Question

1. What patients cannot use DPIs?

2. What is the optimal flow rate and amount of solution to put in a small volume nebulizer (SVN)?

3. Why is it so important to match nebulizer and compressor systems for home use?

4. What potential problem exists when you deliver a SVN via mask? How can you deal with this problem?

5. Explain what is meant by the “blow-by” technique used with infants, and discuss the effectiveness of this technique.

6. In your own words, explain why a breath actuated nebulizer delivers a higher respirable dose of medication than a standard small volume nebulizer?

Answer 1

1)

The Dry power Inhalers ( DPI) often contain lactose as a stabilizing agent. Therefore, in patients with milk protein or Lacoste allergies, DPI asthma medications are contraindicated. Others are, untreated fungal, bacterial and tubercular infections of the respiratory tract.

2)

Flow rate in small volume nebulizer : 6-8 L/min

Amount of solution = 4-5 ml

3)

A nebulizer turns liquid Medications into a mist to help treat the asthma at home itself. They come in a portable size , you can carry with you. Made up of a base that holds an air compressor, a small container for liquid medicine and tube that connects the air compressor to the container. So, matching of nebulizer and compressor system is important for home use.

4)

Potential problems when deliver a Small volume nebulizer via mask are :-

* Equipment required may be large and cumbersome.

* Need power supply ( electrical, battery/ compressed gas )

* Potential for drug delivery into the eyes with face mask delivery.

* Potential for drug delivery exposure to clinicians and care givers.

* Assembly and cleaning are required

* Contamination is possible with improper handling of drugs and inadequate handling.

To deal with the problems,

* Provide an eye protection for the patient

* The clinicians and caregivers Keep a distance from the patient while doing nebulization.

* Thorough cleaning after use

* Measures taken for proper handling of drugs.