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Aerosol PartII

Humidity and Blansd Aerosol Therapy Part II

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
Created by: kparkerlehman