- Resipiratory Problems
- Use Instructions
What Are Metered Dose Inhalers, Spacers, and Nebulizers?
Metered dose inhalers, dry powder inhalers, and nebulizers are types of aerosol drug delivery primarily used to treat respiratory disorders.
Metered dose inhalers are small devices that push a spray of medicine into the airways. Dry powdered inhalers also deliver medicine but the user must inhale deeply to allow the powdered drug to get into the airways.
Nebulizers are electric- or battery-powered machines that change liquid medication into a fine mist so it can be easily inhaled. The mist flows from the machine through a tube attached to a mouthpiece or facemask that is placed over the nose and mouth. Nebulizers are commonly used for children because they don’t have to do any work – they simply need to breathe to get the medicine into the airways.
Spacers are tubes that attach to the mouthpieces of metered dose inhalers that make the inhalers easier to use. Spacers help the appropriate amount of medication to be delivered and make it easier for the patient to use the inhaler.
What Are Metered Dose Inhalers, Spacers, and Nebulizers Used For?
Metered dose inhalers, dry powder inhalers, and nebulizers are generally used to treat breathing disorders such as:
- Obstructive lung disorders (chronic obstructive pulmonary disease, COPD)
- Cystic fibrosis
- Pulmonary arterial hypertension
- Infectious pulmonary disease
Some types of medications for non-respiratory conditions may also utilize aerosol drug delivery. Inhalers may be used for medications for:
What Are Metered Dose Inhaler and Nebulizer Medications?
Metered dose inhaler medications include:
- Albuterol sulfate (Ventolin, Proventil, Ventolin HFA, Proventil HFA, ProAir HFA)
- Beclomethasone dipropionate (QVAR)
- Ciclesonide (Alvesco)
- Cromolyn sodium (Intal)
- Flunisolide (AeroBid, AeroBid-M)
- Flunisolide hemihydrate (Aerospan HFA)
- Fluticasone propionate (Flovent HFA)
- Fluticasone propionate/salmeterol xinafoate (Advair HFA)
- Ipratropium bromide (Atrovent HFA)
- Ipratropium bromide/albuterol sulfate (Combivent Respimat)
- Levalbuterol tartrate (Xopenex HFA)
- Pirbuterol acetate (Maxair Autohaler)
- Mometasone/formoterol (Dulera)
- Triamcinolone acetonide (Azmacort)
Dry powder inhaler medications include:
- Budesonide (Pulmicort Flexhaler)
- Budesonide (Pulmicort Turbuhaler)
- Budesonide/formoterol HFA (Symbicort)
- Fluticasone propionate (Flovent Diskus)
- Fluticasone propionate/salmeterol xinafoate (Advair Diskus)
- Formoterol fumarate (Foradil Aerolizer)
- Mometasone furoate (Asmanex Twisthaler)
- Salmeterol xinafoate (Serevent Diskus)
- Tiotropium bromide (Spiriva HandiHaler)
Nebulizer medications include:
How Do You Use Metered Dose Inhalers, Spacers, and Nebulizers?
The general technique for using a metered dose inhaler is:
- Remove the cap and hold the inhaler upright
- Shake the inhaler
- Exhale completely for 3-5 seconds
- Inhale slowly through the mouth while simultaneously pressing down on the inhaler once to release the medication
- If possible, hold the breath for 10 seconds to allow the medicine to reach deep into the lungs
- Repeat the above process if more than 1 puff (actuation) is prescribed, waiting at least 1 minute between actuations
The technique for using a dry powder inhaler differs with each particular device. Dry powder inhalers are activated when the patient inhales, and the inhaler releases the medicine into the patient's lungs.
- Depending on the inhaler, a capsule may need to be placed into a chamber on the inhaler device
- Open the inhaler and load the dose, then tilt the head slightly back
- Exhale completely before positioning the inhaler
- Position the inhaler horizontally, with the outlet between the lips, slightly inside the mouth
- Inhale deeply and steadily; hold breath for several seconds
- Remove the device from the mouth and exhale
- If a capsule was inserted into the device, the empty capsule shell should be removed after use
- Each type of dry powder inhaler is slightly different so follow manufacturer's instructions before use
A nebulizer kit consists of an air compressor, nebulizer cup, mouthpiece or mask, and measuring device for medication. The general technique for using a nebulizer is:
- Assemble the nebulizer kit and plug in the power source
- Place specified dose of medicine in the nebulizer cup and close it
- Attach the top portion of the nebulizer cup to the mouthpiece or mask
- Connect the bottom of the nebulizer cup with tubing to the air compressor
- Activate a gas pressure source at the mouth of the reservoir
- Breathe through the mouth with a slow inhalations and occasional deep breaths
- Turn the nebulizer on and confirm that a mist is generated
- If a mask is being used, secure it comfortably
- Breathe through the mouth for the duration of the treatment
- Stop the nebulizer once it starts to sputter
Clean inhalers and nebulizers according to the manufacturer’s instructions.