DME lecture

Question 1

Compression products improve ________, help relieve
symptoms of ___________, tired/achy legs, help prevent blood clots and soothe symptoms of varicose veins

Mild, Moderate, Firm

Who needs them?
Any level above 20 mmHg should accompany a physician’s
order

Answer 1

circulation

swelling

Question 2

Metered-Dose Inhalers(______)

Answer 2

MDI

Question 3

Dry Powder Inhaler (______)

Answer 3

DPI

Question 4

Soft Mist Inhaler (______)

Answer 4

SMI

Question 5

Metered Dose Inhaler

Remove cap & hold inhaler upright

Shake the inhaler

Tilt head back slightly and breathe out slowly with inhaler away
from mouth

Position inhaler in one of the ways demonstrated below (B or C is preferred)

Press down on inhaler while breathing in slowly & deeply for 3-5 seconds

Question 6

Dry Powder Inhaler (DPI)

Remove or slide cap & hold inhaler upright

Add or load dose (if necessary)

Tilt head back slightly and breathe out slowly with inhaler away from mouth

Close lips tightly around mouthpiece

Inhale QUICKLY and deeply for 2-3 seconds

Hold breath for 10 seconds to allow medicine to reach lungs

Repeat as directed. Wait 1 minute between inhalations

Question 7

Soft Mist Inhaler

Hold inhaler upright

With cap on, turn the base in the direction of the arrow until it clicks

Breathe out slowly with inhaler away from mouth

Open cap until it snaps fully open

Close lips tightly around mouthpiece without covering the air vents

Press button & inhale slowly and deeply for 2-3 seconds

Hold breath for 10 seconds to allow medicine to reach lungs

Repeat as directed. Wait 1 minute between inhalations

Question 8

Metered-Dose Inhalers (MDI)

Suffix: __________ (e.g. Proair, Ventolin) or none (e.g. Symbicort)

Answer 8

HFA

Question 9

MDI (Metered Dose Inhalers)
Proair, Ventolin, Proventil, Flovent, Atrovent, Xopenex, Asmanex, Dulera, Advair, Symbicort, Qvar

Question 10

Advantages of Metered Dose Inhalers
_____________ doses
Low cost, wide availability

Answer 10

Reproducible

Question 11

Disadvantages of Metered Dose Inhalers
Requires patient to coordinate _____________and inspiration
Must be __________ prior to use
“Cold Freon effect”

Answer 11

actuation

shaken

Question 12

Instructions for Metered Dose Inhalers

1.Shake inhaler well
2. Breathe out fully through the mouth, away from inhaler
3. Put mouthpiece in the mouth and tighten lips around it
4. Press the canister down while inhaling deeply and slowly
through the mouth
5. Hold breath for about 10 seconds or as long as possible
6. Wait at least 60 seconds before second dose
Spacers may increase effectiveness and ease of use

Question 13

Spacers – For MDI’s
Advantages
_______________ amount of medication inhaled by 3-4 times!

Less medication remains in mouth (less ____________), more effective!

Easier to use when patient is __________

Easier for patient to coordinate actuation & inhalation

Answer 13

increases

less irritation

SOB

Question 14

Disadvantages for Spacers for metered dose inhalers

_________, can’t fit in pocket

Additional _______

Some patients mistakenly put multiple puffs in it

Should clean frequently

Answer 14

Large

cost

Question 15

Short mist inhalers (SMI)

Suffix:Respimat

Examples: Combivent, Spiriva,Striverdi,Stiolto

Question 16

Short mist inhalers (SMI)

Advantages:
__________ counter

Slower actuation than MDI, may result in more efficient inhalation

______“cold Freon effect”

Answer 16

clear dosing

NO

Question 17

Disadvantages of Short mist inhalers

New inhaler must be loaded with ___________

Answer 17

medicine cartidge

Question 18

Short mist inhalers

Do not shake, use TOP acronym to educate patients
1. Hold the inhaler upright and turn the base in the
direction of the arrows until it clicks
2. Flip cap until it snaps open
3. Breathe out fully through the mouth, away from inhaler
4. Put the mouthpiece in the mouth and tighten lips around
the end without covering the air vents
5. Press the dose release button and inhale deeply and
slowly through the mouth
6. Hold breath for about 10 seconds or as long as possible

Question 19

Dry Powder Inhaler

Examples:
Diskus:
Advair
Serevent
Flovent
Ventolin

Ellipta Inhalers:
Breo, Incruse, Arnuity

Question 20

Dry Power Inhaler
Do not shake
1. Hold inhaler and prepare dose as indicated on the
individual package insert.
2. Breathe out completely through the mouth, away from
inhaler.
3. Put the mouthpiece in the mouth and tighten lips around
it without covering air vents
4. Breathe in deeply and QUICKLY.
5. Remove inhaler from the mouth and hold breath for 10
seconds or as long as possible
*Suggested techniques vary slightly between the many
different brands

Question 21

Dry Powder Inhaler

RespiClick:Proair, AirDuo

Spiriva Handihaler

Neohalers: Arcapta, Seebri, Utibron

Others: Asmanex Twisthaler Pulmicort Flexhaler Bevespi Aerosphere