Nebulizers for cough are one of the most commonly used medical equipment used to treat lung disease. A nebulizer is a machine that vaporizes liquid medications so that they can be easily inhaled, usually through a mouthpiece or face mask. In this form, medications are able to directly reach the lungs and are more readily absorbed by the body. This can be particularly helpful for conditions that manifest with cough, inflammation, and narrowing of the airways. Read on to learn more about how nebulizers are used for cough, why they are used, and how to set it up. 

What Is a Nebulizer?

The nebulizer vaporizes medications so that they easily reach the lungs¹. It aims to reduce inflammation or constriction of the airways, as well as reduce mucus production.

Inhaled therapies have been used to treat numerous conditions since ancient times². But it was only in the 20^th century with the discovery of epinephrine as a potential treatment for asthma when nebulizers started to gain ground. 

Now, with the rapid progression of technology and growing research into lung disease, nebulizers have become a common modality in the treatment of respiratory illnesses like asthma, chronic obstructive pulmonary disease (COPD), and sometimes the flu. Once the medications are absorbed by the lungs, there may be relief of cough, shortness of breath, wheezing, and tightness. It is worth remembering that nebulizers may treat the symptom of cough, but not the underlying condition causing it. It is important, then, to work closely with your physician regarding the use of a nebulizer for cough.

Types of Nebulizers

Nebulizers come in different forms, but all have the goal of producing vapors out of medication. Here are the three main types³:

• Jet – Compressed gas is used to make an aerosol out of medication.
• Ultrasonic – High-frequency vibrations aerosolize medications. The particles produced are usually larger than with a jet nebulizer.
• Mesh – Liquid medications pass through a fine mess to produce aerosols. Mesh nebulizers produce the tiniest particles, and are therefore the most expensive type.

Apart from the type of nebulizer to use for cough, you should also consult your doctor whether to use a mouthpiece or face mask. Children younger than five years old usually breathe through their nose, making a face mask more appropriate to use. In contrast, older children are better able to control their breathing, so a mouthpiece may be best for this age group. 

How Nebulizers Help with Cough

Nebulizers may be used to treat cough⁴. Remember, cough is a symptom of a disease, not a disease in itself. Coughing is the body’s way of expelling mucus, allergens, or irritants to keep the airways clear. It can be caused by a variety of conditions including:

• Asthma
• Allergies
• Sinusitis
• Post-nasal drip/upper airway cough syndrome
• Smoke exposure
• Common cold
• Chronic obstructive pulmonary disease
• Pneumonia
• Bronchitis
• Cystic fibrosis
• Heart and lung disease

The aim of nebulizers is to quickly and efficiently deliver medications straight to the lungs while breathing normally. This is especially helpful in treating children, who may find it difficult to use inhalers, which require practice. Nebulizers may come in tabletop or portable models. Home nebulizers usually need to be plugged in before use, while portable nebulizers may be battery-operated and can be easily packed⁵. Nebulizers and the appropriate medication require a prescription, so consult your doctor regarding treatment.

Medications Used in Nebulizers for Cough

What is put in a nebulizer for cough will depend on the patient’s age and health status and the severity of the lung disease⁶. Your doctor will conduct a thorough history and physical examination, as well as ask questions regarding the symptoms associated with the cough. Commonly used drugs used to address lung disease are corticosteroids (these reduce inflammation) and bronchodillators (this help the channels in the respiratory system open up). Specific medications include⁷:

• Albuterol (also known as salbutamol; bronchodilator)⁸⁹
• Hypertonic saline (sterile salt water; mucus thinner)¹⁰
• Formoterol (COPD only, not asthma; bronchodilator)¹¹
• Budesonide (corticosteroid)¹²
• Ipratropium (bronchodilator)¹³

These medications may be given through medication for a short- or long-term basis, depending on the patient’s needs. Nebulizers may also be used to prevent inflammation, reduce constriction, and decrease mucus production. Flares of coughing, wheezing, and difficulty breathing may also indicate the need for nebulization. The advantages of nebulizers include ease of use, especially for younger children, and allow for multiple medications to be delivered simultaneously. Remember, consult your physician before using the nebulizer as its use, as well as the medications, require a prescription.

Nebulizer for Kids

Children have a higher risk of developing lung diseases as their immune systems are not yet fully developed¹⁴. As such, a nebulizer can greatly aid children who have chronic respiratory diseases such as asthma and cystic fibrosis, acute lung infections like pneumonia, or children with severe allergic reactions.

However, it can be extra challenging to nebulize a child, especially the younger ones. To make the experience smoother and more effective, here are some tips on how to help your child use a nebulizer¹⁵:

• Incorporate the nebulizer into your daily routine, so your child knows when to expect it.
• Watch a show, read stories, sing songs, or play with toys when using the nebulizer.
• For fidgety children, try using the nebulizer when the child is asleep.
• If your child is old enough, teach them to put the mask on, hold the tubing, and turn the machine on independently (while supervising them, of course); feeling in control can make them more cooperative.
• Praise your child for a job well done, by giving them a simple reward for their cooperation.

No parent would enjoy seeing their child sick, especially with a cough. A nebulizer can be a quick and easy solution to relieve your child’s symptoms, as well as provide an opportunity for bonding as well as independence.

How to Use a Nebulizer for Cough

Nebulizers are an investment in health. The best way to get the most out of your nebulizer is to make sure to operate it properly and clean it regularly. Here is a step-by-step guide on how to use your nebulizer for cough¹⁶:

1. Place the nebulizer on a stable surface and plug the machine. 
2. Wash and dry your hands thoroughly.
3. Carefully and accurately measure out medications as instructed by your doctor. 
4. Remove the cap of the nebulizer cup.
5. Pour the medication into the nebulizer cup. 
6. Close the cap and attach the top part to the mouthpiece or face mask. 
7. Connect the tubes to the machine and the nebulizer cup. 
8. Position the mask or mouthpiece properly.
9. Turn on the compressor. Observe a light mist rising from the nebulizer cup going to the mouthpiece or face mask. 
10. Take slow, deep breaths while nebulizing. Try to hold each breath for about 2-3 seconds before exhaling to allow the medications to thoroughly penetrate the lungs. 
11. Continue nebulizing until the medication is consumed and no more mist arises. 
12. Remove the mask or mouthpiece, turn off, and unplug the nebulizer.
13. Take deep breaths and try to cough out any secretions that may have loosened while nebulizing. 
14. Wash your hands thoroughly afterward.

Using a nebulizer is relatively easy, and so is taking care of it. Make sure to rinse the nebulizer cup, mask, and mouthpiece and allow to air dry. You may also opt to wash these in warm, soapy water using a mild detergent; you should rinse them before air drying. Keep the nebulizer clean as needed with a damp cloth. Clean the compressor’s filter as directed by the equipment instructions. Secure it and the medication in a safe area away from the reach of children. All these steps will help to prolong the life of your nebulizer and ensure you get the best performance out of it.

Precautions

To avoid any untoward incidents, make sure to thoroughly read through the instruction manual of your device¹⁷. Regularly clean your device and store it away from the reach of children. Watch out for signs of allergic reactions such as skin rashes, hives, itching, difficulty breathing or swallowing, and swelling of the face, hands, and mouth. Avoid taking medications unless prescribed or advised by your doctor – this covers both prescription and non-prescription medications, including any herbal or vitamin supplements.

Nebulizer for Cough vs. Inhaler

While a nebulizer and inhaler are similar in that they both deliver a vaporized version of the medications to the lungs, they differ significantly in use. A nebulizer is generally easier to use as it requires you to simply breathe normally, making it an appropriate choice for young children¹⁸. However, it may take longer than an inhaler to administer medication, usually five to ten minutes. Nebulizers may also be larger and bulky, making it difficult to transport for work or travel.

In contrast, inhalers are able to quickly deliver an exact dose of medications. It is smaller, more portable, costs less, and is associated with fewer side effects than nebulizers. However, it requires more practice to use properly, as it requires the user to follow certain breathing patterns in order for the medication to reach the lungs. This makes it the more appropriate choice for older children or adults.

Ultimately, the choice of device will depend on the patient’s age and condition, as well as your doctor’s assessment of the most appropriate device. 

Conclusion

Nebulizers are a handy tool in the management of numerous lung diseases. They work by vaporizing medications into smaller particles that can easily reach and penetrate into lungs. This leads to relief of cough, decrease in mucus production, opening of airways, and lessening of inflammation. There are different types of nebulizer machines as well as mouthpieces and face masks. Consult your doctor for the most appropriate device to use based on your age, symptoms, and condition. Watch out for shortness of breath, wheezing, persistent coughing, and bluish discoloration of the skin, which could be alarming signs warranting an immediate consultation with a doctor. When used appropriately and cleaned regularly, you will get the most out of your nebulizer for cough treatment.

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Mikaela Millan

Mikaela is a dentistry clinician at the University of the Philippines.