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decribe the advantages of aerosol therapy
- drug absorption is fast
- site of action
- smaller effective dosages
- effective and convenient
- painless
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disadvantes of aerosol therapy
- difficult to deliver precise does
- compliance of patient
- good patient education
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list type of aerosol drugs and example of each
- Nasal Decongestant - flonase
- bronchodilators- proventil,atrovent,maxair & serevent
- mast cell stabilizers- cromolyn sodium
- corticosteroids- flovent,asmacort,vanceril
- Mucolytics-mucomyst(acetylcysteine)Antimicrobials- gentamicin,ribavirin,pentamidine
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what is the disadvantage of inhaling and corticosteroid and not rinsing your mouth
oral thrush "yeast infection"
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ideal particle size that reaches the peripheral part (lower airways) of the lung
1-5 microns
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what are the advantages of metered dose inhaers (MDI)
- self administered
- dont require and electrical air compressor
- contains several hundred doses
- treatment time is short
- drug delivery is efficient
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what are the disadvantes of MDI's
the technique and coordination are required for efficient MDI usage
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what is the role of "surfactants"
are added to the drug solution to stabilize the particles to a uniformly small size
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describe the role of the "propellants"
"powers" the aerosol out of the canister
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list the steps in delivering MDI
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•Remove the cap, assemble, if necessary, the canister into the actuator, hold upright
- •Shake (discharge a waste dose if it has been >24 hrs since the inhaler was last used)
- •Exhale normally
- •Place the spacer in your mouth, keep the tongue out of the way, or use the open mouth technique if you don’t have a spacer
- •Slow, deep breath, pressing down (activating) on the canister
- •Breathe in until your lungs are full, hold your breath approximately 10 sec. or as long as you can
- •Breathe out normally, wait 1 –2 minutes before the next puff, before repeating the steps, shake…
- •Reassemble and store the MDI
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what is the purpose of using a spacer
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•Improves lung deposition by
- eliminating the larger particles
- (>5 microns) as the larger
- particles vaporize in the reservoir
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decribe the advantages of using a spacer
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1.Gives the patient time to coordinate their inspiration with activation of the MDI, as their inspiratory effort may lag behind the activation of the MDI
- 2.Can be used for infants and children
- 3.Helps direct the aerosol into the mouth, rather than into the eyes or face.
- 4.Spacers can make it easier for medication to reach the lungs, and also mean less medication gets deposited in the mouth and throat, where it can lead to irritation and mild infections.
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examples of MDI's
albuterol
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what are the advantages of DPI
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•Small and easy to use
- •Contains no harmful propellants
- •Easy to tell how much drug is left
- •Self actuated (breath actuated –pt actively inhales the drug) -Eliminates timing and technique problems with MDIs
- •May deposit more drug in the lungs than MDIs
- •Can be used in cold environments (snow), where propellants will not work
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disadvantes of DPI
- Few drugs are available in powder forms
- Ex: Advair, Serevent, Spiriva, Foradil and Pulmicort
- •Some patients may react to carrier substance
- •Inspiratory flows equal to or at least 50 L/min is required for the device to aerosolize the powder properly
- Note: patients in acute respiratory distress or small children may not be able to generate enough inspiratory flow
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steps of delivering of a DPI
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1.Open the discuss in one hand, put the thumb of the other hand on thumb grip. Push the thumb away from you as far as it will go until the mouthpiece appears and snaps into position.
- 2.Hold discuss in a level, horizontal position with the mouth piece towards you. Slide the lever away from you until it clicks. Now the discuss is ready for use.
- 3.Preparing to Inhale: Breathe out, holding the Diskus level and away from your mouth. (Never breathe out into the Diskus mouth piece.)
- 4.Put the mouth piece to your lips. Breathe in quickly and deeply, through the Diskus into your mouth, not through your nose.
- 5.Remove the Diskus from your mouth.
- 6.Hold your breath for ~10 seconds. Breathe out slowly.
- 7.Close the Diskus. The Diskus will click shut.
- 8.Rinse your mouth with water or mouth wash, spit, don’t swallow.
- NOTE: The numbers on the dose counter show how many doses are left in the Diskus.
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describe the importance of particle size
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–Most important factor in determining whether the aerosol gets to the lung
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ideal particle size range
1-5 microns
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