Definitions

aerogen

Nebulizer

[neb-yuh-lahyz]
In medicine, a nebulizer is a device used to administer medication to people in the form of a mist inhaled into the lungs. It is commonly used in treating cystic fibrosis, asthma, and other respiratory diseases.

There are different types of nebulizer, although the most common are the jet nebulizers, which are also called "atomizers. Jet nebulizers are connected by tubing to a compressed air source that causes air or oxygen to blast at high velocity through a liquid medicine to turn it into an aerosol, which is then inhaled by the patient.

As a general rule, doctors most commonly prescribe metered-dose inhalers for their patients, largely because these are more convenient and portable than nebulizers. However, jet nebulizers are commonly used in hospital settings for patients who have difficulty using inhalers, such as in serious cases of respiratory disease, or severe asthma attacks.

Newer, compact electronic nebulizers are also available. These nebulizers, such as the Pari eFlow, the Resironics i-Neb, the Omron MicroAir series, and the Aerogen Aeroneb, use vibration of membranes or meshes to produce the aerosol and are more portable since they do not need the compressed air source that accompanies jet nebulizers. However, electronic nebulizers are more expensive. Piezoelectric nebulizers are used in electronic cigarettes.

Use and attachments

Nebulizers accept their medicine in the form of a liquid solution, which is often loaded into the device upon use. Bronchodilators such as salbutamol (albuterol USAN) are often used and sometimes additionally ipratropium. Corticosteroids are also used. The reason they are inhaled instead of ingested is usually to target their effect to the respiratory tract, which speeds onset of action of the medicine and reduces side effects compared to when these medicines are delivered by other routes2.

Usually, the aerosolized medicine is inhaled through a tube-like mouthpiece, similar to that of an inhaler. The mouthpiece, however, is sometimes replaced with a face mask, similar to that used for inhaled anaesthesia, for ease of use with young children or the elderly, although mouthpieces are preferable if patients are able to use them since facemasks result in reduced lung delivery because of aerosol losses in the nose1.

After use with corticosteroids, it is theoretically possible for patients to develop a yeast infection in the mouth (thrush) or hoarseness of voice (dysphonia), although these conditions are clinically very rare. To avoid these adverse effects, some clinicians suggest that the person who used the nebulizer should rinse his or her mouth. This is not true for bronchodilators; however, patients may still wish to rinse their mouths due to the unpleasant taste of some bronchodilating drugs.

References

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