Nebuliser question

Clinical Pharmacology and Toxicology

A 26 year old fit and well asthmatic present with wheeze and is diagnosed as having an acute asthma attack.

Assuming she have no other co morbidities what is the preferred route of delivery for the salbutamol?

  • Nebulised via air
  • Nebulised via oxygen high flow
  • Inhaler
  • Inhaler with spacer
  • Intravenous

The correct answer is nebulised via Oxygen.

You can nebulise via medical “air”: air in a medical cylinder. This is useful in some forms of chronic obstructive pulmonary disease.

A nebuliser is more effective at delivering the salbutamol locally. Although IV salbutamol can be used it should be only be directed by a seniour medical doctor under close supervision.

However in acute asthma you want to deliver oxygen and salbutamol at the same time: you can mix ipratropium and salbutamol in the nebuliser and then “drive” the nebuliser by turning up the oxygen.