Chap 3: Administration Of Aerosolized Agents Flashcards
Traditionally, what percent of a given dose of aerosolized medication reaches the lower airways, regardless of the delivery device used?
10-15% or 10%-30%
If a patient is having issues coordinating actuation of the MDI, what should the RT suggest?
Spacer - valved
What is the purpose of the end-inspiratory breath hold used when an aerosol device delivers medication?
The process of sedimentation is time dependent, the end-inspiratory breath hold should maximize the deposition in the periphery, increase settling of particles.
What would be the most appropriate delivery device to use in patients with severe shortness of breath and unable to hold a mouthpiece?
Use small volume nebulizer (SVN) in emergent acute situations requiring aerosol bronchodilator delivery
Define dead volume and what to do
The flow rate needed to disperse the drug of a DPI so patient can effectively inhale the drug ranges from……..
Liters per minute.
Dead volume: the amount or a drug solution remaining in the reservoir when the device begins to spotter and aerosolization ceases. Because of this you should addl diluent to add volume and expand the solution volume (will not change the amount of drug, just expand it)
30 - 90 L/min
What aerosol administration devices would you choose for albuterol/ ribavirin?
Albuterol: SVN or MDI
Ribavirin: small particle aerosol generator (SPAG)
What are optimal numbers for SVN in terms of volume / dead volume/ flow rate/ time of nebulization?
Volume: 3-5 mL
Flow rate: 6-8 mL/min
Time of nebulization: 10 minutes
Dead volume: 0.5-1.0 mL
Match aerosol devices with their description: SVN, pMDI, DPI
SVN: type of aerosol generator that converts liquid drug solutions to suspensions into aerosol
pMDI: canisters, propellants, drug formulary, metering valve, actuator, drug counter. MDI reservoir devices: spacer, valve holding chamber
DPI: drud is in powder form. canisters, propellants, drug formulary, metering valve, actuator, drug counter
What are common problems associated with patient use of a MDI?
- Coordinating inhalation
- too rapid inspiratory flow rate
- failure to shake canister
- cessation of inspiration as the aerosol strikes the throat
- holding in wrong position
- firing multiple times during single inhalation
How should a patient be instructed during un aerosol treatment with DPI, SVN, MDI, to achieve optimal drug deposition in the lower respiratory tract?
DPI: inhale/breath in quickly to disperse powder hold for X amount of time
SVN: breath normally
MDI: take a slow, deep breath in and hold for X amount of time
What are the main components of an MDI?
Canister, medication, propellant, excipient, metering valve, mouthpiece, and actuator
What is the effect of adding additional diluent to the drug in a small volume nebulizer do?
Adding diligent does not alter the amount of drug in the nebulizer, it simply expands the solution volume
The concentration is less, not the amount of drug
The current propellant used in meter dose inhalers is…
Hydrofluroalkane (HFA): nontoxic to the atmosphere and to the patient also has properties suitable for MDI aerosols
Which aerosol delivery device requires the greatest patient generated inspiratory flow rate?
DPI- dry powder inhaler
1ml is equal to how many drops of liquid?
16 drops (gtts)
