COPD is chronic obstructive pulmonary disease. In this condition there is long term inflammation in the airways that results in lesser air delivery to the lungs. Main symptoms are occasional chest pain, wheezing, cough, breathlessness especially during exacerbations, and sputum production. Air pollution like cigarette smoking, smog and other pollutants and sensitivity to these pollutants could result in this inflammation. COPD is of two types: emphysema and chronic bronchitis. Chronic bronchitis affects windpipe (bronchus) and emphysema affects airways in lungs (bronchioles and alveoli). It is a progressive disease but proper management can slow down its progression and provide relief from its symptoms.

As per current guidelines, inhalation route is preferred from administration of medicines in COPD. Inhalation devices are nebulizers and inhalers. Although inhalers can suffice for many patients with COPD, certain patients may be able to use it correctly. These patients may have cognitive impairment, limited help from caregivers, neuromuscular problems, difficulty in coordinating inhalation with release of medicine from inhaler and low air flow to the lungs. Spacers and valved spacers can be attached to inhalers to overcome some issues like impaction of medicine in throat and give more time to inhale medicine.

Nebulizer can be used in COPD to improve airflow to lungs and manually operate the apparatus to allow inhaled medicine into the lungs. It is used in institutes and homes where an inhaler cannot be used. In nebulizer, a tubing may or may not be attached to oxygen source and medicine is put in its chamber. Then mouthpiece and a corrugated tubing is attached to it. Then the patient inhales the medicated air through this tubing. Bronchodilators and other drugs are administered through this apparatus. Quieter and more portable nebulizer devices have made its use easier in patients with COPD.

Written by Dr Vaishalee