People with chronic lung conditions, such as asthma or emphysema, may use a nebulizer -- a machine that turns liquid medicine into mist. During a treatment, the mist is inhaled through a face mask or mouthpiece for a span of about 10 to 15 minutes. Nebulized medicines are often used to help improve airflow. The medications and not the nebulizer are responsible for most side effects. However, some problems are specific to nebulization. Drug side effects are possible, regardless of the delivery method, and may range from mild to severe.
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Possible Side Effects of Nebulizer Use
There is no evidence suggesting that nebulizers cause more side effects than other inhalation devices, such as metered dose inhalers (MDI) or dry powder inhalers (DPI). There are a few things to look out for when using a nebulizer, however. With a face mask, a good fit helps prevent leakage of the mist. A mouthpiece is sometimes preferred to stop skin or eye irritation from the circulating mist. Regular cleaning of the nebulizer parts is necessary, because medicine can accumulate in the cup and the growth of bacteria may cause infection.
Otherwise, side effects are typically from the medicine itself. Beta-agonists, such as albuterol, the mainstay of asthma treatment, may cause uncomfortable side effects such as headache, insomnia, rapid heartbeat, tremor and nervousness. These often go away within a few minutes or after a few doses. Another group of bronchodilators, anticholinergics, may cause dry mouth or cough. If they get into the eyes, the may worsen glaucoma or cause eye irritation. Inhaled corticosteroids, sometimes combined with other medicines, help to reduce swelling in the airways. These tend to cause local effects like sore throat, hoarseness and thrush, a yeast infection in the mouth. Corticosteroids may help with inflammation, but this effect may also increase the risk of infection in some circumstances.
Potentially Serious Side Effects
Serious side effects may be caused by drug overdose, drug interaction, drug allergy or infection. An overdose can occur if you nebulize more often than needed, you do not measure your medicine properly or if you forget to clean the nebulizer cup. An overdose of a beta-agonist, for instance, may lead to rapid heartbeat and chest pain that does not go away within minutes, and it could lead to a life threatening emergency.
Drug interactions are possible. For example, beta blockers -- prescribed for heart conditions -- need to be used with caution with the beta-agonists prescribed for lung conditions, because they can reduce the effects of your medicine, worsening your breathing symptoms. Skin rash and difficulty breathing may be signs of a serious drug allergy. Fever, chills, difficulty breathing and coughing may be signs of an infection, but some of these symptoms, like worsening breathing, can be caused by the medication itself.
Delayed growth in young patients is also a possible side effect of corticosteroid medicine and should be discussed with your doctor. Read your medication label and talk with your doctor to understand other potentially serious side effects.
How to Avoid Complications
Use your nebulizer exactly as directed and clean your nebulizer regularly to get the right amount of medicine and prevent infection. To avoid interactions with other medicines and supplements, make sure you review everything you are taking and any allergies you have with your doctor so she can prescribe the safest options for you. Some medications are not appropriate if you are pregnant, planning to become pregnant or nursing.
When to Contact Your Doctor
Call your nurse or doctor to receive more training if you are having trouble using a nebulizer. Your doctor can also provide medical advice if you experience any side effects related to your medicine. For more serious symptoms such as chest pain, irregular heartbeat or sudden worsening of breathing symptoms, seek medical attention right away.
REFERENCES & RESOURCES
- AARC Clinical Practice Guideline: Aerosol Delivery Device Selection for Spontaneously Breathing Patients
- American Lung Association: How to Use a Nebulizer
- Respiratory Care: Comparing Clinical Features of the Nebulizer, Metered-Dose Inhaler, and Dry Powder Inhaler
- Food and Drug Administration: Center for Devices and Radiological Health
- American Academy of Allergy, Asthma & Immunology: Inhaled Asthma Medications
- American Family Physician: Adverse Drug Reactions - Types and Treatment Options
- Chest: Aerosol Therapy for Obstructive Lung Diseases Device Selection and Practice Management Issues
- European Respiratory Society Guidelines on the Use of Nebulizers
- American Thoracic Society: What are Anticholinergic Medications?
- American Thoracic Society: What are Beta-Agonists?
- American Lung Association: How to Use/Clean a Nebulizer