Inhaled Medications: Inhalers and Nebulizers

Reviewed by Ronina A. Covar, MD
For many years, inhaled medications have been an important part of asthma treatment. Inhaled methods deliver medication directly to the airways, which is useful for lung diseases.

Aerosol devices for inhaled medications may include:

  • Metered-dose inhaler
  • Metered-dose inhaler with spacer
  • Dry powder inhaler
  • Soft-mist inhaler
  • Nebulizer

Your doctor will prescribe the method that is most helpful for your child.

 

Metered-Dose Inhaler

It is crucial that your child use the metered-dose inhaler correctly to get the full dosage and benefit from the medication. It is often hard to use a metered-dose inhaler correctly. At National Jewish Health, we often recommend using a spacer. A spacer is a device which can be attached to the metered-dose inhaler. A spacer helps deliver the medication to the airways of the lungs, instead of the mouth. This helps the medication work better.

Common inhaler spacers include:

  • AeroChamber®
  • Vortex®
These are available with a mask for younger children. Ask your child’s doctor about using a spacer, which helps deliver the medication from the mouth into the airways of the lungs.

 

Dry Powder Inhalers

Dry powder inhalers are breath-activated. When your child inhales fast enough, the medication is released and inhaled.

Common dry powder inhalers include:

  • Flexhaler®
  • Diskus®
  • Aerolizer®
  • Twisthaler®
  • HandiHaler®
  • Ellipta®
  • RespiClick®

 

Soft Mist Inhaler

A soft-mist inhaler delivers a slow moving mist. A soft mist inhaler is the Respimat®

 

Nebulizer

A nebulizer or “breathing machine” is another way to inhale medications. A nebulizer treatment is given with an air compressor machine. Pressurized room air is used to create a mist of the medicine solution, which your child inhales for approximately 5 – 10 minutes.

When the metered-dose inhaler is used correctly with a spacer, it is as effective as the nebulizer, but you may find a nebulizer more beneficial when your child has episodes of extreme breathing difficulty. Your doctor may prescribe an air compressor to give your child breathing treatments at home.

Battery-operated portable compressors are also available. A nebulizer is recommended for most inhaled medications for young children and anyone having difficulty using a metered-dose inhaler with a spacer. If your child uses budesonide or Pulmicort® in a nebulizer, use a jet nebulizer device, not an ultrasonic nebulizer.

At National Jewish Health we prefer to use a mask for younger children, rather than the mouthpiece on the nebulizer, as this allows for more medication to be inhaled into the airways.

Whichever device your child uses, a metered-dose inhaler with or without a spacer, a dry powder inhaler, a soft-mist inhaler or a nebulizer, you must use it correctly to get the most benefit from the medication. Your doctor may have your child demonstrate inhaler technique at each visit to make sure it’s done correctly.

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