• COPD medicines can be taken orally, by injections or can be breathed in (inhaled.)
  • Inhaled medicines are

o    Most commonly used world over.

o    There are various methods of taking inhaled therapy (Inhaler, Rotahaler, Spacer, Accuhaler, Autohaler, Nebulizer).

o    Inhaled medicines are not the last resort.

o    They are not addictive as many people believe.

o    The sooner one starts inhalational therapy the better.

o    Both quick relief and preventive medication can be taken through inhalational route.

  • Oral medicines can be taken as tablets or syrups. But they take longer time to act and reach all over the body via blood where they are not needed.
Inhaled Medications Oral Medications
  • Act rapidly.
  • Goes directly to lung. So less dose is required.
  • Less side effects hence safe as only 1/10th of oral dose is required.
  • Less expensive in the long run (less hospitalization).
  • Take longer time to act.
  • Reaches lung and all other parts of the body by bloodstream hence more dose is required.
  • More side effects.
  • Relatively larger doses are required therefore more expensive.

Inhalational medicine can be given by various devices. Widely used devices are

  • Metered Dose Inhaler (MDI) – Inhalers
  • Dry Powder Inhaler (Rotahaler)
  • Autohaler
  • Accuhaler
  • Spacer
  • Nebulizer

The choice of inhalational device has to be individualized for each patient by the treating physician.

The technique of using an MDI (inhaler) has to be learnt by the patient. It needs a bit of practice and some coordination on the part of the patient.

Use of a spacer, Autohaler, Rotahaler and accuhaler can be a solution in those patients who finds it difficult to use an MDI (inhaler).

Nebulizers are electronic devices (compressed air generators) which are used to deliver COPD medication through inhalational route. It uses drug in the form of a solution which is put in a nebulizing chamber and inhaled as a fine mist over 10 – 15 minutes. It can be used to deliver “reliever” medicine (salbutamol) in an acute attack for instant relief. It can also be used to deliver “preventer” medicines (steroid solutions) for long term treatment. They are to be used judiciously and do not provide any superiority over other inhalational devices (if used properly) in the long run.