Nebulizer Myths and Facts
There are different kinds of devices you can use to take bronchodilator medications. You may have heard of metered dose inhalers (MDIs) or dry powder inhalers (DPIs), which are handheld portable devices you can carry in your pocket or purse.
You may be less familiar with nebulizers. If you have heard of nebulizers, you may think they are large machines like ventilators. Many of the new nebulizers are actually small devices that can fit in a purse or the palm of your hand. For the majority of people, these devices are easy to use at home and are an effective and relatively simple way to take your maintenance medication.18
There are advantages and disadvantages to each type of device.
Myth
Nebulizers are complicated.
Fact
Nebulizers are not complicated. Newer nebulizers are lightweight, portable and only a little bigger than a handheld inhaler. Many nebulizers weigh less than a pound.20 There's no need to carry a nebulizer with you all day, as you might with a handheld inhaler, because you use a nebulizer twice a day at home (morning and night) as part of your daily routine when using it with a medication like PERFOROMIST®. If you are traveling, a nebulizer can easily fit into a bag or suitcase for use twice daily.
Unlike when using an inhaler, no coordination of actions is required when receiving treatment from a nebulizer.18,21 You set up a nebulizer with just a few simple steps; then, breathe normally and calmly into a mouthpiece or facemask to take the medication.1,21
Handheld inhalers, like an MDI or DPI, are small, can be carried around easily in a pocket or purse and can be used quickly.21 However, up to 70% of people use them incorrectly.18
To use an MDI, you must breathe in deeply and slowly, and hold your breath for 10 seconds.22,23 It also requires coordinating your breathing with squeezing the device.18 Unfortunately, up to 86% of people with COPD do not use their MDI correctly.23 If not used correctly, you may not get the full dose of medicine, which means your symptoms may not be controlled as well as they could be.24
Using a DPI (another type of handheld inhaler) requires breathing in a dry powder deeply and quickly, and holding your breath while the medication works, which may be difficult if you have COPD.18,26,27 Some people do not have adequate ability (cannot take a deep enough breath)18 to inhale the drug properly.21 As with an MDI, people commonly misuse their DPI23 because a DPI requires multiple steps.23 Also, because a DPI uses dry powder, accidentally breathing out a little can blow away the medication, inhaling can result in medication on the back of your throat and tongue, and high humidity can cause the medication to clump.28
Myth
With either a handheld inhaler or a nebulizer, you know you're getting the appropriate dose of medication every time.
Fact
All types of devices are designed to deliver a full dose of medication. Unfortunately, many people have trouble using their handheld inhaler properly.5,18,23 If you don't coordinate your breathing and actions correctly or don't take a deep enough breath when using an MDI or DPI, then you will not get the full dose.18,24
Because a nebulizer does not require you to coordinate actions or breathe differently than normal, you know you're getting the appropriate dose during every use as long as you use the nebulizer for the entire specified time (until no more mist is formed in the nebulizer; with PERFOROMIST this is about nine minutes).1 Getting the appropriate dose may be important to achieving the goal of improving your lung function.
Myth
A nebulizer is a big, bulky machine, like a ventilator.
Fact
Today's nebulizers are easier to use and smaller than they used to be.21 Most nebulizers are lightweight—many weigh less than a pound20—and portable, about the size of a small box you can hold in your hand. A nebulizer can sit on your kitchen table or on a side table and can be used while you read or watch TV. When using a nebulizer with a medication like PERFOROMIST, there is no need to carry it around with you, since you use it twice a day at home.
Myth
You use a nebulizer like an inhaler, taking a deep breath while pressing down on the device and holding your breath for 10 seconds.
Fact
You can breathe normally and calmly when using a nebulizer to take PERFOROMIST.21 Unlike with an inhaler, no coordination of actions is required and no special effort is necessary during treatment.18,21
Myth
You have to carry a nebulizer with you when you go out.
Fact
When using a nebulizer for maintenance therapy, you only need to use it twice a day, for a few minutes each time (for PERFOROMIST, it takes about nine minutes).1 You can schedule when you take your COPD medication and work it into your daily routine, since you know you'll be taking it once in the morning and once in the evening. There's no need to take a nebulizer outside of your home, unless you'll be traveling overnight. And if you do travel, a nebulizer is very portable—many can run on batteries and some weigh less than a pound.20
Myth
A nebulizer is like an oxygen tank: only for very sick people with COPD.
Fact
A nebulizer may be a good choice (and patient preferred method) for any person with moderate-to-severe COPD. It delivers medicine, not oxygen. A nebulizer is just a different way to take a maintenance COPD medication like PERFOROMIST.
A nebulizer may be a good choice for someone who has arthritis and has trouble handling and pressing down on an inhaler, or for someone who can't take a really deep breath and hold it, which is needed to get a full dose with some inhalers.
Many People with COPD Breathe Easier with Nebulizers
2009 Nebulization for Easier Breathing (NEB) survey
Nine out of ten people with COPD said that nebulization helped
them breathe easier.25
Almost three out of four people with COPD said that nebulization
helped them live more active lives.25
One out of four people with COPD said that device immobility is
a disadvantage.25
Nebulization helped these patients feel that they had more control of their symptoms, needed less help from friends and family and experienced more comfort in their chest.25
Caregivers Can Help with Devices
Caring for a loved one with COPD means that you are in a good position to judge what kind of device may be the best choice. For instance, if the person you care for has arthritis, he/she may struggle with handheld inhalers and may not be getting a complete dose. You may want to take a look at the facts yourself and see if there's anything you want to talk over with the one you care for.
In a 2009 survey of people with COPD and their caregivers, caregivers agreed that nebulized therapies made caregiving easier, and wished the people they cared for had been given nebulization therapy sooner.25 Talk to your doctor for more information.
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