Fumigation therapy is the use of inhalation drugs to treat asthma attacks, such as Salbutamol under the name Salamol Atronet of the same name and Combiont which is a combination of these two drugs, as well as Corten under the name Pulmicort, which is inhaled in liquid form for a nebulizer device, which in case of exacerbation Asthma symptoms (causing a severe asthma attack) can be used by the patient either at home or in the emergency room of hospitals or in allergy clinics.
The main point is that if the inhalers are used correctly, they will have the same effect as the nebulizer (which most people do not know the correct technique of using) and the inhaler requires a special case as well as a mouth and nose mask, which is not available everywhere, especially during severe attacks, but everyone emphasizes on everything It is better to start the treatment faster, whether at home, in the doctor’s office, or in the hospital (either with an inhaler or a nebulizer), so that appropriate action can be taken to save the patient’s life with the least complications and costs.
Regarding the equal effect of nebulizer and inhaler, all studies have emphasized that patients with severe attacks were not in the study and they did not have the moral courage to bring patients with severe attacks (or close to death) to the research and all received nebulizers.
In cases of mild to moderate attacks (most attacks or relapses of asthma), it is preferable to use an inhaler, whether at home, in the doctor’s office, or in the hospital…and from the point of view of economy and even treatment, this method is recommended and is the first preference and is implemented by all. and if the doctor wants otherwise, the families and patients will not be burdened
But the big disadvantage of this method is that it is not used correctly, it is difficult to teach it, especially in children under 5 years old who do not cooperate (elderly people with nervous and intellectual problems, and special coordination between the pressure on the spray and breathing is necessary… ) or the medicine is wasted or swallowed or sticks to the wall of the container (electrical charge)
In asthma patients with a severe attack who do not have the trachea and the ability to cooperate with the chamber and inhaler, or are restless due to the severity of the disease, a nebulizer is the more appropriate method (the table for the treatment of asthma attacks in severe episodes has omitted the inhaler and only mentioned the nebulizer) because It does not require any special training (unlike an inhaler), it is simple and easy to use, and it is better tolerated (gentle treatment), it does not cause irritation and vomiting, and it does not create a special taste in the mouth, and it is better to calculate the amount per kilogram of weight.
Having a nebulizer, like inhalers, is not recommended in the homes of all patients, and knowledgeable doctors do not recommend the purchase of a nebulizer to all asthma patients, except for families with a high level of education who have a history of many attacks and severe attacks each time, because they may rely heavily The rest of the treatment for asthma attacks cannot be done properly with a nebulizer, that’s why the sales of nebulizers are very small, and because they are expensive, it is not economical to have them at home from time to time (most patients) and the purpose of maintenance treatment is to prevent an attack from happening. which requires this device and even the salbutamol spray itself, but if one of these devices is used in emergency rooms or treatment centers or doctors’ offices in compliance with sterility, many patients will use it in times of emergency, and the cost of purchasing the device has not been covered.
But in all medical centers, offices, emergency rooms, inpatient departments, and ICUs of hospitals, it is necessary to have a nebulizer, so that in case of a severe asthma attack, the treatment can be done as quickly as possible and less treatment burden is imposed on higher treatment centers. and reduce the cost of families and the government
If you are sick and unwell, instead of going to the emergency room, they bring you to the office of specialists and subspecialists (sometimes they become unwell while being brought), and this is despite the fact that not only have they taken salbutamol inhaler many times, but they have also taken its tablets or syrup. They are still in a severe asthma attack, and for real treatment, proper treatment should be started as soon as possible, the best of which is a nebulizer, wherever they are.
Of course, the doctor morally accepts the risk of treating a sick patient (in any office, clinic, or emergency room), which is something to be thankful for, because he has to monitor and provide nursing services for almost an hour, maybe a little more, and if necessary, other than oxygen nebulizer. treatment as well as serum therapy that due to rapid breathing and being sick for several days and vomiting, etc., all these patients have a lack of water in the body and monitor blood gases with pulse oximetry along with vital signs, repeat salbutamol and nebulize budesonide and numerous injections such as hydrocortisone, aminophylline, and sometimes epinephrine, and sometimes injectable antibiotics, etc.
So, like the events in the doctor’s office or clinic, all asthma attack treatment is done completely, and the burden of treatment on the events and the hospital department, which reduces the cost to the family and the economy of the country, as well as psychological help to the families, so that the issue of hospitalization is not raised with a temporary hospitalization. In the doctor’s office, he must manage the responsibility he has assumed well and be accountable. This severe attack treatment, which is sometimes done in the office, is not just a simple nebulizer, and the treatment of severe asthma is under the supervision of a specialist or subspecialist. Corten nebulizer, if done in time Although the attack does not have an immediate effect, it is useful for maintaining the result of treatment with salbutamol, and steroid has no effect for less than two hours, even if it is systemic, but in the first hour of treatment, it is recommended to help maintain the result of the treatment with the appearance of its gradual effect, and the patient can return to The attack will not occur and the next nebulizer or even the next life-saving inhaler will not be needed, and in cases of budesonide inhalation, we will no longer inject hydrocortisone to the patient, and of course, the first dose every 12 hours is also considered to be inhaled corticosteroid, and it can be continued with another inhaled corticosteroid. It is enough to receive an adequate and equivalent dose of budesonide
In summary, for severe cases and patients who do not cooperate (even moderate severity), the nebulizer is better than the inhaler, and after an hour the patient goes home with the continuation of oral Weinhaler treatment.