Information-giving: Inhalers and nebulisers Flashcards
How would you explain to a patient what an inhaler is?
A handheld device that delivers medication directly into the lungs
How would you explain to a patient what a nebuliser is?
A device that converts a medication into a mist, so that it can be inhaled through a mouthpiece or nose piece directly into the lungs
How would you explain to a patient how to set up a nebuliser?
- Wash hands and make sure that all of the nebuliser equipment is clean
- Open the vial of medication by snapping the lid off, and pour medication into nebuliser cup
- Screw on nebuliser lid, then attach mouthpiece/mask/nosepiece
- Attach hose to nebuliser cup and compressor device
- Plug in compressor device to power supply
- Make sure nebuliser cup and lid is securely sealed
- Turn on compressor device and breathe in and out slowly until all medication is gone
- Turn off compressor device, clean nebuliser kit
How do you explain to a patient how to use a mouthpiece with a nebuliser?
Place mouthpiece in mouth and over tongue
Keep lips sealed tightly around mouthpiece so that all of the medication goes into the lungs
Try to focus on mostly breathing in and out of mouth instead of nose
How do you explain to a patient how to use a mask with a nebuliser?
Place on mouth over nose and mouth
What are the 3 types of inhaler devices?
Pressurised meter dose inhaler (pMDI)
Breath activated MDI or dry powder inhaler (DPI)
Inhaler with spacer device
How would you explain to a patient what a pressurised meter dose inhaler is?
Inhaler that holds medication in pressurised cannister, and when you press on the cannister the medication will be pushed by a propellant into your lungs
1 press on the cannister will deliver 1 dose
How would you explain to a patient what a dry powder inhaler is?
Inhaler that stores medication as powder inside a container that is activated when you breathe in at mouthpiece
Doesn’t use propellant to push out the medication, instead you breathe in hard and fast which triggers dose and pulls the medication out
How would you explain to a patient what a spacer is?
Device used with a pMDI that creates space between the inhaler and the mouth, so that the aerosol droplets of medication can become smaller and breathed in more easily and deeper into lungs
How do you explain to a patient how to use a pressurised meter dose inhaler?
- Remove cap from the mouthpiece and gently shake the inhaler
- Breathe out all the way
- Put mouth on inhaler by placing mouthpiece over tongue and sealing lips around edge
- Breathe in and press down on cannister
- Remove inhaler from mouth, keep mouth closed and hold breath for 10 seconds
- Breathe out slowly
How do you explain to a patient how to use a dry powder inhaler?
- Open inhaler by sliding cover open
- Check that there’s nothing in the mouthpiece and check dose counter to see that there are enough
- Hold inhaler horizontally and make sure to not tip over as powder can fall out
- Push lever back until it clicks to load mouthpiece with medication
5.Breathe out all the way
- Put mouth on inhaler by placing mouthpiece over tongue and sealing lips around edge
- Breathe in quickly and deeply until lungs feel full
- Remove inhaler from mouth, keep mouth closed and hold breath for 10 seconds
- Breathe out slowly
- Slide cover closed to reset inhaler, repeat process if more doses are needed
What are the types of inhalers used for asthma?
SABA reliever inhaler: Relieve symptoms when they occur
ICS preventer inhaler: Stop symptoms from occurring
Combination ICS/LABA inhaler: Stop symptoms from occurring, but also relieves them if they do occur
LAMA or SAMA inhaler
LTRA inhaler
What is a SABA reliever inhaler?
Short Acting Beta-2 Antagonists: Rapid onset within 5 mins and therapeutic effect lasts up to 4 hour
Smooth muscle relaxation and bronchodilation
Eg. salbutamol, terbutalin: Blue coloured
What is an ICS preventer inhaler?
Inhaled corticosteroid: Reduce inflammatory mediators (eosinophils, macrophages, lymphocytes) and increase anti-inflammatory mediators in airways
Eg. Beclomethasone, budesonide: Brown coloured
What is a LABA inhaler?
Long Acting Beta-2 Antagonist: Therapeutic effect lasts up to 12 hours
Smooth muscle relaxation and bronchodilation
eg. Salmeterol, formoterol: Green coloured
What is a LAMA or SAMA inhaler?
Muscarinic Antagonist: Block muscarinic cholinergic receptors, which allows bronchodilation and reduces mucus secretion
SAMA: 3-6 hours eg. Ipratropium
LAMA: Up to 24 hours eg. Tiotropium
What is a LTRA inhaler?
Antileukotriene Receptor Antagonist: Block the activity of cysteinyl leukotriene receptors (CysLT) on bronchial smooth muscle, which prevents bronchoconstriction and mucus secretion
eg. Montelukast
What is a combination ICS/LABA inhaler?
Fostair: Beclomethasone and formoterol: Pink coloured
Symbicort: Budesonide/formoterol
What is AIR therapy and the MART regime, and when are they used?
AIR therapy: anti-inflammatory reliever, used for mild asthma
MART regime: Maintenance and reliver therapy, used for moderate-severe asthma
How are inhalers used in AIR therapy?
Use of your combination inhaler (Symbicort 200/6 or DuoResp Spiromax 200/6) for relief when you get asthma symptoms, eg, shortness of breath, wheezing, chest tightness and cough
How are inhalers used in MART regime?
Use of your combination inhaler (Symbicort 100/6, Symbicort 200/6 and DuoResp Spiromax 200/6) for the prevention AND relief of asthma.
You will need to use your inhaler every day AND when you get asthma symptoms, eg, shortness of breath, wheezing, chest tightness and cough
