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35 Cards in this Set
- Front
- Back
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What principle is used by the ultrasonic nebulizer to produce aerosol droplets? |
High frequency sound waves |
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What size do we want the aerosol particles to be to reach the lower airways where the Broncospasm occur? |
2 to 5 um |
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List some things that the CDC recommends the RT doing to help reduce infection rate associated with SVN |
Clean and disinfect, or rinse with sterile water, and air dry between uses. |
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Name some drug categories that are commonly administered by MDI |
Bronchodilators, anticholinergics and steroids |
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Name an anticholinergic drug and how does it work? is it fast acting? rescue drug? |
Ipratropium Bromide(Atrovent) Anticholinergic Bronchodilator *Blocks the cholinergic chemicals that causes bronchoconstriction. *It is not fast acting and therefore is not a rescue drug. |
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What is the standard dose of Proventil when given by aerosol via SVN and what kind of drug is it, and what is its generic name? |
Albuterol *Bronchodilator and beta 2 agonist *180mcg w/ MDI *2.5mg for standard adult neb *1.25mg for standard pedi neb |
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What is the standard dose for levalbuterol given as aerosol via SVN and its brand name? |
Xopenex *Bronchodilator & beta 2 agonist *1.25mg Adult every 6 to 8 hours *.63mg Pedi every 6 to 8 hours |
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Describe some of the advantages and disadvantages of a dry powder inhaler. |
Advantages: *small and portable *built in dose counter *propellant free *breath-actuated *short preparation and administration time
Disadvantages: *Dependence on persons inspiratory flow (>60L/min) *patients less aware of delivered dose *limited range of drugs *different DPIS with different drugs *Relatively high oropharengeal impaction * Vulnerable to ambient humidity or exhaled humidity into mouthpiece * if a patient exhales into mouthpiece the drug is gone |
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What kind of flow rate must a patient provide to make a DPI work properly? |
60 L/min |
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What function does a baffel serve in a jet nebulizer? |
It reduces the size of particles in an aerosol (Knocks big ones out and puts them back in) |
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Describe how flow affects the particle size a jet nebulizer produces |
*Higher flow and shorter time produces smaller particles. *Lower flow and longer time produces bigger particles. |
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Describe how SVN used in the home might affect particle size negatively versus using med air from a wall outlet in the hospital and how should the RT work to solve the problem |
Match neb to compressor according to manufacturer |
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List four categories of jet nebulization and give pros and cons of each |
*small volume nebulizer with reservoir ●Pros: 6 inch piece of aerosol tubing to be used as reservoir may increase inhaled dose by 5 to 10% or increase the inhaled dose 10% to to approximately 11% with reservoir tube.
*continuous small volume nebulizer with collection bag ●Pros: hold the aerosol generated during exhalation and allow the small particles to remain in suspension for inhalation with the next breath, while larger particles rain out, attributed to a 30% to 50% increase in inhaled dose drug
*breath-enhanced nebulizer ●Pros: increases inhaled mass by about 50% over standard continuous nebs and reduces aerosol waste to atmosphere.
*breath-actuated nebulizer ●Pros: responsive to the patient's inspiratory effort and reduces or eliminates aerosol generation during exhalation ,generate aerosol only during inspiration, eliminates waste of aerosol during exhalation and increases the delivered dose threefold or more over continuous and breath-enhanced nebulizers, delivery efficiency
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Describe how a vibrating mesh aerosol generator works and some benefits it provides |
It works by submerging the mesh cup in medicine. *It is quicker, quieter, portable, doesn't mess up a vent and has almost no residual medicine left. |
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Describe continuous nebulization, when is used and for what disease type and standard dosage |
*runs nonstop for 24 to 36 hours *20 mg per hour *10% increase in peak flow after an hour *severe asthmatic spasm |
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Describe how a small volume ultrasonic nebulizer works and its advantages |
Medication is placed directly into the manifold on top of the transducer and the patients inspiratory flow draws the aerosol from the nebulizer into the lung. *administer a variety of medicines *have less residual drug volume *make good particle size *run on batteries |
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What happens when a nebulizer begins to sputter and when a neb starts to sputter what should a RT recommend? |
It means the amount of drug administered drops off or the medicine is low and the RT should stop treatment |
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What happens to some nebulizers if you lay them on their side when administering medicine? |
They won't nebulize |
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Name 2 drugs that have been approved to be administered via aerosol for pulmonary arterial hypertension |
Iloprost (Ventavis) & Treprostinil (Tyvaso) |
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What treatment would you recommend to the doctor if the patient had already been given 5 back-to-back neb treatments with albuterol, followed by MDI at 12 puffs and SVN neb with undiluted albuterol and what dosage would you recommend? |
Continuous Bronchodilator Therapy with albuterol dosages ranging from 5 to 20 mg an hour |
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What is the definition of an aerosol? |
A suspension of solid or liquid particles in gas. |
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Where do most aerosol particles in the 5 to 10 um range deposit? |
In the upper airways |
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Where do most particles in a 1 to 5 um range deposit? |
In the central airways |
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What is the primary fate of inhaled aerosol particles that are between 1 and .5 um? |
They are cleared with exhaled gas |
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What is the primary hazard of aerosol drug therapy? |
Adverse reaction to the medication being administered |
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List a drug that has been associated with increased airway resistance and bronchspasm during aerosol administration |
Acetylcysteine |
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When fired inside the mouth what percentage of the drug dose delivered by a simple metered dose inhaler deposits in the oropharynx? |
80% |
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Which groups of patients are most likely to have difficulty using a metered dose inhaler for aerosol drug therapy? |
Patients in acute distress, infants and young children, and elderly persons |
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Proper use of a dry powder inhaler requires that the patient be able to generate flow of |
Greater than 60L/min |
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Exhalation into which device can result in loss of drug delivery? |
DPI |
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Normally, When using a 50 PSI flowmeter to drive a small volume jet nebulizer to what should you set the flow? |
6 to 8 L/min |
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To minimize a patient's infection risk between drug treatments with a small volume jet nebulizer what would you do? |
Clean and disinfect or rinse with sterile water and air dry between uses |
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A physician has ordered the anti viral agent ribavirin to be administered by aerosol to an infant with bronchiolitis. What device would you recommend in the situation? |
SPAG |
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On the average what percentage of an aerosol drug delivery devices output actually deposits in the lungs? |
20% or less |
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To decrease the likelihood of an opportunistic yeast or fungal infection associated with metered dose inhaler steroids what would you recommend that a patient do? |
Use a spacer and rinse mouth after use |
