How to Properly Take a Breathing Treatment

John Bottrell Health Pro
  • Once you’ve been diagnosed with chronic obstructive pulmonary disease (COPD) your doctor may prescribe for you to take breathing treatments at home.  So what is a breathing treatment and how do you take one?

    When you have inflammation of your skin that causes it to become dry, red, and itchy, you generally apply a topical lotion directly on the irritated skin.  When the air passages inside your lungs are inflamed and likewise irritated, the only way to apply a topical is by inhaling it.  It was for this reason that breathing treatments (and inhalers) were invented.  Check out my related post "How to Properly Use an Inhaler."

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    There are essentially four things required in order to take a breathing treatment:


    1. Nebulizer: A small hand-held device equipped with a cup for medicine and a mouthpiece.  When connected to an air compressor the nebulizer turns the solution to a fine, white mist that can be easily inhaled.

    2. Air compressor:  This is a small device that turns energy into a flow of air. 

    3. Oxygen tubing:  This is used to connect the air compressor to the nebulizer.

    4. Medicine:  The solution form of the medicine is usually premixed with 3cc of normal saline (water) and stored in a plastic, easy-to-open amp.  Once opened, the solution is poured into the nebulizer cup.   The purpose of a breathing treatment is to turn this solution into a mist.  

    In order to get these four things you will need a prescription from your doctor.  A nebulizer and air compressor are usually purchased from a home health care company. In most cases, the company will send a representative to your home with the equipment, and teach you how to use it.  Later on, as you need replacement supplies, all you have to do is talk to this representative.

    Many medicines can be inhaled by using a nebulizer.  Here are the most common ones that are used for COPD:

    1. Albuterol: It’s a beta adrenergic, meaning the medicine attaches to beta receptor cells lining the air passages (bronchioles), and this causes the smooth muscles lining them to relax.  This dilates the airways, making it easier to breathe.  This is a fast-acting medicine, and is also referred to as a rescue medicine.  It can either be taken as needed or up to every 4-6 hours, whichever your doctor prescribes.

    2. Levalbuterol:  It’s also a beta adrenergic, and it works the same way albuterol does.  It can either be taken as needed or up to every 6-8 hours.

    3. Ipatropium Bromide: It’s an anti-cholinergic, meaning the medicine sits on the neurotransmitter acetylcysteine to prevent it from causing smooth muscles that surround the air passages from constricting or spasming. This is essentially a preventative medicine that keeps the airways open.  It is taken either four times a day, or up to every four hours.  

    4. Combo: It’s a combination medicine that includes both albuterol and ipatropium bromide.  It is prescribed either four times a day, or up to every four hours.

    5. Budesonide: It’s an inhaled corticosteroid that, once inhaled, helps treat inflammation that is present in COPD lungs.  It’s a preventative medicine that is only taken twice daily.  

    6. Arformoterol: It’s a long acting beta adrenergic, meaning that it attaches to beta receptors inside the lungs to keep them open long term.  It is taken only twice a day.  

    Now, how do you take a breathing treatment?  It’s not hard, although, how to do it should be explained to you by either a respiratory therapist, nurse, doctor, or the home care representative who brings you the equipment.  The best technique is described at

    1. Plug in the air compressor

    2. Using the oxygen tubing, connect the nebulizer to the air compressor

    3. Squirt the medicine inside the nebulizer cup

    4. Place either a mouthpiece or a mask on the nebulizer cup

    5. Clench the mouthpiece between your teeth, close your lips.  Or, strap the mask over your mouth and nose.

    6. Sit up, either in a chair or on the edge of a bed.  This will help create a direct route for the medicine to get to where you want it: your air passages.

    7. Turn the air compressor on. The flow of air created should generate a fine, white mist from the nebulizer for you to inhale.

    8. Take slow, deep breaths.  Breathe in slowly and deeply over 3-5 seconds, holding your breath for 10 seconds at the end of inhalation.  This allows the medication to deposit deep into the airway.

    9. The treatment should last 5-10 minutes.  If you put more than one medicine inside the cup, the treatment may last up to 20 minutes.  The treatment is over when the white mist stops coming out of the nebulizer, or when the solution starts to sputter.  To get the full effect of the medicine, make sure you take the entire treatment.

    10. Turn off the air compressor.  Take the nebulizer apart, wash with soap and water, let it dry, and then store it in some location that is easy to get to.

    11. About every couple days, or at least once a week, the nebulizer should be taken apart, and all the pieces (except the mask) soaked in a solution of one part distilled white vinegar and three parts water.  After soaking, remove from solution, let dry, and store.  

    12. A nebulizer and compressor can last a long time if taken care of properly.

    As far as breathing is concerned during the treatment, many respiratory therapists simply recommend that you breathe normal.  This, I find, is easier to explain and understand, and also creates the smooth flow needed for good deposition of medicine to the airway.

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    However, as a compromise, some respiratory therapists recommend breathing normal, while occasionally taking a slow, deep breath with a breath hold.  Whichever breathing method you decide to use is the best breathing method.  

    That pretty much covers everything you need to know about breathing treatments. Here are some videos that show proper nebulizer technique:

    We hope this helps you get the most out of your inhaled medicine.  

Published On: April 28, 2014