Problem 13: Deal with conflict between GP and patient's daughter Flashcards Preview

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Flashcards in Problem 13: Deal with conflict between GP and patient's daughter Deck (3)
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1
Q

What is a nebuliser? Describe how nebuliser administration works. Discuss the advantages and disadvantages of using a nebuliser?

A

Compressor and nebulizer chamber - can be used with mask or mouthpiece. Saline is used in chamber, drugs such as salbutamol added in this way. Turn on, secure face mask (secure to ensure dose is administered effectively). Chamber and mask can be directly attached to oxygen mains.

Advantages: It is applicable to more varieties of drug solutions
It has the ability to aerosolize drug mixture (more than one drug) as long as testing of drug activity is done to ensure no interference
Minimal coordination for inhalation is needed
It can be used in very young or very old, debilitated patients or those in acute distress
It works with low inspiratory flows or volumes
Breath-hold is not required for efficacy
Drug concentration can be adjusted if desired

Disadvantages: The equipment can be expensive and cumbersome
For traditional nebulizers, treatment times are somewhat lengthy compared with other types of inhalers and other routes of administration
With inadequate cleaning, medicine can be easily contaminated
The spray is wet and cold
An external power source is needed, either electricity or compressed gas, making it less portable

2
Q

Are there any risks associated with using nebullisers in patients with glaucoma?

A

Nebulisers are a risk factor for the development of glaucoma. Use of a nebuliser (with face mask) therefore undoubtedly increases the risk of glaucoma worsening.

There was no significant rise in intraocular pressure or change in anterior chamber angle in patients with open-angle glaucoma, narrow-angle glaucoma or control subjects following treatment with either drug. However, when the two drugs were used in combination, intraocular pressure rose in patients with narrow-angle glaucoma but not in patients with open-angle glaucoma or in control subjects.

3
Q

How would a pharmacist respond to this request and deal with conflict between GP and patient’s daughter?

A

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