I think there will always be an open debate on the effectiveness of nebulizer versus Metered-Dose Inhalers. Those who use them for the treatment of Asthma, COPD, or other breathing related symptoms usually have a preference and a belief that one surely works better than the other. Personally I too have an opinion on the subject and I will share that with you here. I will also show you what some of the facts and research studies have shown. Maybe the information here help you make up your own mind.
When I first was introduced to "wet nebulizers" it was many years ago when my son was diagnosed with a very minor form of asthma. It was recommended by his pediatrician that he occasionally take albuterol via a wet nebulizer treatment. My son used the nebulizer for about a year and then his symptoms cleared up and he has not used it since. At the time I really had not had any experience with anything else. After about a couple of months of routine use, he no longer had a need for any medication. So, I then made the assumption that he had gotten better and that was a direct result of the medication doing what it was supposed to do. Furthermore, the method of getting the medicine into his lungs by using a wet nebulizer must have worked.
As I started becoming involved with caring for various family members and their breathing issues, I finally had the opportunity to see first hand how Metered-Dose Inhalers operated. Up until this point in time I had only ever seen inhalers on television. My personal experience with wet nebulizers was my only experience with any kind of breathing treatment.
It was my initial impression that the inhaler was somewhat flawed operationally. No matter the age or the experience of the person using it, it always seemed the medication did not reach the patient as intended. It was difficult to explain to the patient how to effectively use it. It was difficult for the patient to put the explanation into practical use. Getting a full dose was also hard because the patient usually had a difficult time trying to time the action of inhaling a full breath at the same time they "puffed" the inhaler.
So what was wrong? Why did the inhaler work so poorly? Or did it? Let's compare the two methods of getting the medication and see just what is happening and which might be better. First of all let me say that in many cases the actual medication being used in each method is the same. Both methods can deliver doses of Albuterol, Ipratropium, Budesonide, and others.
One thing about attempting to compare these two methods is that it is usually very difficult to get an objective answer of any kind from the patient who uses either the Nebulizer or inhaler. The reason for this is the fact that not being able to breathe is such a scary situation for the person going through it. Because of the fear that comes with this symptom, patients generally have a very strong mental opinion on which works better and it has nothing to do with anything scientific. One of the methods usually makes them feel so much more secure about their breathing than the other, that they strongly prefer one over the other for no other reason but because it acts as a safety net of sorts.
Trying to compare the two is then relegated to those around the patient who can observe the use and symptoms and whether or not they get any better after repeated use. The medication itself is very good at treating the symptoms related with COPD or Asthma. Problem is, how much medication is actually getting to the patient? Are either of the methods getting more medicine into the patients lungs than the other? The short answer: yes.
What we have to look at then in my opinion is the ease of use. While a nebulizer might be a bit time consuming to set up. It is usually bulky, needs a power outlet, can be noisy, and can take up to about 20 minutes to complete. If you can look past these simple drawbacks, this is the better and more effective method of dosing the breathing medication.
Once the medication is put into the container that is attached to the tube and the machine switched on, it produces a fine mist that can then be inhaled by the patient. This mist is generated by the machine non stop as long as medication remains in the container. It is then up to the patient to breathe normally (and occasionally deeply) to inhale the mist. The fact that the container and mouth-piece that produces the mist can be held in the hand or strapped to the face via a mask-type apparatus makes it much easier for the patient to just relax.
With the nebulizer there is no need to time the act of inhaling deeply with the "puffing" of the inhaler. Breathing can continue as normal, all the while the medication is being inhaled into the lungs of the patient. This is calming and less stressful also because there is no nervous action or any trying to hurry up as there usually is with a "rescue inhaler".
The benefits that make a nebulizer easier to use than a Metered-Dose Inhaler are not possible with an inhaler. As a matter of fact it is very common for people to use the inhaler incorrectly which is almost impossible to do with a nebulizer. Once you have the medication in the nebulizer container and turn it on, all the patient needs to do is breath. Again, much simpler than attempting to exhale, then time the action of "puffing" the inhaler with a deep inhale.
Another downfall of the inhaler due to its misuse is Thrush. Thrush is an irritation and redness of the throat that is caused by the medication resting in the mouth and throat of the patient. This occurs when they do not use the inhaler properly and the medication remains in the mouth and throat area instead of going into the lungs as it is meant to.
So what is my conclusion? Well, that should be fairly obvious at this point. While both methods DO work, and both methods DO provide the same medications, the nebulizer simply works better. It is much easier for patients to use than the inhaler. The person using the nebulizer really does not have to do anything aside from loading the machine with medication. Once that is complete and the machine turned on, all that is required is patience. There is only one benefit to an inhaler that you do not get with a nebulizer - it is portable.
A nebulizer is as I said earlier, bulky. It also needs a power outlet to function. This is where an inhaler wins over the nebulizer. It is small, fits in a pocket or purse, and you do not need anything except the inhaler itself to use it. Because of this the inhaler is much quicker at putting the medicine where it needs to be. This is the reason they are referred to as "rescue inhalers". When a person is in the throes of a breathing fit or attack and they are having trouble catching their breath - the inhaler's fast action and mobility can be a life saver. This is, providing of course, that the person knows how to properly use it. If they do not then it makes no difference because they will not get the medication into their lungs at all.
Overall, even though nebulizers are easier to use one must always consider their own personal situation and medical condition. While both methods can provide the exact same medication to the patient, their situation or condition may call for a specific treatment in a specific scenario. You should always consult with your physician before making any decisions on your own regarding your medical care. If you have any ideas or thoughts due to something somebody tells you or something you read on the Internet, always consult with your doctor first before doing anything rash.
Aside from that little disclaimer and bit of common sense, the Wet Nebulizer is surely the way to go for it's ease of use and effectiveness. I always suggest treatment using a nebulizer for breathing difficulties or regular medication dosing for those I care for. It causes less stress, does not aggravate the patient, and I know that the medicine actually got into the person I am caring for.
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