through the mask or mouthpiece.

Two classes of broncho-dilators and a couple of steroidal solutions and their combinations are currently available for use by asthmatics. A reasonably good nebulizer costs around Rs. 2000/- or so. They are usually very sturdy and last a long time.

Advantages:

• Invaluable for small children who just cannot use any other inhalation device.
• Useful for old people who cannot coordinate inhalers.
• Useful in an acute attack situation for home self use.
• Having a nebulizer at home is a psychological support to the patient that effective help is at hand.
• Some very severe asthmatics get more relief with nebulized medicines as compared to the usual inhaler devices.

Disadvantages:

• The cost of treatment goes up considerably. If the same usual asthma medication by inhaler is about 6 rupees a day, by nebulizer it would cost 60 to 80 rupees a day. For a few day’s treatment that would not matter much. But for long term treatment it would be a concern for most.
• There are chances of carrying the infection from unsterile chambers or tubings into the lungs, especially with long term use.
• A lot of drug is wasted – that vapour which is coming out from the side.

Practical tips:

• Inhale deeply through the open mouth and nose.
• Don’t worry about the vapours escaping from the sides – that’s normal and expected.
• The chamber and tubing should be cleaned with running water after each use.
• Once a week the chamber should be dipped in one part of white vinegar and four parts of water for 20 minutes for sterilization.
• A usual respule contains 2.5 to 3 ml. of solution which should finish in about 7 minutes. If it takes much longer, something could be wrong with the nebulizer or the filter could be choked.