Inhalation therapy Flashcards
Hypertonic saline
Airway hydration
Improve mucus rheology
Inhibits bacterial motility
Cough
Mannitol
Airway hydration
Cough
Improve mucus rheology
B2 agonists
Increase ciliary action
Improved cough clearance via expiratory flow
Surfactant
Reduce mucus sticking to epithelium
Hypertonic saline compared to isotonic airway surface liquid
Hypertonic saline generates greater osmotic pressure and is saltier so draws water into airway to increase hydration of airway surface
Adding saline to mucus effect
Reduces viscosity, elasticity so mucus can flow more readily
Clinical application of hypertonic saline
Effective with CF, non CF bronchitis
Not supported in COPD
Not recommended in asthma as it can exacerbate airway narrowing
Physio and saline
Can deliver hypertonic saline before ACTs
Or during
What is mannitol?
Naturally occurring non-ionic sugar alcohol
Inhaled as dry powder, around 400mg into 10 capsules
Bronchodilator recommended before each dose
Mannitol benefit
Reduces surface tension of sputum from people with CF, bronchiectasis and asthma
Clinical application of mannitol
Improves lung function in CF after 2 weeks
Improves mucociliary clearance in adults with asthma
Physio and mannitol
Delivered before ACTs
Should be delivered after bronchodilator and before ACTs
Mannitol technique
Tilt head up, tilt mouthpiece down when inhaling
Incorporate recovery time when coughing is triggered
When is hypertonic saline used
In CF
What else can be used in CF
DNaase
Nebulised enzyme that breaks up the structure of sputum and improves sputum clearance.
