How to choose the right inhaler? Characteristics, types, advantages and disadvantages of inhalation

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Inhalation is a method of treating respiratory diseases that has been known and used for thousands of years. However, only in recent years, inhalation has become a daily way of dealing with various ailments within the respiratory tract. Inhalers, i.e. devices that support the administration of drugs, are extremely important for the popularity of this method of treatment. What types of inhalers are on the market? What to look for when buying an inhaler? And how to use it so that the treatment brings the expected results?

What is inhalation and why do it?

Inhalation is also called inhalation. It is a therapeutic procedure during which the patient inhales a pair of mineral waters, drug solutions or their aerosols. Inhalation is performed using an inhaler or nebulizer. At a time when inhalers were not so popular, inhalation was done by inhaling steam of boiling liquid.

Medicines that are used in inhalation are most often antibiotics, antispasmodics and anti-inflammatory drugs. They affect the respiratory tract, facilitating the expectoration of secretions and preventing inflammation. Inhalations are most often performed in the case of bronchial asthma and acute and chronic inflammation of the respiratory tract.

Inhalations are also used to cleanse the respiratory system. This is especially important in winter, when the persistent smog exposes our lungs to inhalation of huge amounts of harmful dust.

Does smog affect our health and well-being? Check: Smog – how does air pollution affect our health?

What is an inhaler?

An inhaler is a medical device that is used to treat the upper and lower respiratory tract.

While inhalation has been known and practiced for thousands of years, the word “inhaler” was first used in 1778. The English physician John Mudge in his book “A Radical and Expend itious Cure for a Recent Catarrhous Cough” described substances useful in the treatment of respiratory diseases. In this book, he also focused on the description of the device that is helpful in the application of these substances. On the other hand first models of inhalers were designed in France and England in the 60s. This period is considered the start of inhalation therapy.

When describing the inhaler, it should be noted that it is a device in which the drug is broken down into tiny particles. Particle size is the main indicator of which part of the respiratory system the medication will reach. This means that:

1. particles greater than 8 µm reach the upper respiratory tract, i.e. the nose and throat;
2. particles with a size of 5 µm – 8 µm reach the trachea in the upper respiratory tract;
3. particles with a size of 2 µm – 5 µm reach the bronchi and bronchioles;
4. particles with a size of 0,5 µm – 3 µm reach the alveoli.

What is inhalation and what should you know about it? Read on: Inhalation – help with sinusitis

What does the inhaler consist of?

An inhaler is a complex medical device which consists of several parts. The most important of them are:

1. compressor – it is a connection line that pressurizes air into the nebulization chamber;
2. nebulization chamber – this is the place where we pour a medical preparation or saline. In the chamber, the drug breaks down into an aerosol. This process is possible thanks to air compression;
3. replaceable air filter – it is an element of the inhaler that cleans the air taken in by the compressor from the environment. Remember to change the filter regularly;
4. additional accessories – it is primarily a mask, mouthpiece, nasal tip and others – they are not always sold in a set, often you have to buy these elements separately. The accessories are attached to the nebulization chamber, which allows for the proper administration of the aerosol.

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Types of inhalers

Currently, there are various types of inhalers available on the medical market. Inhalers are classified into two main types. These are ultrasonic inhalers i pneumatic. Pneumatic inhalers are additionally divided into compression and piston inhalers. Below we present a short description of the most popular inhalers.

1. Ultrasonic inhaler – is a device in which the aerosol is obtained thanks to ultrasound. The particles produced in the ultrasonic inhaler are smaller than 5 µm. They are very quiet devices that can be powered by batteries. Unfortunately, they can only be used for certain types of drugs. Due to the elevated temperature during operation, inhalation with antibiotics and glucocorticosteroids cannot be performed. This type of inhaler is most often used to moisturize the respiratory tract or perform respiratory rehabilitation. The ultrasonic inhaler works well for the administration of mucolytics and the treatment of cystic fibrosis. This device should not be used in newborns and children under one year of age.
2. Pneumatic inhaler – a device in which a compressor is connected to a nebulizer via a rubber tube. Compressed air is pumped in a pneumatic inhaler, causing the medicine to break down into an inhalation aerosol. Pneumatic inhalers are used to administer virtually all forms of drugs. Pneumatic inhalers are quite cheap but very noisy. Therefore, they are not the best devices, especially when the inhalation concerns a child. 
3. Dosing inhaler – is a pressure-dosing device which consists of a pressurized container and a mouthpiece with a medicament releasing mechanism. The pressurized container holds medicine and gas. When the pressure accessory is pressed, a specific dose of the drug is released in the form of a compressed gas. When using this inhaler, remember to coordinate your inhalation as the medicine is released.
4. Powder inhaler – it is a device that uses a dry substance that is punctured or crushed during inhalation. The amount of the released dose depends on the patient’s inhalation force. There are several types of powder inhalers, including nobolizer, turbohaler, handihaler, disk or aerolizer.
5. Inhalator MESH – it is a mesh and membrane inhaler. It is a modern, efficient, quiet, compact, advanced and very good device for inhalation. It works by vibrating the membrane to generate the aerosol. MESH inhalers can be used with any type of medication. Their disadvantage is their relatively high price, which is why they are recommended primarily to those patients who struggle with chronic respiratory diseases.

How can saline affect our respiratory system? Check: Saline inhalations

What are the indications for using the inhaler?

The use of an inhaler and inhalation is indicated in cases of various ailments in the respiratory system. Specialists most often recommend the use of the inhaler to people who struggle with:

1. asthma;
2. chronic obstructive pulmonary disease COPD;
3. cystic fibrosis;
4. bronchitis;
5. bronchiolitis;
6. fixed cilia syndrome;
7. drying of the airways in mechanically ventilated patients;
8. chronic rhinopharyngitis;
9. inflammation of the paranasal sinuses;
10. krupu syndrome, i.e. acute subglottic laryngitis;
11. hay fever;
12. pulmonary mycosis;
13. various types of inhalation allergies.

It is also recommended to use the inhaler for prophylactic purposes. This applies primarily to people who work in difficult conditions or stay in places where the air is heavily polluted.

Is nebulization a safe method of taking medication during the coronavirus pandemic? Check: Nebulization during an epidemic. The doctor warns: in the current situation it is a dangerous form of administering drugs

When not to use the inhaler – contraindications

Unfortunately, not all patients who struggle with respiratory diseases can use the inhaler. Treatment with an inhaler is not recommended for:

1. people allergic to compounds present in water vapor;
2. people who have tuberculosis or heart failure;
3. people with high fever;
4. people with respiratory haemorrhage;
5. people struggling with chronic, severe respiratory diseases such as cancer;
6. in patients with asthma attacks;
7. in patients with heart failure.

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What to look for when choosing the best inhaler?

The purchase of an inhaler suitable for you, your child or the whole family is a decision that should be preceded by an analysis of needs and expectations. When buying an inhaler, there are some important indicators to keep in mind:

1. MMAD indicator, i.e. the size of the particles to which the drug is sprayed – it depends on which part of the respiratory system the administered drug will reach;
2. respirable fraction (%) – an indicator of the percentage of particles generated by the inhaler that are the correct size. The rate of better devices is 80% –90%;
3. dead volume (residual) – this is the amount of drug solution that remains in the device after inhalation. This indicator should be as low as possible, usually around 1-3 ml;
4. gas flow – the optimal value is 8-16 l / min;
5. possible maximum inhalation time and regulating working time;
6. the rate at which the drugs are sprayed – the faster the speed of the device, the shorter the duration of inhalation;
7. the type of medication that can be used – some inhalers, due to their high operating temperature, are not suitable for the administration of antibiotics or glucocorticosteroids;
8. possibility continuous work;
9. device volume – especially if inhalations are performed in children or people who are sensitive to loud sounds;
10. additional accessories and sizes of masks;
11. possession nebulization function;
12. Dinner.

Advantages and disadvantages of the inhaler

Inhalation is a very effective method of treatment and administration of drugs, especially for the youngest patients.

Among the advantages of using the inhaler for the administration of drugs are mentioned:

1. direct delivery of the drug to the site of its action and achieving a high concentration of the drug in the bronchial tree;
2. very low probability of systemic side effects after using the drug;
3. the dose of the drug is lower than in the case of traditional application, which is associated with a high concentration of the drug at the site of action, as well as limiting the first-pass effect of the preparation through the liver;
4. a large absorption area of ​​the drug significantly increases its effectiveness and speed of action;
5. elimination of the problem of negative drug interactions, especially during metabolism;
6. easier adjustment of the specific dose of the drug to the individual needs of the patient – it is easy to measure the indicated dose in the inhaler;
7. easy inhalation and the ability to combine different drugs, which significantly supports the treatment of respiratory diseases.

Despite the many advantages of treatment using an inhaler, the disadvantages of this method cannot be forgotten. The high cost of purchasing a good inhaler is very often indicated. The cost of purchasing such a device may exceed the financial capacity of some families.

In addition, it is indicated that in cases of poor performance of the procedure, the effectiveness of inhalation is significantly reduced. An example of an incorrectly performed procedure is, for example, not properly holding the mask. If the mask does not stick to the face of the patient, a significant amount of the drug mist may leak into the surrounding air instead of into the lungs of the inhaled patient.

What is worth remembering when using medications? Check: How to take medications effectively?

How to use the inhaler?

Inhaling is not a difficult procedure. However, for inhalation to be effective, you need to remember a few rules. Effective inhalation step by step includes the following elements:

1. thoroughly washing and drying hands;
2. connect all parts of the inhaler as instructed. If the inhaler is not battery operated, plug the device in;
3. measuring the correct dose of medicine and checking the smallest volume of liquid necessary for the inhaler to work. In the case of too little drug, the liquid is diluted with saline;
4. shaking the ampoule with the drug and adding it to the inhaler;
5. actuation of the inhaler and inhalation through the mouthpiece or mask;
6. Inhalation should continue until the medication is finished in the nebuliser chamber. Characteristic bubbling may be heard and observed when the tip of the medicine remains in the container. Usually one-time inhalation lasts about 5-10 minutes;
7. after inhalation, the inhaler is turned off and its components cleaned, which includes: washing the nebulizer container, mask or mouthpiece and allowing it to dry;
8. in case of inhalation with steroids, in order to avoid fungal infections, it is recommended to rinse the mouth.

Performing the procedure in accordance with the above recommendations is a guarantee of the effectiveness of inhalation. However, it should be remembered that the effectiveness of inhalation may be influenced by several factors at the same time. It is very important to ensure that as little solution as possible goes beyond the respiratory system.

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How do I care for my inhaler?

The inhaler is a medical device that must be looked after. Not only so that it will serve us for years, but also so that its use does not harm our health. When taking care of your inhaler, remember to:

1. thoroughly washing and disinfecting additional accessories after each use of the inhaler – this will help prevent mouth ulcers, irritations or fungal infections. Each inhaler comes with an instruction manual with instructions on how to clean the device;
2. systematic replacement of air filters – the frequency of filter replacement depends on how often the device is used;
3. cleaning and disinfecting the mask and mouthpiece – using boiling water or household sterilizers.

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Inhaler – additional accessories

Inhalers are medical devices that can be purchased with many additional accessories. These accessories allow you to better use the potential of the inhaler to its maximum extent. The most frequently chosen accessories for inhalers are:

1. inhalation masks;
2. inhalation mouthpieces;
3. nebulizatory;
4. inhaler filters;
5. nose tips;
6. air ducts;
7. inhalation nipples;
8. irygatory;
9. case for nebulizers
10. power supplies.

How to choose the best inhaler for children? Check: Children’s inhalers

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