Nebulizer vs. MDI Inhaler: A Detailed Comparison

This article compares nebulizers and metered-dose inhalers (MDIs), highlighting their differences, advantages, and disadvantages. Both are medical devices designed to deliver medication directly to the lungs, offering effective and quick relief for asthma patients and those with breathing difficulties.

What is a Nebulizer?

A nebulizer transforms liquid medicine into a fine mist, which the patient inhales directly into their lungs. This mist is breathed in through a facemask or mouthpiece. Nebulizers are typically electric or battery-operated.

Image: Omron Nebulizer

Using a nebulizer takes a bit more time (approximately 5-10 minutes) to deliver the medication. It’s generally easy to administer medication to children, although some may be resistant and cry.

Advantages of Nebulizers

• Easier to use: Requires less coordination than an MDI.
• Easy to administer high doses: Can deliver larger amounts of medication.
• No CFCs: Most modern nebulizers don’t rely on chlorofluorocarbons.

Disadvantages of Nebulizers

• Higher machine cost: Nebulizers are generally more expensive than inhalers.
• Not portable: They are bulkier and require a power source.
• Slower delivery: Requires preparation before use.
• Less efficient: Some medication can be lost through the expiratory port.
• Easier to contaminate: Requires careful cleaning and maintenance.
• Potential visual changes: Use with a facemask and certain medications (aerosolized anticholinergics) can cause visual disturbances or worsen narrow-angle glaucoma.

What is an MDI Inhaler?

Inhalers are handheld and portable devices. The two main types are Metered Dose Inhalers (MDIs) and Dry Powder Inhalers.

Image: MDI Inhaler

MDIs release a pre-measured spray of medication when the user presses the canister. They deliver a consistent dose with each actuation. MDIs need to be replaced after a certain number of doses. Dry Powder Inhalers, on the other hand, deliver the medication in powder form, without using a propellant.

Advantages of MDI Inhalers

• Portable: Small and easy to carry.
• Cheaper: Generally less expensive than nebulizers.
• No prior drug preparation: Ready to use immediately.
• More efficient: Delivers a higher percentage of the medication to the lungs (when used correctly).

Disadvantages of MDI Inhalers

• Difficult to use properly: Requires coordination and proper technique.
• Oropharyngeal deposition: Medication can get deposited in the mouth and throat.
• CFCs: Historically, MDIs used chlorofluorocarbons (CFCs) as propellants. CFCs are harmful to the ozone layer and are being phased out for more environmentally friendly alternatives.