Allergy & Asthma Network Mothers of Asthmatics (AANMA)

Nebulizers – When Only the Mist Will Do …

Published June - 4 - 2009 Print This Post

nebulizerchallengeBy Laurie Ross
Ivory-tower research studies say that metered-dose inhalers (when used correctly either with or without a valved holding chamber) are just as effective as nebulizers at getting medication deep into your airways. However, many of you have told us otherwise: Inhalers are great when you’re out and about, but if you’re under the weather and feeling short of breath, there’s nothing more therapeutic than inhaling the cool, medicated mist of your trusty nebulizer. Nebulizers have changed a lot through the years. No longer do you have to measure out doses with a syringe, mix with sterile saline, then sit with a loud, bulky machine and inhale/exhale for 20 minutes. Today’s medications come in easy-to-use sterile, unit-dose vials and some machines are small enough for dorm rooms and quiet enough for silent nights. But do you know how to use them safely? Used incorrectly, nebulizer medication can cause respiratory symptoms to worsen.



Before you begin, take a look at your medicine:

  • Has it expired?
  • Is the vial crushed or damaged?
  • Does the medicine look discolored?
  • Has it been exposed to any extremely hot or cold temperatures?

If you answer “yes” to any of these, replace it.



To keep your nebulizer – and your lungs – free of germs, always wash your hands before handling the medication and equipment.



Jet compressors force air into the nebulizer cup that holds the liquid medication, breaking the liquid into an aerosol. They come in all sizes and are much quieter than they used to be. The nebulizer cup design determines how consistently the system can produce droplets that are the right size to travel deep into the airways. This is no time to skimp – use quality equipment, keep it meticulously clean and replace it as recommended. You won’t notice the droplet size, but your lungs certainly will. Breath-enhanced and breath-actuated units allow less medication to escape into the air.

Very young children, as well as handicapped or elderly patients unable to hold a mouthpiece in their mouths dependably should always use a mask. Choose one that is soft and pliable enough to fit snug on the face and large enough to cover the mouth and nose.



Unit-dose vials are a snap to use; just twist off the top and pour. To avoid spills, choose a nebulizer cup that will sit flat. Take a sniff as you pour and throw out any medication that smells foul, spoiled or like it may contain rubbing alcohol. (If it smells of alcohol, it’s illegal – it’s not FDA-approved.)



Put the mask in place or place the mouthpiece over your tongue and close your teeth and lips tightly around it, then turn on the machine. Breathe normally. If you start to cough, turn the machine off until you can breathe freely again. Continue the breathing treatment until the cup is empty. If the medication foams or bubbles, stop the treatment; you may have defective or contaminated medicine or equipment.


STEP 6: Wash Up

Follow manufacturer’s instructions to keep your nebulizer cup, mouthpiece and tubing clean. Be fastidious; whatever gets into your cup – from your hands, medication or house dust – will get into your lungs. When everything is clean and dry, store the system where it will stay dust-free.Nebulizer cup/mouthpiece units and tubing don’t last forever. You may not notice, but the plastic will break down over time. Replace them as recommended – and don’t forget to clean or change the air filter (most machines have one).

New Technology

Some nebulizing systems use vibration or ultrasound to break down the liquid
instead of forced air. These are small, battery powered and quiet, but not
all medications are suited to the new technology. Check with your healthcare
provider to make sure you’re using the right system for your medicine.

Fakes & Frauds

Some home health companies and large pharmacies mix and package their own nebulizer medications and market them directly to patients as cheaper and more convenient (”delivered straight to your home!”). These medications may not be manufactured under sterile conditions and may contain bacteria, irritating preservatives or substandard ingredients.

For more information, go here. If you suspect your vials are not FDA-approved, contact AANMA at 800.878.4403, ext. 1511 or Contact us.