What Is Inhalation Therapy?

Introduction

Inhalation therapy, also known as respiratory therapy or nebulizer therapy is a method of delivering medication straight to the lungs by breathing it in. This method is typically used to manage and treat respiratory illnesses, these may include asthma, chronic obstructive pulmonary disease (COPD), respiratory tract infections (RTI), and more.

Compared with other routes of medicinal administration, inhalation therapy provides many more advantages when treating respiratory diseases. This enables rapid therapeutic relief and better quality of life for individuals undergoing the therapy.

The primary benefit of inhalation therapy is that direct inhalation allows for more targeted organ treatment and a higher medicinal concentration of the target while keeping a lower systemic drug concentration.¹ This ensures direct delivery to the lungs and avoids the risks of side effects to any other organs that may have received the medication through more conventional methods of intake.

There are multiple types of inhalation therapies, the ones that will be discussed in this article are; Metered-Dose Inhalers (MDIs), Dry Powder Inhalers (DPIs), and Nebulizers. Each method has its own set of advantages and can be used according to the treatment, age, and condition of the individual.

Types of inhalation therapy

As mentioned previously, inhalation therapy contains multiple delivery methods with each having different pros and cons. This section will discuss the three most popular methods.

Metered-dose inhalers (MDIs)

A metered-dose inhaler or MDI for short is a small handheld device that allows the patient to self-administer short bursts of aerosolised medicine into their lungs. The device is a pressurised canister consisting of the medicine and a metering valve that releases the medication upon activation. 

Mechanism of action

The medication within the MDI is propelled using a propellant called hydrofluoroalkane (HFA) to convert it into a mist that is easily inhaled by the user. The medication then enters the airways and causes dilation of the bronchial passages leading to reduced inflammation or loosening of mucus. 

Method of use

Proper technique when using an MDI is extremely important. The patient must shake their device before use, and place the mouthpiece between their lips while keeping their tongue out of the passageway for the medication. Once the patient starts slowly inhaling they should activate the inhaler and inhale fully until their lungs are full. Then it is recommended for the patient to hold their breath for about 10 seconds before slowly exhaling.

Dry powder inhalers (DPIs)

As the name suggests, DPIs are a form of medication that is in powdered form. They differentiate from MDIs as they do not have a propellent and the patient must generate the required force to inhale the medication into their lungs.

How they work

The device contains a reservoir with the medication, which is punctured upon the beginning of inhalation. The airflow caused by the inhalation allows the medication to reach the lungs.

Limitations

Although DPIs are extremely easy to use and are extremely portable, they will not be applicable and challenging to use for patients with already compromised or limited lung function as generating the airflow to inhale the powder will not be possible for them.

Nebulizer

A nebulizer is when a liquid medicine is reduced into a fine spray or mist by a small machine. Nebulizers are suggested for use in individuals who cannot use MDIs or DPIs effectively. This is meant for the elderly and children who may not be able to produce sufficient airflow without the assistance of a machine.

Functionality and setup

A nebulizer consists of 3 parts, a compressor, medication chamber, and mouthpiece or mask. Once the machine is turned on, it produces a constant airflow that passes through the medication chamber and causes it to turn from liquid into an aerosol state which the patient can then inhale through their mask allowing it to be transported straight to their lungs. 

Types of nebulizers

There are three main types of nebulizers: jet, ultrasonic, and mesh. Jet nebulizers are the most common and are the ones described above. They use compressed air to convert the medication into aerosol form. Ultrasonic nebulizers, as the name suggests use ultrasonic waves to convert the medication into aerosol form. Lastly, mesh nebulizers make the medication pass through a fine mesh that breaks it down and turns it into a fine mist that is easy to inhale.

Conditions treated with inhalation therapy

Inhalation therapy is one of the main methods of managing and treating respiratory illnesses. Chronic obstructive pulmonary disease (COPD) and asthma are 2 of many respiratory conditions that can be treated by this method.

Chronic obstructive pulmonary disease (COPD)

COPD is a disease in which the lungs can get damaged or clogged up with phlegm. This in turn leads to airway limitations and further symptoms such as coughing. The global burden of COPD morbidity is predicted to rise substantially in the coming decade but could be moderated by better use of existing management strategies.² COPD is a condition that worsens over time therefore finding a method that can help manage the symptoms and decrease morbidity rates. 

Role of inhalation therapy

inhaled bronchodilators, alongside other medications, have become the cornerstone for the treatment of COPD.³ Long-acting bronchodilators, such as long-acting beta-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) are often known as the ‘first-line therapy for COPD’.³ These are used to improve airflow and reduce symptoms. However, it is important to know medication adherence is extremely important for managing symptoms.

Asthma

Asthma, is one of the most common respiratory illnesses in the world, affecting people of all types and ages. It is caused by the inflammation and tightening of muscles around the airways, bronchoconstriction, and mucus buildup making it difficult to breathe. 

Role of inhalation therapy

Inhalation therapy is one of the most preferred routes to deliver medication to manage asthma symptoms.⁴ The direct route the medication has to the lungs allows for reduced inflammation and an easier passage of breathing. Bypassing the other organs allows for a more directed approach to treatment while avoiding any side effects that may have presented themselves if the medication was to reach said organs.⁴ MDIs and DPIs are generally used in asthma users to provide a quick sense of relief and opening up of airways for better breathing. Controller and reliever medications are both used through inhalers to allow 

FAQs

What are the examples of inhalation therapy?

Examples of inhalation therapy include dry powder inhalers (DPIs), metered-dose inhalers (MDIs) and nebulizers.

What are the advantages of inhalation therapy?

Advantages include a rapid onset of medication, targeted delivery to the lungs and reduction in systemic side effects.

What is the meaning of inhaler therapy?

Inhaler therapy is the action of using inhalers to assist in inhaling medication in mist or aerosol form directly to the lungs for direct delivery.

What is the inhalation technique?

Inhalation technique refers to the proper technique used when using inhalers or nebulizers to inhale medication into the lungs. This involves sealing the masks around the face, shaking the inhaler, taking a big deep breath in to inhale all the medication, and more.

Summary

Inhalation therapy is the idea of using methods to deliver medication directly to the lungs by inhaling medication in mist or aerosol form. It is a method of treatment and management associated with respiratory diseases. Types of inhalation therapy include metered-dose inhalers (MDIs), powdered-dose inhalers (PDIs), and nebulizers. They all have their differences, but all provide the key advantages of rapid onset of action, direct delivery, and reduction in systemic side effects. For conditions like COPD and asthma, inhalation therapy is crucial, providing relief and improving quality of life. Medication adherence is vital for effective management, ensuring better outcomes and reducing health burdens. Overall, inhalation therapy offers a targeted approach to respiratory care, enhancing patient well-being and symptom control.