Inhalations for coughing with a nebulizer for children and adults

, medical expert
Last reviewed: 14.06.2022

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

Inhaler or nebulizer: what is it?

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

What is an inhaler? This is a special medical equipment (apparatus or device) with which the drug is sprayed. It enters directly into the respiratory organs, where it is deposited on the mucous membranes and can be absorbed.

By the way, in the nasopharyngeal region - 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, while insoluble substances are transported by the ciliated epithelium back to the nasopharynx and oral cavity. But in the alveoli of the lungs, even relatively soluble substances are quickly absorbed into the systemic circulation (and insoluble substances are absorbed by alveolar macrophages).

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

The aerosol with the drug is inhaled through the mouthpiece, but for the elderly it is replaced with a face mask. Also - with a mask - a nebulizer is used for children from coughing, runny nose and inflammation of the respiratory tract.

However, the use of a mouthpiece has the advantage that more aerosol is deposited in the bronchi and lungs, while when inhaled through a mask, a diffuse spray of the solution occurs, 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. What kind of cough is a nebulizer used for? It can be used in the treatment of both dry (unproductive) cough and wet - productive: to reduce the viscosity of the bronchial mucous secretion (sputum) and facilitate its expectoration.

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

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

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

You can use a cough nebulizer during pregnancy; what drugs are allowed to be used, in detail in the article -  How to treat a cough during pregnancy  and in the material - Inhalations during pregnancy

In addition, inhalations are performed for the common cold, especially allergic and vasomotor, more about this -  Treatment of the common cold with inhalations

Technique of the inhalation when coughing with a nebulizer

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 for inhalation with decoctions of medicinal plants and solutions containing essential and other oils. And for the dilution of drugs, only 0.9% isotonic saline or distilled water is used.

Inhalation for dry cough at home

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

What to do inhalations with a dry barking cough with a nebulizer, see -  Inhalations from dry cough for a child and an adult: is it possible to do, what, recipes  (including with the help of a nebulizer).

Recommend mucolytic agents - solutions for inhalation with a nebulizer with ambroxol hydrochloride (trans-4-cyclohexanol hydrochloride - the active metabolite of bromhexine): Mucosolvan, Amobronk, Ambroxolo EG, Muciclar, Gammaxol or Lintos (15 mg / 2 ml), Fluibron or Broxol (0, 75%). Read more -  Ambroxol for inhalation [1]

Lazolvan solution (synonymous with Ambroxol) is used, read in detail -  Lazolvan for inhalation when coughing: how to dilute, proportions, how many days to do . [2]

What is useful for dry cough is inhalation of mineral water with a nebulizer, how any inhaler with therapeutic hydrocarbonate mineral water and a nebulizer with Borjomi is used for coughing, in detail in the article -  Inhalations with mineral water

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

Inhalation when coughing with sputum

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

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

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

Do not forget about sodium bicarbonate or baking soda, which is an alkaline compound and belongs to secretory expectorants. Reviews of doctors testify in favor of  inhalations with soda when coughing , which contribute to a rapid increase in the pH level in the lungs and bronchi, which neutralizes the acidity of the bronchial secretion and makes it less thick. Therefore, inhalation of soda when coughing with a nebulizer - one or two procedures a day, 8-9 g of sodium bicarbonate per 100 ml of distilled water - will greatly facilitate the expectoration of sputum.

Antiseptic solution Miramistin refers to quaternary ammonium salts, is a bactericidal agent, a derivative of benzene and myristic anhydride chloride. It is used topically and externally in surgery, gynecology, urology and dermatovenereology) in ENT practice 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 are not carried out when coughing with purulent sputum. It is better to use Dekasan antiseptic.

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

Nebulizer for allergic cough

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

The drugs of this group expand the lumen of the bronchi, and these include: Salbutamol sulfate (Salbutamol) and its synonym  Ventolin for inhalation ; Fenoterol (other trade names - Bronchoterol, Berotek); Salmeterol (Serobid, Serevent); Formoterol (Foratec). The predominant part of these products is available in aerosol form, which simplifies their use and minimizes overdose. [4]

Combined 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 medicine 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 experts believe that Dexamethasone for inhalation with a nebulizer for coughing should not be used, since this corticosteroid (solution for injection in ampoules) is a drug for systemic use (parenteral), and Dexamethasone drops are intended for use in ophthalmology. Although this drug may be inhaled before surgery in patients undergoing general anesthesia by endotracheal intubation (to reduce the frequency and severity of postoperative pain and sore throat). [6]

And inhaled glucocorticoids - the most effective for this method of use - include Budesonide (synonymous with 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 overdose, fraught with systemic side effects. [7]

The purpose of these drugs is justified by their anti-inflammatory effect and the ability to reduce the hyperreactivity of the nasal and bronchial mucosa. Read -  Pulmicort for obstructive and acute bronchitis: inhalation treatment

Contraindications to the procedure

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

Do not carry out inhalation with fever and hyperthermia, disorders of cerebral circulation, edema of lung tissue and pulmonary bleeding, a tendency to spasms of the laryngopharynx.

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 severe cough after a nebulizer may temporarily appear when using Ambroxol or Lazolvan.

And inhalation with Berodual can lead to increased heart rate, headache, hyperhidrosis and tremor of the fingers.

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), although such complications after the procedure are quite rare.

Spasm of the bronchi occurs more often, nausea may occur (and with increased excitability of the vomiting center - vomiting), tachycardia, fever, fatigue.

Care after the procedure

Within an hour after inhalation do not drink liquids and do not eat. Also, do not sing, shout and 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.

How to care for the nebulizer, you should find out in advance - from the instructions for use attached to it.

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