Inhaled medications, nebulizers and metered dose inhalers
The most effective delivery system for asthma medications is inhalation. The nebulizer is the most effective; the metered dose inhaler most convenient.
A nebulizer, which you can obtain from our office, is simply a machine that compresses air and sends it through a small length of tubing into a receptacle where the stream of fast moving compressed air hits a pool of medication creating a mist of air. That medication is then sent through a mouthpiece or mask to be inhaled by the patient.
The tubing, mouthpieces, masks and receptacles are washable and ultimately replaceable.
Currently, short acting bronchodilators such as albuterol and the newer isomer of albuterol (Xopenex) are the only bronchodilators that are available for this delivery system.
Controller medications, cromylyn (Intal) and corticosteroids (Pulmicort) are also available in a liquid form.
There are a variety of short acting albuterol metered dose inhalers as well as versions of corticosteroids and cromolyn . Each of the metered dose inhalers delivers a more reliable and more effective dose of medication if it is used in conjunction with a spacer. Instead of having the metered dose inhaler spray directly into the mouth, where a large percentage remains in the back of the throat and is inactived, the spacer allows a far greater percentage of the medication to be inhaled directly into the lungs. Undesired side effects of the residue in the mouth can thus be avoided.
The metered dose inhaler is inserted into one end of the spacer, the metered dose inhaler is activated to release the dose into the chamber, and then the patient inhales the medication through the mouthpiece at the other end. The spacers make it especially easy for children to use an inhaled medication safely and reliably.
