What medicine is used for aerosolization of respiratory diseases

At present, there are only three major categories of regular drugs approved for atomization in China, namely inhaled corticosteroids, short-acting bronchodilators and atomization-specific expectorants. The rest, whether antibiotics, antiviral drugs or Chinese patent medicine injections, are not recommended for routine atomization. Blind and indiscriminate use may irritate the airway and aggravate the condition.

A while ago, we received a 5-year-old child from the outpatient clinic. The parents said that the child had been coughing for 3 days and was still wheezing. He searched for a guide at home and used ambroxol injection for 2 days. Instead, he coughed and could not sleep all night. When he came, his lungs were full of wheezing. We prescribed budesonide combined with terbutaline mist. After two treatments, the asthma subsided. The parent was still wondering why the medicine he was using didn't work - in fact, the ambroxol he used was in the form of an injection. The preservatives and excipients in it would irritate the mucosa if they entered the airway. The atomized form of ambroxol has not been approved in China, so of course it is not used correctly.

Budesonide is currently the most widely used atomized inhaled hormone. Many people are frightened when they hear the word "hormone". They are afraid of gaining weight and affecting the development of their children. In fact, there is no need to worry. The dose of atomized hormone is only a few tenths of that of systemic hormone. It will only act on local airways and will hardly enter the systemic circulation. Regular use will not have those so-called side effects. Whether it is allergic cough, acute asthma attack, or acute laryngitis, it is the first choice. Last time, I received a baby with laryngitis in the emergency department. When he came in, his throat was so hoarse that he couldn't make a sound, and he could make a sound when he breathed in. So he took a nebulized budesonide, and he could cry out in half an hour. The effect is much faster than oral medicine.

If you feel overwhelmed or have severe asthma, the doctor will usually prescribe bronchodilators. Commonly used ones are terbutaline and ipratropium bromide, which are equivalent to "loosening" the spasm and tightening of the airway. You can feel the air flowing smoothly after inhaling for three to five minutes, whether it is asthma or asthma. Children with acute asthma attacks, or elderly people with chronic obstructive pulmonary disease who can't lie down can quickly relieve their symptoms. However, a few people will have some palpitations and trembling hands after using it, which will subside when they stop. Don't be too nervous. Just tell the doctor in advance about your tolerance and adjust the dosage.

If the phlegm is too sticky to be coughed out, the doctor will prescribe nebulized acetylcysteine. This medicine is like "relaxing" the sticky phlegm, breaking up the clumps of phlegm, making it easier to cough it out. It is especially used by the elderly with dilated bronchi and chronic bronchitis. Again, don't use ambroxol for injection, antibiotics, etc., as it is really not symptomatic.

Of course there are some controversies now, such as whether antibiotics can be aerosolized? At present, there are no approved dosage forms of antibiotics for atomization in China. Only a few patients with severe lung infections and severe phlegm blockage will be used off-label by doctors after assessing the risks. Ordinary people must not randomly add antibiotics at home, otherwise it will easily induce drug resistance, and the more they are used, the less effective they will be. There are also interferon nebulizers that many parents have asked about before. Now the opinions in the industry are not unanimous. Only severe wheezing caused by viral infection will be considered. There is no need to join in the fun for coughs caused by common colds.

Speaking of the simple operation of nebulization, many people like to do it at home, but don’t randomly search for prescriptions and make prescriptions. A while ago, an old man with COPD added three medicines at home and mixed gentamicin. After three days of nebulization, he coughed up sputum with blood streaks. It was found that the airway mucosa was irritated and damaged. Which medicine to use, what dosage, how many times a day, and how long to use it must be evaluated by a doctor before making a decision. Don’t use your own airway as a test field.