Difference Between Inhaler and Nebulizer

Inhaler vs Nebulizer

The administration of medicines in respiratory disorders like asthma, COPD (chronic obstructive pulmonary disease) and Cystic Fibrosis by means of inhalation is common practice. Inhalers and nebulizers are the devices used to administer these medicines which may be relievers or preventers.

Difference in devices:

Inhalers, also called puffers, are small, handheld devices made of plastic and metal. They comprise of a pressurized tin canister containing the medicine solution which is released in fixed measured doses when the canister is pressed. Thus, they are also referred to as ‘metered dose inhalers’. These inhalers may be used with a plastic add-on device called a ‘spacer’ which is placed between the canister and the patient’s mouth to assist the inhalation of medicine. The other type of inhaler available is a DPI (dry powder inhaler) which uses a calculated dose of powdered medicine present in a conventional capsule requiring manual loading.

The nebulizer is a bulky device, a compressor, containing compressed air or oxygen that delivers the air through a tube to the mouthpiece. The compressed air or oxygen flows with high velocity through the tube and into the liquid medicine present within a small cup in the mouthpiece, converting it into mist for inhalation. Nebulizers are either electronic with plug-ins or battery operated. The most commonly used ones are jet nebulizers which are easy to use but make a loud vibratory sound when switched on.

Difference in mechanism:

Inhalers work by releasing the medicine in the form of aerosols that are inhaled through the mouth; the patient needs to co-ordinate his inhalation with the release of the medicine. The spacer device catches the aerosols released from the inhaler which can then be taken into the mouth via slow, deep breaths, 4 to 6 times. Following this, the patient needs to hold his breath for 10 seconds to allow the aerosols to settle over the bronchial walls.
Nebulizers convert liquid medicine into mist using pressurized air/oxygen which is then inhaled by the patient through a mask covering the nose, connected to the nebulizer. The medicine is poured into the cup attached to the mask and when the nebulizer is switched on, slowly the solution gets converted into mist for inhalation over a duration of 10 to 20 minutes.

Advantages and Disadvantages:

Inhalers are cheaper, quicker and can be easily carried by the patient everywhere. Being cost-effective they are prescribed for routine use in respiratory disorders. However, inhalers require co-ordination of breath to enable the medicine to reach the lungs which if not done properly, will result in poor breathing relief for the asthmatic. This has been addressed to a great extent by the spacer devices.

Nebulizers prove of advantage in hospitals when medications need to be administered to patients with a tracheostomy collar or who are intubated, those with severe breathing difficulty, in ambulances, etc. However, nebulizers are bulky, not easily portable and prove more expensive than inhalers. It is unfounded that a nebulizer is better than an inhaler. In fact, side effects like anxiety and tremors due to asthma medicines are seen to occur more when delivered through a nebulizer.

Summary:

Inhalers and nebulizers are both equally effective in the administration of the medicine. Inhalers are portable devices which when used with a spacer prove to be more efficient. Nebulizers are not portable and costlier as liquid medicine is more expensive so they are mostly used in hospitals. The device recommended by your doctor could be any one, what is important is to learn the appropriate way of using it so that the medicines administered reach the lungs completely to control your respiratory disorder.

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