inhaler types Flashcards
4 types
- pMDI
- breath actuated MDI
- dry powder inhalers
- soft mist inhalers
pMDI requires
dexterity and the ability to coordinate actuation with inhalation
where this is an issue, a spacer device can be used or an alternative inhaler device can be considered
breath actuated MDI and DPI requires
minimum inspiratory effort to be able to generate enough inspiratory flow to allow effective drug delivery
A minimum level of inspiratory effort is necessary to use these inhalers effectively, as insufficient inhalation can result in poor medication delivery to the lungs, reducing therapeutic efficacy. For patients with very low inspiratory flow, alternative options, like nebulizers or traditional MDIs with spacers, may be more appropriate.
on changing from pMDI to DPI, patients may notice the following
lack of sensation in mouth and throat previously associated with each actuation
coughing may also occur
If a pt is on high ICS dose, and they are on pMDI, they must always have
spacer device
This inhaler type delivers a fiche number of medication doses per canister, and after thee doses have been used it, the inhaler will continue to actuate, expelling propellant gas but no API!
MDI
this inhaler type is associated with unnecessary expulsion of harmful propellant gas into the environment
MDI
patients on this type of inhaler may inadvertently use ‘empty’ inhalers and inhale only propellant gas once all the medicated doses have been used up which could lead to exacerbation and destabilisation of their condition
MDI
true or false - shaking, weighing or flaring the inhaler device, or using it until it not longer actuates is an accurate way of seeing when the inhaler runs out
false. not accurate and not recommended.
MHRA advice: pMDI - risk of airway obstruction from aspiration of loose objects
reports of pt who have inhaled objects into back of throat, in some cases these were aspirated causing airway obstruction
remove mouthpiece cover fully, soak inhaler device and check that both outside and inside of mouthpiece are clear and undamaged before inhaling dose
always store inhaler with mouthpiece cover on
the MHRA released safety information concerning this inhaler type after there were reports of patients inhaling objects into the back of the throat, in some cases these were aspirated leading to airway obstruction
pMDI
spacer devices can be used for this type of inhaler
pMDI
advantages of using spacer device with pMDI
- removes need for coordination between actuation of pMDI and inhalation
- reduce velocity of aerosol and subsequent impaction on oropharynx, and allow more time for evaporation or propellant so that large proportion of particles can be inhaled and deposited into lungs
- useful if poor inhalation technique, elderly, high dose ICS, prone to oral thrush with ICS
are spacer devices interchangeable
no
pt should be advised not to switch between spacer devices
when should patients inhale from spacer device after actuation and why?
ASAP because drug aerosol is very short lived
