medication administration

1. Administering
medication through
Inhalation
By,
Ms. Ekta S Patel,
Assistant Professor.

2. Inhalation- Definition
Inhalation is any drug or solution of drugs
administered by the nasal or oral
respiratory route.
Inhalation (also known as inspiration) is the
movement of air from the external
environment, through the air ways, and
into the alveoli.

4. Common conditions
 Inhalation therapy is a
traditional treatment in
chronic asthma and
chronic bronchitis.
 Emphysema,
 Bronchiectasis

5. Advantages and Disadvantages:
 Advantages:
-Less systemic toxicity
-More rapid onset of medication
-Delivery to target of action
-Higher concentrations available in the lung
 Disadvantages:
-Time and effort consuming
-Limitation of delivery device

6. Inhalant drugs
 Antiallergic agents
 Bronchodilators
 Anesthetics
 Mucolytic agents
 Antimicrobials

7. Device
 Selections of device include：
 Nebulizer: small volume, large
volume, ultrasonic
 Metered dose inhaler, MDI
 Dry powder inhaler, DPI
 Spacer
 Rotahaler

8. Metered-dose inhalers
 A liquid propellant
 A metering valve that dispenses
a constant volume of a solution in
the propellant.
 Inhalation technique is critical for
optimal drug delivery – only about 10%
of drug reaches the lungs.

10. • Fist be shaken to ensure that drug
should be evenly distributed.
• Held upright and the cap is removed.
• Breathes out gently, but not fully

11. • With the mouth around the mouthpiece of the
inhaler, the device is pressed to release the
drug as soon as inspiration has begun.
• Inspiration should be slow and deep, be
held for 10seconds if possible.
• Dose of inhalation will involve > 1 “puff”
• The length of time between inhalation
is 15- 20 seconds.

12. Dry powder inhalers
 No propellant
 Breath-activated, and patient
coordination is not as important an issue.
 The drug is formulated in a filler and
contained in a capsule that is placed in the
device and punctured to
release the powder.

13. ▪ Releasing drug on inspiration,
require faster inspiratory flow
rate
▪ Inspiratory flow required depends on
the resistance within device.

15. Rotahaler
 Insert a capsule into the rotahaler ,
the coloured end first.
 Twist the rotahaler to break the
capsule
 Inhale deeply to get powder into the
airway
 Several breath may berequired, does
not required the coordination of the
aerosol

17. Spacer
 Patient could not required coordinate inspiration
a) Patient seals lips around the mouthpiece
b) Depresses the actuator
c) The mist is trapped in the middle
section
a) Inhale without loosing the drug

19. Nebulizers
•Patient cooperation and coordination is not
as critical
•It converts solution into aerosol particles,
< 5μm.
•An acceptable time 5-10minutes.

20. • Two types:
oJet nebulizers
oUltrasonic nebulizers
• Commercially available nebulizers
deliver 12% to 20% of the
nebulized dose into the bronchial
tree.

22. Jet nebulizer
 With a jet nebulizer driving gas is forced
through a narrow orifice.
 The negative pressure created around
the orifice and it allows the smaller
particles for inhalation and larger particles
drop back into the reservoir

24. Ultrasonic nebulizers
An aerosol can also created by high
frequency(1- 2MHz) sound waves.
• Piezo-electric crystal causes ultrasonic
vibrations, it will travel through liquid to
the surface where they produce aerosol.
• Produce higher output than jet nebulizers

26. Steam inhalation
▪ Check the physician’s order .
▪ Warm the inhaler by pouring a little hot
water into the inhaler and emptying it after
one minute.
▪ It reduces loss of heat from inhaler during
procedure.

28. ▪ Pour the required amount of inhalant into
the inhaler and fill to a level below the
spout with boiling water.
▪ The water should remain just below the
spout.
▪ If the inhaler is filled up to the level of
spout there is possibility of drawing water
into the mouth when inhaling and can
cause scalds.
▪ If the spout is filled with water it will not act
as an air inlet.

29. ▪ Place sterile mouthpieces and close the
inhaler tightly.
▪ Cover the mouth piece with a gauze piece and
plug the spout with a cotton ball.
▪ Covering the mouthpiece with a gauze piece
will prevent burns of the lips.
▪ Cotton ball in the spout will prevent escape of
steam.

30. ▪ Place a towel around the inhaler and
position it in the bowl.
▪ It insulates the inhaler and prevents
heat loss.
▪ Take it to the patient without losing
time.

31. ▪ Switch off fan/AC and close windows and doors
▪ Position the patient in high fowlers or sitting
position.
▪ Place the apparatus conveniently in front of the
patient on cardiac table with spout opposite to
the patient.
▪ Remove the cotton plug and discard it into the
kidney tray.

32. ▪ Keeping the spout opposite to the
patient reduces the chances of burns.
Removing the cotton plug helps to
open spout, so that it can act as an
inlet for air.

33. ▪ Instruct the patient to place lips on the
mouthpiece and take deep breath.
▪ After removing the lips from the
mouthpiece, breathe out air through nose.
▪ Directing the steam out through the
nostril relieves the congestion of the
mucous membranes of the nostril.

34. ▪ Continue the treatment for 15 to 20 minutes as
long as patient gets the steam. Observe the
patient during procedure.
▪ Removes inhaler from the patient after the
stated time, wipe off perspiration from the
patient’s face
▪ Give chest physiotherapy and encourage patient
to bring out sputum by coughing.
▪ Instruct the patient to remain in the bed for 1 to
2 hours.

35. Electric inhaler
▪ Explain the procedure to relieve anxiety and
gain cooperation.
▪ Auscultate the patient lung fields to know the
lung condition.
▪ Place him/ her in a sitting position for comfort.
▪ Put off the fan and cover the patient with a
bed sheet or blanket to avoid chills or droughts
to help collect the steam around the face of
the patient to prevent steam loss.

37. ▪ Place the electric inhaler to the cardiac
table.
▪ Switch on the electric inhaler.
▪ Instruct the patient to inhale by mouth
and exhale through the nose for 15 to 20
minutes – steam through nostrils
relieves congestion of the mucous
membranes.

38. ▪ Keep the sputum cup with
disinfectant ( 1% savlon) and face
towel for spitting and wiping the face.
▪ Remove the inhaler, keep the patient
in a comfortable position and observe
him/ her frequently, keep him/ her
well covered- to prevent chilling.