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Inhalation therapy
- 1. Administering medication through Inhalation By, Ms. EktaS Patel, Assistant Professor.
- 2. Inhalation- Definition Inhalation isany drug or solution of drugs administered by the nasal or oral respiratory route. Inhalation (also known as inspiration) is the movement of air from the external environment, through the air ways, and into the alveoli.
- 4. Common conditions Inhalationtherapy is a traditional treatment in chronic asthma and chronic bronchitis. Emphysema, Bronchiectasis
- 5. Advantages and Disadvantages: Advantages: -Less systemic toxicity -More rapid onset of medication -Delivery to target of action -Higher concentrations available in the lung Disadvantages: -Time and effort consuming -Limitation of delivery device
- 6. Inhalant drugs Antiallergicagents Bronchodilators Anesthetics Mucolytic agents Antimicrobials
- 7. Device Selections ofdevice include： Nebulizer: small volume, large volume, ultrasonic Metered dose inhaler, MDI Dry powder inhaler, DPI Spacer Rotahaler
- 8. Metered-dose inhalers Aliquid propellant A metering valve that dispenses a constant volume of a solution in the propellant. Inhalation technique is critical for optimal drug delivery – only about 10% of drug reaches the lungs.
- 10. • Fist beshaken to ensure that drug should be evenly distributed. • Held upright and the cap is removed. • Breathes out gently, but not fully
- 11. • With themouth around the mouthpiece of the inhaler, the device is pressed to release the drug as soon as inspiration has begun. • Inspiration should be slow and deep, be held for 10seconds if possible. • Dose of inhalation will involve > 1 “puff” • The length of time between inhalation is 15- 20 seconds.
- 12. Dry powder inhalers No propellant Breath-activated, and patient coordination is not as important an issue. The drug is formulated in a filler and contained in a capsule that is placed in the device and punctured to release the powder.
- 13. ▪ Releasing drugon inspiration, require faster inspiratory flow rate ▪ Inspiratory flow required depends on the resistance within device.
- 15. Rotahaler Insert acapsule into the rotahaler , the coloured end first. Twist the rotahaler to break the capsule Inhale deeply to get powder into the airway Several breath may berequired, does not required the coordination of the aerosol
- 17. Spacer Patient couldnot required coordinate inspiration a) Patient seals lips around the mouthpiece b) Depresses the actuator c) The mist is trapped in the middle section a) Inhale without loosing the drug
- 19. Nebulizers •Patient cooperation andcoordination is not as critical •It converts solution into aerosol particles, < 5μm. •An acceptable time 5-10minutes.
- 20. • Two types: oJetnebulizers oUltrasonic nebulizers • Commercially available nebulizers deliver 12% to 20% of the nebulized dose into the bronchial tree.
- 22. Jet nebulizer Witha jet nebulizer driving gas is forced through a narrow orifice. The negative pressure created around the orifice and it allows the smaller particles for inhalation and larger particles drop back into the reservoir
- 24. Ultrasonic nebulizers An aerosolcan also created by high frequency(1- 2MHz) sound waves. • Piezo-electric crystal causes ultrasonic vibrations, it will travel through liquid to the surface where they produce aerosol. • Produce higher output than jet nebulizers
- 26. Steam inhalation ▪ Checkthe physician’s order . ▪ Warm the inhaler by pouring a little hot water into the inhaler and emptying it after one minute. ▪ It reduces loss of heat from inhaler during procedure.
- 28. ▪ Pour therequired amount of inhalant into the inhaler and fill to a level below the spout with boiling water. ▪ The water should remain just below the spout. ▪ If the inhaler is filled up to the level of spout there is possibility of drawing water into the mouth when inhaling and can cause scalds. ▪ If the spout is filled with water it will not act as an air inlet.
- 29. ▪ Place sterilemouthpieces and close the inhaler tightly. ▪ Cover the mouth piece with a gauze piece and plug the spout with a cotton ball. ▪ Covering the mouthpiece with a gauze piece will prevent burns of the lips. ▪ Cotton ball in the spout will prevent escape of steam.
- 30. ▪ Place atowel around the inhaler and position it in the bowl. ▪ It insulates the inhaler and prevents heat loss. ▪ Take it to the patient without losing time.
- 31. ▪ Switch offfan/AC and close windows and doors ▪ Position the patient in high fowlers or sitting position. ▪ Place the apparatus conveniently in front of the patient on cardiac table with spout opposite to the patient. ▪ Remove the cotton plug and discard it into the kidney tray.
- 32. ▪ Keeping thespout opposite to the patient reduces the chances of burns. Removing the cotton plug helps to open spout, so that it can act as an inlet for air.
- 33. ▪ Instruct thepatient to place lips on the mouthpiece and take deep breath. ▪ After removing the lips from the mouthpiece, breathe out air through nose. ▪ Directing the steam out through the nostril relieves the congestion of the mucous membranes of the nostril.
- 34. ▪ Continue thetreatment for 15 to 20 minutes as long as patient gets the steam. Observe the patient during procedure. ▪ Removes inhaler from the patient after the stated time, wipe off perspiration from the patient’s face ▪ Give chest physiotherapy and encourage patient to bring out sputum by coughing. ▪ Instruct the patient to remain in the bed for 1 to 2 hours.
- 35. Electric inhaler ▪ Explainthe procedure to relieve anxiety and gain cooperation. ▪ Auscultate the patient lung fields to know the lung condition. ▪ Place him/ her in a sitting position for comfort. ▪ Put off the fan and cover the patient with a bed sheet or blanket to avoid chills or droughts to help collect the steam around the face of the patient to prevent steam loss.
- 37. ▪ Place theelectric inhaler to the cardiac table. ▪ Switch on the electric inhaler. ▪ Instruct the patient to inhale by mouth and exhale through the nose for 15 to 20 minutes – steam through nostrils relieves congestion of the mucous membranes.
- 38. ▪ Keep thesputum cup with disinfectant ( 1% savlon) and face towel for spitting and wiping the face. ▪ Remove the inhaler, keep the patient in a comfortable position and observe him/ her frequently, keep him/ her well covered- to prevent chilling.