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The important thing to remember is that both inhalers and nebulizers can provide the same types of medicine and are equally effective when used properly. They just offer different ways to get these drugs into the lungs where you need them.
Inhalers are small, handheld devices that deliver a puff of medicine into the airways. There are two basic types: metered-dose inhalers (MDIs) and dry powder inhalers (DPIs).
MDIs contain a liquid medication delivered as an aerosol spray. You can place the mouthpiece 1 to 2 inches from your mouth and breathe in slowly as you press down on the inhaler. Alternatively, you may be better off using a spacer -- a hollow plastic tube between the mouthpiece and the canister of medicine. A spacer makes it easier to get the full dose of medication all the way to your lungs.
A DPI is similar, but it releases a puff of dry powder instead of a liquid mist. DPIs should not be used with a spacer. Instead, close your mouth tightly around the mouthpiece of the DPI inhaler and inhale rapidly.
While inhalers use the same general principle, don't assume that they all work the same way. For instance, while you're supposed to shake an MDI before using it, you should never shake a DPI. Each device needs to be cleaned differently and has a different way of tracking when it’s empty. Always follow the instructions for the specific device.
Nebulizers are machines that convert a liquid medicine into a mist that you inhale into your lungs.
Nebulizers aren't particularly portable, so you would keep a nebulizer at home. To use it, you would measure out the medicine into a cup and attach the cup with tubing to the machine. Then you would turn it on, relax, and breathe the mist in deeply through a mouthpiece or mask. Depending on the medication, it usually takes 20 minutes or less to inhale the medication.
Afterwards, you'll need to clean the nebulizer, mouthpiece or mask with water and periodically with soap as well before you use it again.
Inhalers and nebulizers are only available by prescription. While you might see some bronchodilator inhalers sold over-the-counter, don't use them unless your doctor recommends it. They could be dangerous for people with certain health conditions, such as heart problems.