Learn how to use a nebulizer when you have asthma. The use of a nebulizer in bronchial asthma

Of course, the question does not have a clear answer. All existing models have their pros and cons, their nuances, and focus on certain categories of patients.
Nevertheless, in the treatment of bronchial asthma, as well as chronic obstructive bronchitis, several fundamental points should be taken into account:

1. Attention should be paid to the size of the produced particles and the percentage of particles optimal size in the total volume of the aerosol. The optimal size is 2-2.5 microns, acceptable - up to 5 microns. It is these particles that most effectively settle in the small bronchi and alveoli. Smaller particles, entering the lungs when inhaling, fly back when exhaling. Larger particles settle in the large bronchi, trachea, and nasopharynx.
2. Quite expensive drugs are often used to treat bronchial asthma, and nebulizers have such a characteristic as loss of the drug on exhalation. This is the amount of the medicine you purchased, which, during inhalation, did not enter the patient's lungs, but, in the literal sense, flew "down the pipe". Simple (straight-through) sprayers (nebulizers) have losses up to 60-65%. Nebulizers with inhalation-exhalation valves (breath-controlled, inhalation-activated) - 25-35% ( at correct use ). Nebulizers with flow interruption devices (buttons, economizers) - up to 10% (also when used correctly).
3. Unfortunately, the process of treating bronchial asthma is very long. And nebulizers (by the way, they are called nebulizers, but, complete with a compressor, tube, mask, etc. form inhalation device) have a well-defined service life, after which the hole in the atomizer is "developed" and the device begins to produce ever larger particles that do not reach the "destination". Moreover, the patient does not notice any changes during inhalation - the "process" goes on, the aerosol is formed, the drug "leaves". But the effectiveness of treatment decreases, the risk of side effects increases. The simplest models require a nozzle change every 2-3 months, but there are models that last a year or even 3 years.

Unfortunately, many sellers and even manufacturers do not advertise some of the fundamental characteristics of nebulizers (especially if they lose to competitors).

Now - more specifically on these points.

1. According to the first point, devices manufactured by PARI (Germany) and OMRON (Japan) are optimal. This does not mean at all that other nebulizers are not suitable for the treatment of bronchial asthma, we are only talking about the maximum approximation to the optimal parameters.
2. On the second point, there are several points to consider:

   Inspiratory-expiratory valves and flow interrupters only affect drug savings during inhalation;

   When using a mask (with the exception of some PARI masks), the effect of having valves is reduced to zero. Therefore, when choosing a nebulizer for children (elderly or seriously ill patients who cannot or do not want to breathe through the mouthpiece), valves can be saved without compromising the quality of treatment;

   The use of flow breakers will only bring effect when synchronizing button presses (or economizer) and breaths. This requires some skill and, of course, is not possible for the categories of patients listed in the previous paragraph.

3. Of the devices presented by us, all (with the exception of PARI) require a change of the nebulizer (nebulizer) once every about 3 months with 3 inhalations per day. Those. they are designed for approximately 100 inhalations. If inhalations are carried out less frequently, then the life of the atomizer will increase accordingly. PARI LC series nebulizers serve (under the same conditions) 1 year, LL series - 3 years. But their price increases accordingly.

A few more final remarks:

• be sure to check out;
• despite claims from some manufacturers, many sprayers are compatible with compressors from other companies. This will allow you to choose the best kit for you with a minimum of costs;
• by purchasing a less expensive option first, you will eventually be able to purchase a better atomizer for it, if the need arises for it;
• the simpler the nebulizer, the (generally) the longer the inhalations will take. The average inhalation time is usually 5 minutes to half an hour.

Bronchial asthma - chronic illness caused by an increased reaction of the bronchi to physical, chemical or other pharmacological stimuli. In patients with asthma, the bronchial mucosa is inflamed, the patency of the bronchial tree is impaired. An attack of suffocation can occur in response to exposure to cold air, allergens, or nervous strain. Inhalation for asthma best option treatment of the disease. This method will deliver the medicine to the bronchi and lungs. The choice of inhaler for therapeutic therapy depends on many factors.

An inhaler is a device that allows medicines to enter the respiratory tract of a patient with bronchial asthma. There are several types of inhalers.
Varieties of inhalers used in the treatment of bronchial asthma:

Nebulizers

Nebulizer- This is a device capable of breaking the medicinal substance into small particles that penetrate the bronchi and lungs in the form of a cloud. The steam from the drug is not hot, which expands the range of use of drugs for treatment. This method of supplying particles of a substance contributes to the maximum effect and a speedy recovery. The main condition for using a nebulizer at home is that after the procedure, it is necessary to thoroughly rinse the solution chamber, tube, mouthpiece and mask.

Types of nebulizers

For inhalation with bronchial asthma use the following types of nebulizer:

1. Compressor- This is a device in which the drug is sprayed using a compressor. A tube with a chamber for a therapeutic agent is connected to the compressor. An inhalation mask is attached to the chamber. This kind of device is easy to operate, medication inhaled only during inhalation, which saves it. The compressor, when generating air masses, does not destroy the structure of the substance, which makes it possible to use almost any medication for the treatment of bronchitis. The disadvantages include large size and noise during compressor operation.
2. Ultrasonic- this device is equipped with an ultrasonic generator, with the help of which the solution turns into an aerosol and enters the asthmatic bronchi. The ultrasonic nebulizer is compact, light weight and virtually silent. A significant disadvantage This device is that ultrasound destroys the structure of some substances, so it cannot be used hormonal preparations and antibiotics
3. Mesh nebulizer- This device has a compact size, easily fits in a handbag. What is its undeniable advantage over other types of nebulizer. The principle of action - the drug is broken into particles using a membrane. There are no restrictions on the choice of drug. The device can be used even in an inclined position, which is important if a person is very sick and has to lie down. A relative disadvantage is the price of the device - it is higher than that of other types.

Which device to choose?

Before you buy a nebulizer for inhalation for asthma, you need to consult with a specialist. The choice of device depends on several factors:

• the size of the substance in the aerosol state;
• device compatibility with prescribed medications;
• equipment;
• the ability to work without a network;
• sprayer life.

First of all, it is necessary to pay attention to the particle size in the aerosol for inhalation with a nebulizer for asthma. Especially when it comes to ultrasonic devices. The particle size for inhalation in asthma at home should be no more than 2 - 6 microns. This size of molecules produced by the nebulizer will allow the drug to penetrate deeply to the intended target. If a person is seriously ill, then he may need a nebulizer for asthma in any conditions, so you should choose a model with autonomous operation. In addition, the drug nebulizer has a certain service life. Usually it is enough for 100 procedures. A device with a longer service life is more expensive than its counterparts.

Medicines for therapy

Inhalations in bronchial asthma can block asthma attacks and carry out medical therapy. Drugs prescribed for use in a nebulizer can be divided into groups:

• drugs that relieve spasm (so-called bronchodilators);
• anti-inflammatory substances (relieve swelling well, make breathing easier);
• drugs that thin sputum (moisturize the mucosa, softening inflammation);
• antibacterial drugs;
• antitussives (with severe dry cough).

Not all prescribed drugs can be used during inhalation for asthma using a nebulizer. Not recommended for use in the device, as they do not have the advantage of using in a nebulizer:

• oil solutions, decoctions and infusions of herbs;
• Eufillin, Papaverine, Diphenhydramine (do not affect the mucous membrane);
• Systemic hormones (hydrocortisone, prednisolone and other systemic hormones)

The following table lists drugs that are approved for use in the device.

Thanks to the use of a nebulizer, you can achieve stable remission at home, block asthma attacks, and even return to a normal lifestyle. To do this, you must follow the recommendations for the use of drugs and their dosages.

Since bronchial asthma is an intractable disease, the goal of therapy is to maintain a stable condition of the patient. Effective way to level the symptoms are medicinal inhalations for asthma.

Inhalation with a nebulizer

Indications

Symptoms such as choking, swelling of the mucous membranes, increased coughing and lack of air when breathing are indications for the use of inhalation. The most effective in this case are inhalations for bronchial asthma through a nebulizer, since this type of device has more advantages compared to classic inhalers.

Restrictions

Despite the effectiveness of the method, there are also limitations for the use of inhalations in bronchial asthma:

• elevated body temperature - 37.5 and above;
• bleeding in the lungs;
• recurrent pneumothorax;
• cerebral atherosclerosis;
• diseases of the cardiovascular system;
• respiratory failure (due to diseases other than asthma);
• hypertension.

Advantages

The undoubted advantage of nebulizers is the availability of a wide selection of models according to the following characteristics:

• device principle: compressor, ultrasonic, electronic mesh (mesh);
• size variability: from portable, but large-sized devices used in a hospital and home environment, or mobile "pocket" nebulizer devices.

Varieties of drugs

Most effective drugs used in inhalation treatments for asthma:

• glucocorticosteroids;
• bronchodilators;

Glucocorticosteroids

The purpose of the use of glucocorticosteroids during inhalation procedures is their anti-allergic and anti-inflammatory effects. Treatment with this type of steroid is as follows:

• increased formation of anti-inflammatory proteins in the cells of the body;
• decreased vascular permeability;
• reduction of bronchial edema;
• decrease in the activity of the body's own cells, directed against the organs and structures of the respiratory system;
• slowing down the sclerotic syndrome.

Since glucocorticosteroids are hormonal means, they have explicit restrictions on the time of use. The possibility of their use is also determined by the doctor, taking into account other health characteristics of the asthmatic.

Bronchodilators

Bronchodilators or otherwise bronchodilators are divided into three groups:

1. B-adrenergic stimulants (AdS), as the name implies, have an adrenaline-like effect on the tissues of the respiratory system. Through AdS, the bronchi expand, so breathing becomes free. At the same time, the effect on other organs is minimal.
2. Anticholinergic bronchodilators reach therapeutic effect by blocking cholinergic nerves that compress the airways.
3. Xanthine bronchodilators help relax the muscles of the bronchi, thereby achieving the effect of their expansion.

Mucolytics

In bronchial asthma and other complicated diseases of the upper respiratory tract and respiratory tract mucolytics are also used. They are used to thin viscous and thick sputum. At the same time, their advantage is the separation of sputum without increasing its volume.

Other

Other topical drugs for inhalation in bronchial asthma include:

• antibiotics and antiseptics if the cause of asthma is an infectious disease;
• antihistamines (for allergic type asthma);
• immunomodulatory drugs in case of a reduced level of the patient's immunity on an ongoing basis.

In addition, for prevention purposes, as well as for pregnant women with asthma, in order to avoid exacerbation of the disease, inhalations using saline or mineral water.

Inhalations using a nebulizer and their advantages

The main difference between an inhaler and a nebulizer is their ability to transform medicinal solution into small particles. The first converts the solution into a drop or vapor form, due to which the medicine settles in the nasopharynx and upper respiratory tract. The nebulizer turns the medicine into a fine aerosol consisting of microparticles, which allows them to be delivered to remote areas of the respiratory system.

Compression nebulizers are characterized by loud operation of the mechanism, large dimensions, and the ability to work with various drugs. At the same time, ultrasonic versions of the devices, as a rule, are more compact and operate silently. But you can use them with certain types of drugs in order to avoid the destruction of the composition and damage to the device itself. Mesh nebulizers combine all the advantages of the previous two types of devices. They are silent, compact and applicable in combination with most drugs, as they do not destroy their structure. The main disadvantage of this type of device is the high price.

Each nebulizer has other specific features. The selection of a suitable device is carried out not only according to the above criteria, but also taking into account age and general condition the health of patients. Thus, according to the visual design, you can choose the option suitable for an adult or a child. In addition, the motor capabilities of a person are also taken into account. Thus, when the camera or flask is tilted, some devices do not leak the drug, which is well suited for bedridden patients, as well as infants and sleeping children.

The operation algorithm of the devices does not imply a high complexity of their mechanisms, so the service life is usually long.

Also an advantage of nebulizers latest generation there is the possibility of economical use of the drug due to a special valve system, which is important for asthmatics who are forced to constantly spend large sums on drugs.

Carrying out procedures

The procedures are carried out within the framework of certain rules:

1. It is recommended to use the drug in advance before meals or some time after.
2. The time of the procedures is limited by the volume of solution used. Usually, no more than 5 ml of solution should be poured into the flask, which corresponds to ten minutes of using the device. With restrictions on the volume of the drug used, in some cases it is allowed to fill the device with it together with saline.
3. It is recommended to take a calm fixed position and not to talk during the procedure.
4. Inhalation and exhalation must be carried out in the standard mode. There is no need to forcefully breathe drugs.
5. After the procedure, wash the used nozzle or mask with soapy water or disinfect the used parts of the device with alcohol in the presence of an infectious disease.
6. It is not recommended to use the device with homemade solutions based on medicinal herbs(for example, chamomile) or such food additives like soda. Such solutions may harm the operation of the machine. Herbal ingredients can also be used pharmaceutical preparations. Folk soda recipe is applicable only for home steam inhalation and does not have unequivocal approval among doctors.

The inhalation method of treatment and prevention of bronchial asthma has been known for a long time. The effectiveness of its use for the treatment of respiratory diseases led to the creation of inhalers, and then nebulizers, as the latest generation of devices.

It implies the inclusion of an increasing number of drugs in the treatment, depending on the severity of the disease. A significant part of the drugs is injected directly into the respiratory tract using inhalers. About what inhalers can be prescribed for bronchial asthma, and will be discussed in the article. We also provide a table trade names and approximate prices for these medicines.

In the treatment of asthma, two fundamentally different directions are used: basic and symptomatic therapy. have an anti-inflammatory effect and are designed to stabilize the course of the disease. With the right selection, you can get rid of seizures or reduce their number.

If basic therapy is not effective enough, attacks of suffocation appear or. In these cases, drugs that expand the bronchi come to the rescue. Therapeutic effect they do not, but they quickly alleviate the symptoms of an attack.

Inhalers used in the basic therapy of asthma

The metered-dose aerosol inhaler is the simplest device.

For regular use, your doctor may prescribe one or more of the following:

• inhaled glucocorticoids (IGCS);
• cromones;
• combined means, including several components at once.

Another group of drugs for basic therapy - leukotriene receptor antagonists - is available in the form of tablets for oral administration.

Inhaled glucocorticoids - inhalers for bronchial asthma

This is the basis of basic therapy. In most cases, regular use of these drugs for asthma is indispensable.

One of the following IGCS is assigned:

Depending on the dosage form the drug is administered in the form of an aerosol, with the help (suspension or solution) or special devices (powder).

Cromons

These drugs are safer than ICS. Therefore, they are often used for treatment. However, their main effect is anti-allergic, anti-inflammatory properties are less pronounced.

Aerosols for relieving an asthma attack

To quickly stop what has arisen, each patient with this disease should always have one of the drugs listed below with him.

Combined inhalers for bronchial asthma

For more convenient treatment of asthma, multicomponent preparations have been created. They contain complexes for basic therapy, for relief of symptoms, and sometimes both groups of drugs at the same time.

According to these tables, you can select analogues of prescribed drugs and check with your doctor about their effectiveness and safety. Not always good means for asthma are given free of charge, so the price / quality ratio is of particular importance. Do not buy these drugs without a doctor's prescription - in this case, they can be deadly.