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Nebulizer basics

Nebulizer overview

Nebulizers use a compressor to aerosolize liquid medication, which is then delivered via a face mask or mouthpiece.

  • Nebulizer delivery in young children is less dependent on patient coordination or cooperation
  • In pivotal trials, the mean nebulization time was 5 minutes or less; though, depending on the compressor, nebulizing can take between 5 and 10 minutes

The National Institutes of Health (NIH) recognizes the nebulizer as an effective delivery method for young children.1

Two main types of nebulizers are available for delivering aerosol medication to the lungs: jet nebulizers and ultrasonic nebulizers.

  • Jet nebulizers form droplets by using a compressor to deliver a pressurized jet stream of air down a narrow tube and through a narrow opening. The result is a drop in pressure that creates a vacuum effect (Venturi effect), forcing the liquid drug to come up from the reservoir. Small droplets of liquid created in this manner are propelled out of the device by the jet stream
  • Ultrasonic nebulizers produce aerosolized droplets using high–frequency sound waves generated by a special crystal. During their operation, liquid drug is usually delivered to the crystal's surface. A thin layer of liquid forms between the surface of the crystal and a mesh layer. The crystals are then electrically excited, which causes them to vibrate at an extremely high frequency. The vibration forces the liquid through the mesh, turning it into a fine mist. Droplet size is determined by the frequency of the sound waves

IMPORTANT: Jet nebulizers can be used for both suspensions and solutions. Ultrasonic nebulizers are only to be used with solutions, not suspensions. PULMICORT RESPULES is a suspension and should only be administered with a jet nebulizer.

How jet nebulizers work

Jet nebulizers are the most commonly used device for all aerosol medications, and they are the only effective devices for PULMICORT RESPULES. Because of their physical characteristics, drug particles in suspension are generally poorly nebulized by ultrasonic nebulizers.

There are many different brands of nebulizers available as well as many sources from which they can be acquired, including local durable medical equipment suppliers and dozens of Web-based companies. It is important to make sure that your patient's caregivers are aware that they need to use a jet nebulizer if you have prescribed PULMICORT RESPULES for their child.

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Indication and Important Safety Information

PULMICORT RESPULES is indicated for the maintenance treatment of asthma and as prophylactic therapy in children ages 12 months to 8 years.

PULMICORT RESPULES is not a bronchodilator and is NOT indicated for the relief of acute bronchospasm.

Common adverse events reported in clinical trials, regardless of relationship to treatment, included respiratory infection, rhinitis, coughing, otitis media, viral infection, gastroenteritis, ear infection, oral thrush/candidiasis, and epistaxis.

Inhaled corticosteroids may cause a reduction in growth velocity. The long-term effect on final adult height is unknown.

PULMICORT RESPULES, like other inhaled corticosteroids, may impact the hypothalamic-pituitary-adrenal axis, especially in susceptible individuals, in young children, and in patients given high doses for prolonged periods.

Particular care is needed for patients who are transferred from systemically active corticosteroids to less systemically available corticosteroids, because deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids (see WARNINGS in full Prescribing Information).

Patients taking immunosuppressant doses of corticosteroids should avoid exposure to infections such as chicken pox and measles.

[Please see accompanying full Prescribing Information (PDF).]

References

  1. National Heart, Lung, and Blood Institute. Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma—Update on Selected Topics 2002. Bethesda, MD: National Institutes of Health, June 2003. NIH Publication 02-5074; p.18.