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Breathing Treatments

By

Catherine Spader, RN

What are breathing treatments?

Breathing treatments help you breathe better by treating wheezing, shortness of breath, and other respiratory problems. Breathing treatments involve inhaling medications in a mist form using a nebulizer device. Your doctor may recommend breathing treatments to treat asthma, pneumonia, cystic fibrosis, severe allergic reactions, and chronic obstructive pulmonary disease (COPD).  

Breathing treatments, or nebulizer treatments, are only one method of treating respiratory diseases. Respiratory inhalers and oral and intravenous (IV) medications are other methods of treating respiratory problems. Discuss all the treatment options with your doctor to understand which choices are best for you.

Types of breathing treatments

Breathing treatments include medications that treat respiratory infections, chronic lung diseases, asthma attacks, and respiratory emergencies. Types of breathing treatments include:

  • Antimicrobial medications to treat respiratory infections. Examples include pentamidine (Nebupent), ribavirin (Virazole), and tobramycin (TOBI).

  • Bronchodilator medications to help relax and open airways. Examples include ipratropium (Atrovent)and metaproterenol (Alupent).

  • Combination medications include ipratropium/albuterol (DuoNeb)

  • Corticosteroids (steroids) to reduce airway inflammation. Budesonide (Pulmicort Respules) is an example.

  • Mucolytics to loosen, thin, and help clear mucus secretions from the lungs. Examples include acetylcysteine (Mucomyst) and dornase alfa (Pulmozyme).

  • Short-acting beta agonists are bronchodilators that relax and open your narrowed airways. Examples include albuterol sulfate (AccuNeb) and levalbuterol HCl (Xopenex).

  • Long-acting beta agonists are bronchodilators that you use in combination with inhaled corticosteroids. Examples include arformoterol (Brovana) and formoterol (Perforomist).

  • Racemic epinephrine to treat severe asthma attacks, croup, and other emergency breathing situations

Other procedures that may be performed

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Your doctor will likely prescribe one or more additional treatments and procedures to manage your respiratory disease and breathing problems. These will vary depending on the specific disease, the severity of the disease, your medical history, your age, and other factors. Treatments and procedures may include:

  • Allergy testing and allergy treatments for people with allergic asthma

  • Arterial blood gas test to measure oxygen and carbon dioxide levels and other factors in the blood

  • Chest X-ray and CT scan to diagnose respiratory diseases and other conditions, such as congestive heart failure, that may occur with respiratory diseases and make them worse

  • Intubation and ventilation for exhaustion or respiratory arrest due to severe respiratory disease

  • IV antibiotics to treat an acute infection, such as bacterial bronchitis or bacterial pneumonia

  • Pulmonary (lung) function tests to evaluate breathing and lung function and help diagnose and manage respiratory diseases. Tests include spirometry and bronchoprovocation testing.

  • Pulse oximetry to measure oxygen levels in the blood

  • Supplemental oxygen to increase the amount of oxygen in the blood

Why are breathing treatments used? 

Your doctor may recommend breathing treatments to treat airway inflammation, shortness of breath, wheezing, coughing, and thick mucus due to the following diseases and conditions:

  • Anaphylaxis, which is a life-threatening allergic reaction that causes swelling of the breathing passages

  • Chronic respiratory diseases including asthma, cystic fibrosis, bronchopulmonary dysplasia, and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema

  • Lung infections including pneumonia, acute bronchitis, and fungal and viral infections

  • Foreign substances in the airway or lungs including objects and stomach contents that are inhaled into the lungs

  • Sleep apnea including snoring and breathing pauses in children and adults

Who performs breathing treatments?

A respiratory therapist or nurse will perform your first breathing treatment and teach you how to do your own breathing treatments at home. 

The following doctors prescribe breathing treatments: 

  • Allergists/immunologists are internists or pediatricians with specialized training in the diagnosis and treatment of allergies, asthma, and immune deficiency disorders.

  • Critical care medicine doctors specialize in the diagnosis and management of life threatening conditions.

  • Emergency medicine doctors and pediatric emergency medicine doctors specialize in the rapidly diagnosing and treating acute or sudden illnesses, conditions, injuries, and complications of chronic diseases.

  • Primary care providers including internists, family practitioners (family medicine), pediatricians, geriatricians, physician assistants (PAs), and nurse practitioners (NPs). Primary care providers offer comprehensive healthcare services and treat a wide range of illnesses and conditions.

  • Pulmonologists are internists or pediatricians with specialized training in treating diseases and conditions of the chest, such as pneumonia, asthma, tuberculosis, emphysema, or complicated chest infections.

How are breathing treatments given?

Breathing treatments involve inhaling medications using a nebulizer device. A nebulizer converts liquid medication into a mist. The mist is easy to inhale, making it useful for treating infants, children, and others who may have difficulty using respiratory inhalers properly.

Nebulizer breathing treatments take 10 to 30 minutes and generally involve these steps:  

  1. Wash your hands with soap and water before assembling a nebulizer breathing treatment.

  2. Place the exact amount of prescribed liquid medication in the nebulizer medicine cup.

  3. Connect the hose from the nebulizer device to the air compressor.

  4. Attach the mouthpiece to the medicine cup. Infants and toddlers may use a mask attached to the nebulizer. If you are seriously ill, a respiratory therapist or nurse may attach the nebulizer to a mask or a breathing tube (endotracheal tube).

  5. Turn on the device and take slow, deep breaths through the mouthpiece until the liquid medication is gone.

  6. Rinse the mouthpiece and medicine cup with warm water and let them air dry.

Will I feel pain with breathing treatments?

Your comfort and relaxation is important to ensure you get the most benefit from your breathing treatment. Shortness of breath and other breathing problems can cause anxiety, which in turn can worsen breathing difficulties

Remember that breathing treatments are not painful. Taking deep, relaxed breaths will move the medication deeply into the lungs so you get most benefit from the treatment. Tell your doctor or care team if you are uncomfortable or your breathing is getting worse.

What are the risks and potential complications of breathing treatments?  

Breathing treatments are generally safe unless you use them more often than recommended. Rarely, a serious allergic reaction can occur. Symptoms include a rash, hives, difficulty breathing, or chest tightness. Call your doctor or 911 if you have these symptoms.

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