Inhaled aerosol compatibility


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Inhaled aerosol medication, that is given by respiratory therapist, need to be mixed with another medication for quicker time, less cost, or synergic effect.

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Inhaled aerosol compatibility

  1. 1. COMPATIBILITY By : HIND SALMAN AL-SUBGH Supervisor : MAHER AL-QUAIMI University of Dammam College of Applied Medical Science Respiratory Care Department Page 1
  2. 2. OUTLINES •Compound vs Mixture •Compatibility •Category of respiratory medications •Physiological effects •Some of the Most Common drugs in respiratory therapy •What should we mix + Studies •Cases Page 2
  3. 3. Compound vs Mixture Compound Mixture A compound is a substance for med when two or mor e elements ar e chemically joined. Mix tures ar e two or more substances that are mix ed together but not chemically joined. can be broken down into a simpler type of matter (elements) by chemical means can be separated into its components by physical means Page 3
  4. 4. compatibility CHAMICAL MEDICAL Page 4
  5. 5. CHAMICAL  a measure of how stable a Substance is when mixed with another substance Page 5
  6. 6. Page 6
  7. 7. MEDICAL Two or mor e dr ugs can be administer ed at the same time without pr oducing undesir ed side effects or without canceling or affecting the ther apeutic effects of the other s. Page 7
  8. 8. The Category of Respiratory Medications Prescription drugs and medicines for conditions and diseases relating to the lungs and/or breathing are : •Antihistamines •Antitussives •Bronchodilators •Decongestants •Expectorants Page 8
  9. 9. Antihistamines • Histamine is a body chemical that, when released in the body, typically causes swelling and itching. Antihistamines counteract these allergy symptoms by blocking the effects of histamine and are used for mild respiratory allergies, such as hay fever • Diphenhydramine • Meclizine • Scopolamine Page 9
  10. 10. Antitussives • Medications control coughs • These preparations must be absorbed into the blood, circulate through the system, and then act on the brain. • Codeine • Dextromethorphan Page 10
  11. 11. Expectorants • used to change a dry nonproductive cough into a productive one • Mucolytics Page 11
  12. 12. Decongestants • Constrict blood vessels in the nose and sinuses to open air passages • Oral preparations • Nose drops • Nasal sprays Page 12
  13. 13. Bronchodilators • Agents that open airways in the lungs and medications that relax smooth-muscle tissue (such as that found in the lungs) are used to improve breathing • Sympathomimetic • Anticholinergic • Corticosteroids • Mast Cell Stabilizers Page 13
  14. 14. Physiological effects • Adrenergic bronchodilators represent the largest group of drugs among the aerosolized used for inhalation. • Mode of Action and Effects:  Alpha receptor stimulation  Beta-1-receptor stimulation  Beta-2-receptor stimulation Page 14
  15. 15. Sympathomimetic Beta-Agonists Short acting Long acting Epinephrine Racemic epinephrine SABA Ventolin Proventil LABA Formoterol Salmeterol Page 15
  16. 16. Page 16
  17. 17. Anticholinergic Block parasympathetic receptors influences (beta2 stimulation) Spiriva Ipratropium bromide (Tiotropium) (Atrovent) Page 17
  18. 18. Corticosteroids Anti- inflammatory agents Prevent or reduce airway inflammation in asthma  Budesonide ( Pulmicort) Dexamethasone sodium phosphate Page 18
  19. 19. Some of Most Common used drugs in respiratory therapy Page 19
  20. 20. Ventolin What is Ventolin HFA? Before using Ventolin! How should I use Ventolin? Ventolin side effects! What other drugs will affect Ventolin? Page 20
  21. 21. Atrovent What is Atrovent? Before using Atrovent! How should I use Atrovent? What other drugs will affect Atrovent? Page 21
  22. 22. Symbicort • An asthma controller medication combining two drugs into one inhaler • Polmicort (Budesonide) • Foradil (formoterol) Page 22
  23. 23. Advair • Advair Diskus is a controller asthma medication that combines two drugs into one inhaler.  • Flovent • Salmetrol Page 23
  24. 24. What can we mix? Page 24
  25. 25. Studies • Physical and chemical compatibility is one consideration when determining the appropriateness of mixing medications for nebulization. • Several studies have investigated the compatibility of nebulizer solutions, including antibiotics and bronchodilators. • Studies of the efficacy and safety of mixing nebulizer medications have been limited, and few inhalation solutions are approved by (FDA) to be mixed. Page 25
  26. 26. levalbuterol acetylcysteine sodium cromolyn sodium ipratropium budesonide bromide Page 26
  27. 27. Page 27
  28. 28. cases Cases Page 28
  29. 29. RT has administered an aerosol TX of albuterol to 67-year-old COPD pt. CC/ acute exacerbation & SOB When the RT returns to the pt. informs him that he began to feel very shaky and nervous , beginning about 30 min after the TX. He also noticed a tremor when he held his water cup.His HR during the earlier TX. Was 84 beats/min. After the RT did the assessment every thing was normal and stable although the auscultation reveals mild wheezing and mild tremor is apparent when he holds his hand out. He states that he is now feeling better and the ‘ shakiness’ has subsided a bit. Page 29
  30. 30. COPD pt. receiving regular TX. Of ipratropium bromide who require additional bronchodilation for relief of airflow obstruction. Q: What do you think is the other appropriate Bronchodilator for him? And why did you choice it? Albuterol Page 30
  31. 31. 21-year male Pt. came to the ER with a sever allergic reaction of seafoods he was gasping for air. Q : what would be the appropriate Tx. For him ? Epinephrine injection Page 31
  32. 32. Proventil Corticosteroid Flovent Salmetrol Foradil Atrovent Pulmicort Page 32
  33. 33. HFA referring to…? Propellant “Hydrofluoroalkane” Page 33
  34. 34. Can you tell us about your experience in the 1st clinical practice and what did you feel at that time and how did you improve your self?! Page 34
  35. 35. THaNK YOU all Page 35