A nebulizer is a machine that turns liquid medicine into a mist that is then inhaled into the lungs. These inhaled medications are used to treat asthma, chronic obstructive pulmonary disease, emphysema, bronchitis and other respiratory ailments. Several classes of medicines are available in a solution or suspension that can be used in a nebulizer.
Beta Agonists
These medications stimulate receptors in the airways to induce relaxation of the smooth muscles lining the bronchioles. This leads to a relative increase in the diameter of the airways, which makes breathing easier. Short-acting beta agonists like albuterol, metaproterenol and levalbuterol work quickly, but have effects that are relatively short-lived. Formoterol and aformoterol are long-acting beta agonists that take a bit longer to begin working, but are effective for a longer period of time.
Corticosteroids
These respiratory medications relieve inflammation in the airways. As of 2009, budesonide is the only steroid preparation available for use in a nebulizer.
Miscellaneous
Cromolyn works to stabilize specific types of cells so that they don't release products that lead to inflammation in the lungs. Ipratropium is an anticholinergic drug that acts as a bronchodilator. Acetylcysteine is a medicine used for its ability to thin mucus secretions in the pulmonary system. Racemic epinehprine is used in the treatment of croup and other lung disorders. Beractant and calfactant are medicines that reduce surface tension in the lungs and are used to treat newborns with premature lungs. Tobramycin is an antibiotic that can be nebulized and is used most often in patients with cystic fibrosis. Saline, although not technically a medicine, is often used to dilute other medicines for use in the nebulizer.
Combinations
Some respiratory medications can be mixed and administered via a nebulizer. Albuterol and ipratropium is a common combination marketed under the brand name DuoNeb. Although not commonly used, cromolyn can be combined with albuterol as well. Budesonide is sometimes mixed with other medicines, but this is an off-label use, meaning it is not approved by the U.S. Food and Drug Administration.
References
- National Jewish Hospital
- Monthly Prescribing Reference
- Tarascon Phamacopoeia; Richard J. Hamilton, M.D., editor; 2008
