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COPD, type two respiratory failure. Using nebulizer, breathlessness. Suggestions?

Hi Doctor ! My mom. has been diagnosed as a COPD with type II respiratory failure a year ago and she is in oxygen and medications. Doctors suggest to use nabulizer but she can not handle the nabulizer at all. She tried couple of times but everytime she had a very bad expreience, she becomes almost breathless immediate after the nabulization and need to rush to the hospital in ER. Even vaporizer does not suit her. Please suggest me what can cause this type of pblms....thank you.
Asked On : Sat, 3 Nov 2012
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General & Family Physician 's  Response
As per your description your mother is probably in GOLD stage 4 COPD. She requires home oxygen therapy to avoid shortness of breath. Please purchase an oxygen concentrator and give oxygen for atleast 15 hours a day. As far your question with nebuliser , it;s probably more psychological. As per efficacy is concerned, Metered dose inhaler is as effective as nebuliser and also less expensive. If your mother is reluctant to take nebuliser then start metered dose inhaler(MDI) with spacer. My preferred regime will be MDI formoterol-budesonide (200) 2 puff BD , MDI tiotropium (9) 2 puff O.D ,M.D.I levosalbutamol 2 puff QDS. You should also make your mother walk even a little bit if she can and do some free hand exercise because that will have a big impact in long run. Also take influenza and pneumococcal vaccination each year. If your mother still do not improve , then you may consult with a doctor and may purchase a BIPAP machine at home. Hope, I satisfied your queries.
Answered: Sun, 4 Nov 2012
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