Nebulizer: Benefits and Side Effects

According to their functional properties, nebulizers can be divided into three types: nozzle nebulizers, mesh nebulizers and ultrasonic nebulizers.

• Nozzle nebulizers: This is the most common type of nebulizer. In this type of nebuliser, there is an inbuilt compressor which generates air. This air flows through the liquid medicine and converts it into tiny aerosols, which can be inhaled by the patient. 
• Mesh nebulizers: These nebulizers are light in weight and do not make any sound. A mesh nebulizer contains a thin membrane which has small holes in it. With the help of a vibrating element, liquid medicine is pushed through these fine holes. This converts the liquid medicine into tiny aerosols, which can then be inhaled.
• Ultrasonic nebulizers: In these nebulizers, piezoelectric vibrators are used which create high-frequency vibrations - that is, up to two million to three million vibrations per second. These vibrations are passed through the water tank to reach the liquid medication. These strong vibrations convert the liquid medication into tiny aerosols particles which can then be inhaled.

Nebulizers can be used in the following conditions:

• Bronchiectasis: Bronchiectasis is a chronic condition in which the airways become abnormally wide along with a build-up of excess mucous that makes the lungs more prone to infections. Medications to reduce the thickness of the phlegm can be delivered easily with the help of a nebulizer. Further, antibiotics can also be delivered via a nebulizer in the case of a simultaneous bacterial infection, or upper respiratory tract infection.
• Cystic fibrosis: This is a progressive genetic disease in which an excess of mucous clogs the airways and also traps bacteria within the organs, leading to life-threatening infections. Nebulizers can help in delivering medicines to clear out some of the clogged mucous.
• Asthma: This is a chronic condition in which the airways get swollen, constricted and fill up with mucous, making it hard for the patient to breathe. Nebulizers filled with bronchodilators (medicines to expand the airway) can help resolve the breathlessness.
• Chronic obstructive pulmonary disease (COPD): COPD is a chronic progressive disease marked by excess production of mucous along with wheezing, shortness of breath or dyspnea and chest tightness.

Depending on the underlying condition, a number of medications can be given using a nebulizer:

• Bronchodilators: Your doctor may prescribe bronchodilators like Proventil, albuterol, salbutamol and terbutaline to help expand the constricted airways.
• Mucomysts: These are drugs that help in breaking down excess mucous, which can then be coughed out - this can clear up the airways for easier breathing.
• Hypertonic saline solutions: These are the medical-grade saltwater solutions that help in breaking down the mucous, making it easier to cough out.  
• Antibiotics: Nebulizers can be used to deliver antibiotics to treat and prevent infections.

These are the basic steps you need to follow to use a nebulizer: 

• If you’re using a previously used nebulizer, ensure that the nebulizer has been cleaned correctly.
• Once cleaned, connect the tube to the main device.
• Pour out the prescribed medication into the medicine cup or reservoir. 
• Now, connect the tubing and face mask/mouthpiece to the medicine cup/reservoir.
• Place the mask on your face. Make sure the mask covers your nose and mouth properly and makes a seal on your face, to stop the medicine aerosols from escaping the mask.
• If you are using a mouthpiece, hold it firmly with your lips closed around it so that all of the active ingredients of the medicine reach your lungs.
• Once the face mask/ mouthpiece is placed, switch the nebulizer on and breathe through the mouth until all the medicine vapours out. This process can take up to 10-15 minutes.
• Switch the nebulizer off once the medicine in the medicine reservoir is over.
• Clean the medicine reservoir and the mouthpiece/mask before keeping it back in its place.

Young children are usually more prone to infections, as their immune system tends to be weaker than that of adults. On top of that, it can be hard to administer medicines to children.

Nebulizers are both easy to use and more effective, so they can be quite useful for children suffering from severe congestion, asthma, COPD and other respiratory disorders. You should get medical advice before administrating any medication with nebulizers.

Small-sized face masks and mouthpieces can be used to administer medications with the help of nebulizers.

Read more: Home remedies for nasal congestion

Compared with ingesting the medicine, a nebulizer can deliver the drugs directly into the airways and lungs. For this reason, doctors advise their use for illnesses of the upper respiratory tract. The benefits of nebulizers include:

• It is a painless way of delivering any medicine.
• It is an easy method which can be used for children as well.
• The nebulizer machine is light in weight and can be carried along even while travelling.
• It allows better and targeted delivery of medicines (delivers medicine directly into the airway).
• It gives faster relief as compared to conventional tablets and injections.

Nebulizer machines cost Rs 1,000 or more in India, depending on the brand and type.

There are certain side-effects that can be seen with improper use of nebulizers: 

• If the nebulizer is not cleaned properly before and after every use, it can lead to bacterial infections. 
• If the face mask is not applied properly, the aerosols can go into the eyes and lead to eye irritation.
• One should avoid the use of face masks while using corticosteroids as they may cause acne and pigmentations on the skin of the face.

Read more: Home remedies to reduce pigmentation on the face

It's important to clean the nebulizer machine after every use and before the next use as well. This is because reusing the machine without proper cleaning can increase the chances of infection. To clean the nebulizer machine in-between uses:

• Remove the medicine cup and mask or mouthpiece. Rinse them individually with lukewarm water, and place on a clean towel for 5-7 minutes or until they are dry and ready for storage.
• If you are unlikely to use the nebulizer again for a few days, you can add a mild detergent to the warm water to clean the mask and nebulizer cup. Make sure to rinse all the soap out with clean water before you leave the cup and mask to dry on the towel and re-store.
• If you have a chronic ailment and use the nebulizer often, you should clean the nebulizer cup and mask in a solution that is one part white vinegar and three parts warm water after every three days. Leave the cup and mouthpiece or mask to soak in the solution for about 20 minutes. Rinse with clean, warm water and leave to dry on a towel.

Do not remove the tubing or try to clean it with water.