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NEBULIZATION THERAPY

Oxygen. Vital to cellular metabolism, critical for sustaining life.Indicated in almost all respiratory distress.Relative contraindication - patients with chronic hypoventilation. These patients use low blood oxygenation as a stimulation for breathing. Administering oxygen suppresses this stimulati

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NEBULIZATION THERAPY

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    1. NEBULIZATION THERAPY MEDICATIONS

    2. Oxygen Vital to cellular metabolism, critical for sustaining life. Indicated in almost all respiratory distress. Relative contraindication - patients with chronic hypoventilation. These patients use low blood oxygenation as a stimulation for breathing. Administering oxygen suppresses this stimulation.

    3. Oxygen Usual flow rate - at least 6 liter/minute delivered by face mask. Use pulse oximetry to monitor and titrate flow rate to desired oxygen saturation level. Highly combustible.

    4. Mask disadvantages Skin irritation Fear of suffocation accumulation of moisture on face Potential for inhalation of vomit

    5. Nasal Cannula - disadvantages Uncomfortable May not deliver enough oxygen if the patient is a mouth breather

    6. Medication Delivery Hand Held Nebulizers: “Breathing treatment” (HHN) Metered Dose Inhaler (MDI) use a spacer (Aerochamber for optimal delivery) Dry Powder Inhalers (DPI) Turbuhaler or diskus

    7. Bronchodilators Relax the muscle band surrounding the airway. Provide rapid relief of symptoms.

    8. Bronchodilators Provide quick relief of mild symptoms. Overuse increases side effects, decreases effectiveness and allows inflammation to worsen. Side effects: Rapid heart rate, tremors, and nervousness. These side effects decreases as the body becomes tolerant to the medication.

    9. Albuterol (Beta 2 agonist) Other names: Ventolin, Proventil Stimulating parts of the sympathetic nervous system including smooth muscles of the lung causing the airway to open up. Indicated in acute bronchospasm such as asthma. Relative contraindication - Cardiac dysfunction, hypertension, diabetes, hyperthyroidism, and seizure disorders.

    10. Albuterol (Beta 2 agonist) Usual dose: 3 ml vial delivered by hand held nebulizer compressor. Smaller infants need specific dose adjustment using 0.5% solution. Monitor heart rate and post treatment peak flow rate. Expect palpitation, cough, tremor, nervousness, increase BP, and dizziness.

    11. Ipratropium (Atrovent) Anticholinergic effect causes smooth muscles of the lung to relax and dilation of the airways. Indicated in bronchospasm, especially in chronic bronchitis and emphysema. Not effective for episodes of bronchospasm where rapid response is required. Use cautiously in patients with cardiac dysfunction, glaucoma, and urinary retention. Contraindicated in patients with hypersensitivity to the drug or atropine, soybeans or peanuts.

    12. Ipratropium (Atrovent) Usual dose is one 2.5 ml vial delivered by hand held nebulizer compressor. Monitor heart rate and post treatment peak flow rate. Expect palpitation, cough, nervousness, dizziness, GI upset, dry mouth.

    13. Anti-inflammatory Decreases the swelling of the bronchial tube wall. Decreases mucus production. Blocks the response of the airway to trigger factors. Makes the airways less sensitive to triggers. Long-term use inhaled anti-inflammatory medication can help prevent asthma flare-ups and maintain good lung function.

    14. Anti-inflammatory - Side Effects Cromolyn is an extremely safe medication. Side effects are rare. Sometimes inhaled steroids can cause oral thrush. Preventive methods - use a spacer device and rinse the mouth with water after using the medication. Short term use of oral steroid may increase appetite, fluid retention, and mood changes.

    15. Steroid Prednisone, Pediapred, Prednisolone, Prelone, Solumedrol, Dexamethasone, Decadron, Hydrocortisone, Solucortef. Used to reduce inflammation and swelling. Relative contraindication in patients with herpes, chickenpox, TB, diabetes, peptic ulcers, osteoporosis, kidney dysfunction, and hypertension.

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