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Inhalers, Nebulizer, Peak Flow Meters - Coggle Diagram
Inhalers, Nebulizer, Peak Flow Meters
Inhalers
Deliver drugs directly to the cells lining the inside of the bronchial tree so as to: prevent bronchospasm, reduce/prevent the inflammatory response
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Types of inhaler
Breath Activated Inhalers: aerosol spray (BAI's), dry powder (DPI's)
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Limitations of MDI
Inhalation must be timed with activation of the device to maximise drug delivery & clinical effectiveness. Inhaling too fast can cause medication to aggregate @ back of throat. Drug is then swallowed reducing effectiveness
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BAI's
Aerosol Spray: Autohaler, Easi-Breathe
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Dry Powder Inhalers: Diskus, Turbohaler
Nebulizer
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Jet Nebulizer: Attachments- T-piece & mouth piece.
Jet Nebs are based on the venturi principle.
Gas is driven through a narrow opening (or venturi) creating - pressure or a vacuum @ that point, which in turn draws up (entrains) the solution (drug) from the reservoir.
Some aerosol particles are large, so a baffle is placed in the aerosol stream to reduce their size.
If the flow rate is <6l/min, it won't produce an adequate distribution of respirable particles.
For pt. with chronic hypoxia +/- hypercapnia (advanced COPD), whose resp. drive is dependant on low levels of arterial O2, always use a room air compressor
Jet Neb Driven by:
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Volume of solution: 2mls is sufficient, but 2 bronchodilators may be mixed giving 4.5mls
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Time: 5-10mins, except for antibiotics
Ultrasonic Neb
Use high frequency sound waves to aerosolise the solution. These nebs use oscillations caused by a piezoelectric crystal to produce a 'fountain' in a liquid, which leads to the formation of mist
Advantages: higher output rate, but larger particle size. Requires simple tidal breathing. Dose modification is possible.
Disadvantages: May hydrate retained secretions & obstruct airways. More expensive than jet neb. May cause drug degradation.
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PFM
Purpose: to detect decrease in lung function, to evaluate effectiveness of treatment, to evaluate lung function over time
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Facilitates day to day monitoring of lung function by comparing changes in readings with 'Personal Best'
Changes in readings indicate, subtle changes in airway obstruction
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Traffic Light System
Yellow = caution, condition may be worsening. Contact physician to review treatment 50-80%
Red = Danger. Treatment is failing, use inhaled bronchodilators & contact doctor
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