What is a nebulizer used for?
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A nebulizer is a modern inhaler that allows you to obtain a very fine aerosol with a drug. Everyone knows, for example, a “homemade” inhaler - boiled potatoes in a pan covered with a towel.
So, when inhaling the steam formed over potatoes, it only affects the upper parts of the respiratory tract, because the droplets are quite large in size and settle quickly. When using a nebulizer, the aerosol droplets are so small that they penetrate into the lowest parts of the lungs and there they exert their therapeutic effect.
Therefore, the main purpose of using nebulizers is to treat respiratory diseases throughout. Such diseases include bronchitis, tracheitis, laryngitis, pneumonia, sinusitis, and influenza.
In what cases are inhalations contraindicated?
There are two types of inhalers - ultrasonic and nebulizer. They are both easy to use. Medicinal components easily penetrate the area of inflammatory processes.
Inhalation with a nebulizer is contraindicated in the following cases:
- heat;
- tendency to nosebleeds;
- severe cardiac and vascular pathologies;
- diseases that lead to unstable heart rhythm;
- bronchial asthma;
- severe laryngitis;
- individual intolerance to the active components of the drug used.
As with any treatment method, there are also contraindications. Doctors prohibit inhalation for laryngitis not only for babies under 1 year old, but also for children under 7 years old.
In addition, steam inhalation is contraindicated in the following pathologies:
- development of purulent processes - sinusitis, otitis, tonsillitis, etc.;
- laryngitis caused by bacterial infections - this can, on the contrary, increase the rate of their reproduction;
This treatment method may also be prohibited for patients with weakened immune systems.
Experts say
At the moment, the best way to treat acute respiratory infections is nebulizers. With their help, you can deliver the necessary medications directly to the site of inflammation - to the bronchi, trachea. It is recommended to start doing inhalations with a nebulizer at a temperature and the first signs of acute respiratory infections - coughing, runny nose, sneezing.
Nebulizers are especially effective in children: their bronchi have a small lumen and, when inflamed, quickly become clogged with the resulting sputum.
Therefore, the answer to the question: is it possible to do inhalation with a nebulizer in children at high temperatures (for example, 38 degrees or more) is definitely positive. The effect is observed literally within the first minutes after inhalation: sputum begins to disappear, a wet cough appears, the condition improves, and after a while the temperature begins to decrease.
In this case, medications administered through a nebulizer are used in such low dosages that they do not have any systemic effect on the human body.
Is it possible to do inhalations with a nebulizer at a fever? Can! Inhalations with this device at a temperature can be used not only for acute respiratory infections, but also for other acute and chronic lung diseases in adults and children, for example, pneumonia, exacerbations of chronic bronchitis, cystic fibrosis. In all cases, there is a reduction in the duration of the temperature period, a rapid improvement in well-being, accelerated recovery, and a reduced need for medication.
Berodual
Use during pregnancy and breastfeeding
Data from preclinical studies and human experience indicate that fenoterol or ipratropium bromide do not have a negative effect during pregnancy.
The possibility of an inhibitory effect of fenoterol on uterine contractility should be taken into account.
The drug is contraindicated in the 1st and 3rd trimesters (possibility of weakening labor by fenoterol).
The drug should be used with caution in the second trimester of pregnancy.
Fenoterol is excreted in breast milk. There is no data confirming that ipratropium bromide passes into breast milk. However, Berodual® should be prescribed to nursing mothers with caution.
Clinical data on the effect of the combination of ipratropium bromide and fenoterol hydrobromide on fertility are not known.
Use for renal impairment
The drug should be prescribed with caution for obstruction of the bladder neck.
Use in children
In adolescents over 12 years of age during acute attacks of bronchospasm, depending on the severity of the attack, doses can vary from 1 ml (1 ml = 20 drops) to 2.5 ml (2.5 ml = 50 drops). In especially severe cases, it is possible to use doses reaching 4 ml (4 ml = 80 drops).
In children aged 6-12 years during acute attacks of bronchial asthma, depending on the severity of the attack, doses can vary from 0.5 ml (0.5 ml = 10 drops) to 2 ml (2 ml = 40 drops).
In children under 6 years of age (body weight <22 kg), due to the fact that information on the use of the drug in this age group is limited, the following dose is recommended (only under medical supervision): about 25 mcg ipratropium bromide and 50 mcg fenoterol hydrobromide = 0.1 ml (2 drops) per kg of body weight (per dose), but not more than 0.5 ml (10 drops) (per dose). The maximum daily dose is 1.5 ml.
special instructions
The patient should be informed that if shortness of breath (difficulty breathing) suddenly increases rapidly, consult a doctor immediately.
Hypersensitivity
After using Berodual, immediate hypersensitivity reactions may occur, signs of which in rare cases may include urticaria, angioedema, rash, bronchospasm, oropharyngeal edema, anaphylactic shock.
Paradoxical bronchospasm
Berodual®, like other inhaled drugs, can cause paradoxical bronchospasm, which can be life-threatening. If paradoxical bronchospasm develops, the use of Berodual should be stopped immediately and switched to alternative therapy.
Long-term use
In patients with bronchial asthma, Berodual® should be used only as needed. In patients with mild COPD, symptomatic treatment may be preferable to regular use.
In patients with bronchial asthma, one should remember the need to carry out or intensify anti-inflammatory therapy to control the inflammatory process of the respiratory tract and the course of the disease.
Regular use of increasing doses of drugs containing β2-adrenergic agonists, such as Berodual®, to relieve bronchial obstruction can cause uncontrolled worsening of the disease. In case of increased bronchial obstruction, increase the dose of β2-agonists, incl. Beroduala, more than recommended for a long time is not only not justified, but also dangerous. To prevent life-threatening worsening of the disease, consideration should be given to reviewing the patient's treatment plan and adequate anti-inflammatory therapy with inhaled corticosteroids.
Other sympathomimetic bronchodilators should be prescribed concomitantly with Berodual only under medical supervision.
Gastrointestinal disorders
In patients with a history of cystic fibrosis, gastrointestinal motility disorders are possible.
Berodual® should be prescribed with caution to patients predisposed to the development of glaucoma. There are isolated reports of complications from the organ of vision (for example, increased intraocular pressure, mydriasis, angle-closure glaucoma, eye pain) that developed when inhaled ipratropium bromide (or ipratropium bromide in combination with β2-adrenergic receptor agonists) entered the eyes. Symptoms of acute angle-closure glaucoma may include pain or discomfort in the eyes, blurred vision, the appearance of a halo on objects and colored spots in front of the eyes in combination with corneal edema and redness of the eyes due to conjunctival vascular injection. If any combination of these symptoms develops, the use of eye drops that reduce intraocular pressure and immediate consultation with a specialist are indicated. Patients should be instructed on the correct use of Berodual® inhalation solution. To prevent the solution from getting into the eyes, it is recommended that the solution used with a nebulizer be inhaled through the mouthpiece. If you do not have a mouthpiece, use a mask that fits tightly to your face. Particular care should be taken to protect the eyes of patients predisposed to the development of glaucoma.
Systemic effects
For the following diseases: recent myocardial infarction, diabetes mellitus with inadequate glycemic control, severe organic diseases of the heart and blood vessels, hyperthyroidism, pheochromocytoma or urinary tract obstruction (for example, prostatic hyperplasia or bladder neck obstruction), Berodual® should be prescribed only after careful assessment of the risk/benefit ratio, especially when used in doses higher than recommended.
Effect on the cardiovascular system
In post-marketing studies, rare cases of myocardial ischemia have been reported when taking beta-adrenergic agonists. Patients with concomitant serious heart disease (for example, coronary artery disease, arrhythmias or severe heart failure) receiving Berodual® should be warned to consult a doctor if they develop heart pain or other symptoms indicating worsening of heart disease. It is necessary to pay attention to symptoms such as shortness of breath and chest pain, because... they can be of both cardiac and pulmonary etiology.
Hypokalemia
Hypokalemia may occur when using β2-adrenergic agonists.
In athletes, the use of Berodual, due to the presence of fenoterol in its composition, can lead to positive results of doping tests.
The drug contains a preservative, benzalkonium chloride, and a stabilizer, disodium edetate dihydrate. During inhalation, these components may cause bronchospasm in sensitive patients with airway hyperresponsiveness.
Nebulizer as a method of treating laryngitis
This is a very convenient way to treat laryngitis. It is suitable even for children from one year old. This is a godsend for parents, since sometimes it is simply impossible to make a small child breathe steam. And this device can be used when the child is sleeping.
During operation, the nebulizer sprays tiny particles of active drug components. Thus, they easily penetrate into the very focus of the inflammatory process.
Nebulizers are of the air-ionization type. Such models enhance the effect of the active components and significantly reduce the duration of treatment, since the therapeutic effect is noticeable after just a few inhalations.
Rules for inhalation for laryngitis
Doing inhalation is not as easy as it seems at first glance. If you carry out the procedure incorrectly, you can only make the situation worse. Therefore, before starting, you should carefully study all the rules.
- Inhalations are carried out only in a calm state.
- The procedure takes no more than 10 minutes.
- Inhalations are not performed on a full stomach. Doctors advise carrying out the procedure only a few hours after eating.
- It is strictly forbidden to talk during the inhalation period and for the next half hour.
- You should not eat or drink after inhalation.
- Patients diagnosed with laryngitis should breathe through the mouth and exhale through the nose.
- It is strictly forbidden to breathe in a solution that is boiling. This is very harmful for patients with laryngitis.
In most cases, doctors prescribe several medications at once. In this case, patients must follow their sequence. Inhalation can be repeated only after 15 minutes. After the sputum comes out, it is necessary to carry out the procedure with medications that will relieve inflammation and rid the larynx of pathogenic microorganisms.
