When you turn the nebulizer, on exhale to the limit of possibility, then inhale from the
nebulizer to the limt, take your mouth off the
nebulizer and hold your breath as long as you can. Wait four minutes and do the same with two puffs of Atrovent (iatropium bromide). Atrovent (in some people) does not irritate the heart as much. The combination treatments reduce the incidence of tachycardia.