Nebulizer cough inhalations for children and adults

When taking various cough tablets, mixtures, syrups and drops, do not miss the opportunity to increase the effectiveness of treatment and recover faster using such a simple and effective method as inhalation for cough with a nebulizer.

Inhaler or nebulizer: what is it?

In medicine, the process of inhaling drugs and therapeutically active (mucoactive) substances – in the form of vapors or liquid suspensions in a gaseous medium – is called inhalation (from the Latin inhalare – to inhale). In this way, they are introduced directly into the respiratory organs: the nasopharynx, larynx, trachea, bronchi and lungs, the inflammation of which causes coughing. The advantages of targeted drug delivery are obvious: they begin to act faster. The question of higher efficiency remains debatable, since the pharmacokinetics of some drugs taken orally include a stage of their absorption in the gastrointestinal tract. Depending on the inhaled drug, systemic side effects may be reduced, since a lower dose can provide the required local concentration.

What is an inhaler? This is a special medical equipment (device or device) that is used to spray a medicine. It goes directly into the respiratory organs, where it settles on the mucous membranes and can be absorbed.

By the way, in the nasopharynx area - due to the large size of the mucous membrane cells and the rapid movement of air through the nasopharyngeal region - absorption is minimal. In the tracheobronchial part of the respiratory system, only soluble substances are absorbed, and insoluble substances are moved by the ciliated epithelium back into the nasopharynx and oral cavity. But in the alveoli of the lungs, even relatively soluble substances are quickly absorbed into the systemic bloodstream (and insoluble substances are absorbed by alveolar macrophages).

And now – what is a nebulizer? In English, nebulizer means a sprayer, and nebulosity – cloudiness, fog, although the etymology clearly traces Latin: nebula – fog. Thus, this is a type of inhaler that first transforms the inhaled drug into an aerosol – a mixture of air and liquid droplets, the degree of dispersion of which is close to fog (with a maximum particle diameter of 0.005 mm). To achieve this size of droplets, pneumatic (compressor) sprayers use compressed air, and ultrasonic nebulizers use high-frequency sound vibrations that are induced by a piezoelectric emitter.

The aerosol with the medicine is inhaled through a mouthpiece tube, but for elderly people it is replaced with a face mask. A nebulizer for children for coughs, runny noses and inflammation of the respiratory tract is also used with a mask.

However, using a mouthpiece has the advantage that more aerosol is deposited in the bronchi and lungs, while inhalation through a mask results in diffuse spraying of the solution, mainly in the upper respiratory tract.

Indications for the procedure

The inhalation method is used for acute respiratory diseases accompanied by rhinitis, cough, inflammation of the nasopharynx and throat. For what kind of cough is a nebulizer used? It can be used to treat both dry (unproductive) cough and wet - productive cough: to reduce the viscosity of bronchial mucus (sputum) and facilitate its coughing up.

The main indications for inhalation with a nebulizer include laryngitis, laryngotracheitis (including acute stenotic), bronchitis (acute, chronic, asthmatic, obstructive), bronchiolitis, tracheobronchitis, bronchial asthma, bronchiectasis, pneumonia and bronchopneumonia, obstructive lung diseases, respiratory cystic fibrosis (mucoviscidosis), emphysema and pulmonary tuberculosis.

How to perform inhalations for bronchitis, what drugs for their implementation are most often prescribed by doctors, in detail in the publications:

• Inhalations for bronchitis with a nebulizer for children and adults: how to breathe correctly and recipes
• Inhalations for chronic and obstructive bronchitis.

These articles and the material - Inhalations for Laryngitis with a Nebulizer - describe the preparation and technique for this procedure, provide the main drugs and medical recommendations for their use, and also give recipes for a nebulizer for coughs of various etiologies.

Can you use a nebulizer for cough during pregnancy; what medications are allowed to be used, in detail in the article - How to treat cough during pregnancy and in the material - Inhalations during pregnancy

In addition, inhalations are carried out for rhinitis, especially allergic and vasomotor, more about this - Treatment of rhinitis with inhalations

Technique nebulizer cough inhalations

It should be borne in mind that due to the technical features of the nebulizer (and this is indicated in the instructions for the devices), it cannot be used to inhale decoctions of medicinal plants and solutions containing essential and other oils. And only 0.9% isotonic saline or distilled water is used to dilute medications.

Inhalations for dry cough at home

To perform inhalation for dry cough at home, it is necessary that the solutions, drugs, and inhalation drops corresponding to the diagnosis are prescribed by the attending physician - taking into account the specific diagnosis and existing contraindications. This is especially true for children, as well as pregnant women, who are not recommended or prohibited from taking many medications.

What inhalations to do for a dry barking cough with a nebulizer, see - Inhalations for dry cough for children and adults: is it possible to do, what, recipes (including using a nebulizer).

Mucolytic agents are recommended – solutions for inhalation with a nebulizer containing ambroxol hydrochloride (hydrochloride of trans-4-cyclohexanol – an active metabolite of bromhexine): Mucosolvan, Amobronk, Ambroxolo EG, Muciclar, Gammaxol or Lintos (15 mg/2 ml), Fluibron or Broxol (0.75%). More details – Ambroxol for inhalation [ 1 ]

Use Lazolvan solution (synonym of Ambroxol), read in detail - Lazolvan for inhalation for cough: how to dilute, proportions, how many days to do. [ 2 ]

How is inhalation of mineral water with a nebulizer useful for dry cough, how any inhaler with medicinal hydrocarbonate mineral water and a nebulizer with Borjomi are used for cough, in detail in the article - Inhalation with mineral water

Improves the condition of the mucous membranes of the respiratory tract by spraying saline solution into them - Inhalation of saline solution for children and adults

Inhalations for cough with phlegm

Mucolytics and expectorants are the main groups of drugs used for inhalation when coughing with phlegm.

If the bronchial secretion is viscous, Acetylcysteine (a derivative of the amino acid L-cysteine) is used: 20% solution, on average 2-5 ml per procedure.

When coughing with sputum, inhalation of the same expectorant Amboxol or Lazolvan (they were discussed above) improves mucociliary clearance of the bronchi. These drugs can be used through a nebulizer for children for cough only after five years.

Do not forget about sodium bicarbonate or baking soda, which is an alkaline compound and is classified as a secretomotor expectorant. Reviews from doctors indicate in favor of inhalations with soda for coughs, which help to quickly increase the pH level in the lungs and bronchi, which neutralizes the acidity of bronchial secretions and makes them less thick. Therefore, inhalations with soda for coughs using a nebulizer - one or two procedures per day, 8-9 g of sodium bicarbonate per 100 ml of distilled water - will significantly facilitate the expectoration of phlegm.

Antiseptic solution Miramistin refers to quaternary ammonium salts, is a bactericidal agent, a derivative of benzene and myristic acid chloride. It is used locally and externally in surgery, gynecology, urology and dermatovenereology) in ENT practice it can be used for inflammation of the paranasal sinuses (for washing them) and tonsillitis (for gargling). And, according to the official instructions, inhalations with Miramistin for coughing with purulent sputum are not carried out. It is better to use the antiseptic Dekasan.

In such cases, antibacterial drugs are prescribed for oral administration or injections (in case of bacterial etiology of diseases). Antibiotics for inhalation with a nebulizer for cough can also be prescribed, in particular - Antibiotic Fluimucil for inhalation [ 3 ]

Nebulizer for allergic cough

For inhalations through a nebulizer for allergic cough, asthmatic cough or cough associated with obstructive bronchopulmonary diseases, as well as for bronchial spasms, drugs from the sympathomimetic group (selective beta2-adrenergic receptor agonists) are prescribed, since all bronchovascular effects are mediated by the sympathetic beta-adrenergic system.

The drugs in this group expand the bronchial lumen and include: Salbutamol sulfate (Salbutamol) and its synonym Ventolin for inhalation; Fenoterol (other trade names – Bronchoterol, Berotek); Salmeterol (Serobid, Serevent); Formoterol (Foratek). The majority of these drugs are available in aerosol form, which simplifies their use and minimizes overdosing. [ 4 ]

The combination drug Berodual, containing fenoterol (stimulating beta2-adrenergic receptors) and ipratropium bromide (blocking m-cholinergic receptors of bronchial muscle fibers and reducing the production of bronchial secretions). How this drug is diluted, in what dosage it is used, contraindications to its use and possible side effects, in all details in the material - Berodual for obstructive bronchitis [ 5 ]

More and more specialists believe that Dexamethasone for inhalation with a nebulizer for cough should not be used, since this corticosteroid (injection solution in ampoules) is a drug for systemic use (parenteral), and Dexamethasone drops are intended for use in ophthalmology. Although this drug can be inhaled before surgery in patients who undergo general anesthesia by endotracheal intubation (to reduce the frequency and severity of postoperative pain and inflammation in the throat). [ 6 ]

And the inhaled glucocorticoids – the most effective for this method of application – include Budesonide (synonym – Pulmicort), Beclomethasone (Beclazone, Beclocort, Beclovent, Aldecin), Fluticasone (Fluticasone propionate), Mometasone (Asmanex, Zenhale, Nasonex), Triamcinolone (Azmacort). Many of them are available in the form of sprays with dispensers, which reduces the risk of exceeding the dose, fraught with systemic side effects. [ 7 ]

The use of these drugs is justified by their anti-inflammatory action and ability to reduce hyperreactivity of the nasal mucosa and bronchi. Read - Pulmicort for obstructive and acute bronchitis: treatment with inhalations

Contraindications to the procedure

In some cases, there are contraindications to inhalations or their limitations due to possible adverse effects. This applies to people with unstable and high blood pressure, with cardiac arrhythmia and/or tachycardia.

Inhalations are not performed in cases of fever and hyperthermia, cerebral circulatory disorders, pulmonary edema and pulmonary hemorrhage, or a tendency to laryngopharyngeal spasms.

Consequences after the procedure

After inhalation with a nebulizer, negative consequences are possible, but they occur very rarely and can manifest themselves, in most cases, as side effects of the drugs used, in particular, as an allergic reaction to them.

For example, a strong cough after a nebulizer may temporarily appear when using Ambroxol or Lazolvan.

And inhalation of Berodual can lead to increased heart rate, headache, hyperhidrosis and finger tremors.

Complications after the procedure

After repeated inhalations with corticosteroids, it is theoretically possible to develop a fungal infection (candidiasis) in the mouth or dysphonia (hoarseness of voice), although such complications after the procedure are quite rare.

Bronchial spasm occurs more often, nausea may occur (and with increased excitability of the vomiting center - vomiting), tachycardia, fever, and a feeling of fatigue.

Care after the procedure

Do not drink any liquids or eat anything for an hour after the inhalation. Also, do not sing, shout or just talk, do physical exercises or go for a walk. All this can be done no earlier than 2-2.5 hours after the procedure.

You should find out how to care for the nebulizer in advance - from the operating instructions included with it.