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Aerosol PartII
Humidity and Blansd Aerosol Therapy Part II
Question | Answer |
---|---|
What are the factors that affect aerosol drug therapy? | Aerosol output Particle Size Deposition Aging Breathing Pattern Physical characteristics of the airway |
Particle Size | Depends on substance nebulized, methods used to generate aerosol and environmental conditions. |
What is the optimal particle size? | 1 to 5 microns |
Deposition | How it lands. The size deetermines how it deposits. It's affected by inertia, sedimentation, and bownian movement. |
What is inertia? | Particles collide and burst resulting in rainout and less medication to site of action. Turbulent flow can cause this. |
What is sedimentation? | The larger the particle the more effect gravity will have. This can cause rainout. |
What is brownian movement? | As you breathe in airflow slows down. Particles slow down and hit eachother causing rain out. |
What is aging? | How long it is supsended before it gets to target site. |
Aging depends on? | Composition of aerosol, initial size of particles, time in suspension, ambient condition which it is exposed. |
What is optimal breathing pattern? | Slow laminar flow with gentle, deep breaths. |
Different medications... | need different particle sizes |
What are the types of nebulizers used for aerosol drug therapy? | Small volume jet nebulizer Metered Dose inhalers (MDI) Dry Powder Inhaler (DPI) |
How is the small volume jet nebulizer powered? | Pneumatically, flow 6-8 L/Min |
The efficiency of small volume jet nebulizer depends on what? | flow, gas source, ambient conditions, characteristics of the drug and breathing pattern |
What can be used with the small volume jet nebulizer? | mask or mouthpiece |
Can it be used with a ventilator circuit? | yes |
How should the small volume jet nebulizer be positioned? | Upright |
Does it contain a baffle? | Yes |
Facts about the small volume jet nebulizer. | Can be continuous or intermittent (may be breath actuated) May contain a filter |
Why would a small volume jet nebulizer contain a filter? | In the case of PCP pneumonia when administering pentaminide. You only want the patient to have the drug and you don't want it in the air. |
Metered dose inhalers are also known as | MDI's They are the most commonly prescribed method. |
The efficiency depends on? | Patient technique 60% of people will use them incorrectly. |
How is the MDI powered? | It is either hand or breath actuated. When breath actuated, patient must be able to generate enough flow rate. |
Can the MDI be used in a ventilator circuit? | Yes |
The propellent makes up what percent of the cannister? | 80%, only 1% is actual drug. The propellent used is HFA, CFC is no longer used |
What apparatus is used with the MDI? | Spacers They reduce the need for hand/breath coordination |
What is an easy acronym to instruct patients that are having difficulty? | (SMB) Shake, Mash, Breathe |
Dry Powder inhalers contain? | Powdered drugs |
How are dry powder inhalers powered? | They are breath actuated metered dose inhalers |
What must patient be able to do in order to use the DPI? | They must be able to generate adequate flow rate and efficiency will depend on patient technique |
DPI's are different from MDI's in that they....; | contain no propellent |
DPI's cannot be used with | a ventilatory circuit |
What are other drug devices used for aerosol drug therapy? | Large volume jet nebulizers Small volume ultrasonic nebulizers Small Particle Aerosol Generatore (SPAG) Nasal Spray pumps |
What is the SPAG used for? | only used for administration of Ribavirin (treatment of RSV in small children) |
To choose a device you should consider | Available drug formulation Patient's characteristics Desired site of deposition Patient's Preference |
To determine efffectiveness of chosen device you should | assess patient technique Assess patient compliance with use Assess patient response to therapy |
What factors are associated with reduced aerosol deposition in the lung? | Patient technique Obstruction |
What are the hazards of aerosol drug therapy? | side effects of the drug airway reactivity (bronchospasm) Infection risk Drug reconcentration Irritation of tissues in the mouth |