Inhalers/other Devices Flashcards
(7 cards)
What is a inhaler?
Medical device that gets meds quickly to PTs lung. Many types of inhalers.
- Smaller doses in inhalers needed than by oral meds
- Less AEs
Types of devices for breathing in meds
- Inhalers
- Nebulisers
- Parenteral (IV/IM)
- Spacers
- Peak flow meters
Inhalers Types
Pressurised metered dose inhaler (PMDI)
Mild/Moderate asthma
Salbutamol - SABA - Quick relief
Salmeterol/Formoterol/Vilanterol etc - LABA
- Remove cap and press top of inhaler and breathe in at same time. INHALE SLOW & DEEP
- Harder for elderly/Young to use.
- Spacer give to <5 yrs and for PTs who struggle. They remove the need to time breathing - makes treatment more effective
Breath actuated inhaler (PMDI)
Mild/Moderate asthma
Salbutamol, Beclomethasone (ICS - maintenance)
- Pull cap down, breath in and medicines is automatically released. INHALE SLOW & DEEP
- Safe for >12 yrs
Top of inhaler has vents vital for med to work DONT block vents, Hold the inhaler from the side, Big powerful breath in is needed to release meds
Dry Powder inhaler (DPI) Accuhaler
Use in >4 yrs.
- Option if struggle with PDMI.
Twist to open dose counter will go down to show inhaler is ready have in horizontal position and deep breath in to inhale med. INHALE QUICK & DEEP
- left over on throat more likely so rinse with water after use
- AEs: Cough, Lack of feeling med in mouth unlike spray
Dry Powder inhaler (DPI) turbohaler
Plumicort (budesonide)
Symbicort (budesonide/formeterol)
- Take lid off twist cap hold horizontal, place on mouth breathe in. INHALE QUICK & DEEP
>6 yrs
Has a dose counter. Left over also more likely
Comes in 60 or 200 doses.
Soft mist inhaler
Respimat - requires button pressing
Turn base until clicks. ensure cap is closed
Comes as cartridge and cartridge + device
Breathe in slow and steady as pushing the button
>6 yrs.
Needs priming when new. insert cartridge in inhaler then press button until mist appears.
New device needed after 6 cartridges
Can use with spacer
Nebulisers
Severe acute asthma
Converts solution of drug into aerosol to breath in
Higher doses than inhaler.
API come as ampoules
Equipment is to be replaced every 6/12 months. But mouth piece etc every 3 months
Saline steri-neb used to dilute nebuliser solution. Saline is put in the machine then mixed with 1 of:
- Salbutamol, ipratropium, budesonide
MHRA WARNING
Nebuliser use with extreme caution in children and only use under specialist care
- masks deterioration of disease and delays seeking medical attention
Parenteral (IV/IM)
Severe acute asthma
- B2 agonists, corticosteroids, aminophylline, theophylline
Given when nebuliser cant be used.
Can need a loading dose. Regular levels checked are needed Ie blood tests etc,
Need to know when to switch to oral
Spacers
Breathe in ASAP to inhale meds after they are pressed
Single breathe is more recommended But can do multiple. - Breath slowly and deeply and hold breathe for 10 seconds OR breathe in and out 5 times slowly
- still should rinse mouth/face after use
Only used with PMDI
- others aren’t suitable.
Useful for PT who:
- Poor technique, Child, Using High doses ICS, Nocturnal asthma, risk of candidiasis with ICS.
Aero-chamber:
0-18 mnths - Orange
1-5 yrs - Yellow
>5 - Blue
+ vs + flow vu:
- Flow vu has a flap to show if PT is breathing in.
- Flow VU dishwasher safe and is POM. + is P
Volumatic/Volumatic paediatric:
Volumatic - >3yrs
V paediatric - birth - 3yrs
- Larger the spacer the more effective
- More med will be delivered
- Better than aero-chamber
Use and CARE of spacer
Clean once a month.
Clean with mild detergent, rinse, AIR dry AVOID towels.
- New spacer every 6/12 months
Peak flow meter/in check dial
Device used to test how fast you can blow air in and out of your lungs.
- Helps diagnose asthma and tests exacerbation severity
Low range - used for small kids and adult with low readings
Standard range - Older children + adults with normal reading
- Reading is age, height and gender dependent
Monitors asthma
Ranges increase with age. 80-100% of best is well controlled. (Yellow-50-80, Red <50[Severe])
FACTORS affecting peak flow - Age, gender, height, health
in check dial
Device that helps see if Pt is breathing well enough got proper inhaler technique
MART
=
Maintenance and Reliver therapy
= ICS + LABA in 1 inhaler
E.G., Fostair, symbicort etc
