Inhaler technique

Question 1

Fate of inhaled drugs- good technique

Answer 1

80% swallowed
20% deposited in lung
Metabolism or absorption from the lung leads to systemic circulation
Mucociliary clearance&raquo_space; absorption from gut&raquo_space; first pass metabolism&raquo_space; oral bioavailability&raquo_space; systemic circulation

Question 2

Fate of inhaled drugs- poor technique

Answer 2

95% swallowed

5% deposited in lung

Question 3

Why should device be shaken before use?

Answer 3

To disaggregate the powder and make the right size particles come out

Question 4

How is an aerosol generated in a triggered device?

Answer 4

Patient starts breathing, then aerosol delivers drug when patient breathing correctly
Bottom part of lung doesn’t get drug as patient inhaling before drug released

Question 5

Correct metered dose inhaler technique

Answer 5

Remove cap and shake device. Breath out, put open end in mouth and start breathing in at normal velocity. Depress trigger, while continuing to breath in as much as possible. Hold breath for 10 seconds, breath out and wait for 30 seconds before repeating as needed. Replace cap after use.

Question 6

Correct dry powder inhaler technique

Answer 6

Remove cap and open trigger guard until you hear a click, then move lever until you hear a click. Breath out, then holding device horizontally, put opening in the mouth and breath in as quickly and as hard as you can. Hold breath for 10 seconds, then breath out, waiting 30 seconds before repeating as needed. Close trigger guard after use.

Question 7

Spacers can help by…

Answer 7

Capture aerosol avoiding coordination problems

Reduces particles deposited in oropharynx