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Nebulizer Therapy

A nebulizer changes liquid medicine into fine droplets or mist that can be inhaled through a mouthpiece or mask. It is powered by compressed air and is used to deliver bronchodilator medicines to open the airways. Nebulizers are preferred over inhalers for young children who have trouble using inhalers properly. Common indications for nebulizer therapy include asthma, bronchitis, emphysema, and COPD. The benefits of nebulizers include direct delivery to the lungs, a large absorbing surface area, and potentially smaller doses than oral medications. Disadvantages include the difficulty some have using the devices properly and medicines not fully absorbing or being cleared by mucus.

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154 views10 pages

Nebulizer Therapy

A nebulizer changes liquid medicine into fine droplets or mist that can be inhaled through a mouthpiece or mask. It is powered by compressed air and is used to deliver bronchodilator medicines to open the airways. Nebulizers are preferred over inhalers for young children who have trouble using inhalers properly. Common indications for nebulizer therapy include asthma, bronchitis, emphysema, and COPD. The benefits of nebulizers include direct delivery to the lungs, a large absorbing surface area, and potentially smaller doses than oral medications. Disadvantages include the difficulty some have using the devices properly and medicines not fully absorbing or being cleared by mucus.

Uploaded by

jerinthomasrajan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Respiratory Care Quality

Assurance

Nebulizer Therapy
What is a nebulizer?
• A nebulizer changes liquid medicine into fine
droplets ( in aerosol or mist form) that are inhaled
through a mouthpiece or mask.
• Can be used to deliver bronchodialator ( airway-
opening ) medicines such as albuterol /salbutamol
5 mg ( Ventolin, Proventil, Airet ), terbutalin
10 mg ( Bricanyl ) or ipratropium bromide 0,5 mg
( Atrovent )
• A nebulizer may be used instead of a metered dose
inhaler ( MDI ). It is powered by a compressed air
machine and plugs into a electrical outlet.
• Babies and young children have trouble
coordinating inspiratory effort by using inhalers
and dry powder devices require a high minimum
inspiratory flow rate
• Thus for children under age 3 preferably use
nebulizers or space-inhalers
• Indicators for nebulizer therapy:
– tightness in chest in allergy - bronchitis
– increased or thick secretions - bronchiolitis
– pneumonia - asthma
– atelectasis - bronchus spasm
– COPD - emphysema
• Benefits of the nebulizer therapy:

– direct effect on the desired place on bronchial branches


– large absorbing space in the lungs
– absorbing is quick
– the cell permeability in the lungs is better for many drugs
than in the intestines or other mucous areas
– the dose needed for desired effect is often smaller than
oral dose
– can be administered drugs which are not absorbed taken
orally or they disperse during the first round metabolia
• Disadvantages

- in spite of the careful teaching and instructions


the use of aerosol-inhalers can be difficult
– dosing needs complicated inhalation devices
– medicine to reach down to the lungs is not easy
– the mucus of the lungs can prevent the absorbtion
– the mucocilliaric clearence decreases medicines to stay
upon the lungs so that medicines could be absorbed
– inhaled medicine can stratify inside mouth and throat
causing side effects
Asthma medicines
1. Anti-inflammatory agents
• A) Corticosteroids :basic asthma care
beclomethasone, budenosidi, fluticasone,
B ) System corticosteroids orally and intravenously
2. Bronchodilators
A ) Short-acting beta2-agonists – quick-relief
’’rescue’medicines: salbutamol, terbutaline
B ) Long-acting beta2-agonists: formoterol, salmetorol if
needed used together with corticosteroids
C ) Combination inhalers: ipratropium-salbutamol
3. Cromolyn medicines: inhaled natriumcromolygate and
nedocromolyn
4. Anticolinergics : inhaled ipratropium, oksitropium
5. Leukotrines: orally taken leukotrienes montelucast,
zafirlucast
6. Theophylline :
• Theophylline / aminophylline are oldest used
preparations for asthma care but now considered
third or second-line agent
• narrow margin between therapeutic and toxic effects
• relaxes bronchial smooth muscles
• usually now used to relieve nocturnal and morning
wheezing e.g. teophylliini 200–300 mg evening dose
• side-effects: gastrointestinal irritation, restlessness,
anxiety, tremor, palpitations, headache, dizziness,
convulsions, arrhythmias, hypotension, cardiac
arrest
7. Magnesium sulfate iv.
• Management of asthma
• if temporary intermittent symptoms short-acting
beta2-agonist inhaler is enough such as salbutamol
• basic medicine for mild, moderate and severe
persistent asthma is inhaled anti-inflammatory
corticosteroid such as beclomethasone or budenosidi
400–800 ug x 2 and fluticasone 250–500 ug x 2,
( for school age children e.g. fluticasone 100 ug x 2,
beclomethasone or budenosidi 200 ug x 2 )
• if needed then long-acting beta2-agonist such as
salmetorol, formoterol
• anticolinergics: inhaled ipratropium, oksitropine are
short-acting bronchodialtors, adjunct to inhaled
beta2-agonists in patients who have severe asthma
Oxygen

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