2. Nebulizer is the device may be used for inhalation of drugs. It
is also used for moistening airways with saline or sterile water.
3. PRINCIPLE OF NEBULIZAR
A nebulizer converts solutions into aerosol particles which
are suspended in stream of gas.
Nebulizer is defined as the process of reduction of bulk
liquids into fine spray in which large particles are removed
by introduction of suitable type of baffle
4. The aim of nebulizer therapy is to deliver a therapeutic dose
of prescribed drug as an aerosol in the from of repairable
particles (particles <5 micrometer in diameter) in acceptable
period of time, approximately 5 to 10 minutes.
5. INDICATIONS
Patient with thick tenacious secretions.
Patients who need to clear secretions but are mouth
breather, find expectoration difficult.
Patients whose humidifying system has been bypassed by
tracheal tube.
Babies with respiratory problem whose small airways easily
block with secretions
Useful in chronic obstructive and restrictive diseases.
Patients with bronchospasm.
6. DRIVNG GAS
Most jet nebulizer operates efficiently with a flow rate of 6-8
lit/min.
For patients in hospital it is convenient to use piped oxygen
supply.
In hypoxic patients without carbon dioxide retention, oxygen
should be used.
10. TYPES OF NEBULIZER
JET NEBULIZER
With jet nebulizer, a driving gas(electric air compressor or
compressor air or oxygen) is forced through a narrow orifice
The negative pressure created around orifice draws solution
up the feed tube from the liquid reservoir and the jet of gas
fragments the liquid into droplets.
11. ULTRASONIC NEBULIZER
An aerosol can be created by the high frequency sound waves
(1-2 MHZ)
An electric current applied to piezoelectric crystal causes
ultrasonic vibrations
The sound waves will travel through a liquid to the surface they
produce an aerosol
The particle size is influenced by the frequency of oscillation of
the crystal.
12. ADVANTAGES OF US NEBULIZER OVER
JET NEBULIZER
It can produce higher output than jet nebulizers.
They operate quietly.
Suitable for home use.
Very useful for delivering high humidity to patients with
tenacious sputum to aid expectoration.
13. DISADVANTAGES
It is expensive
Few models require the patient to breathe in actively to
open a valve of nebulizer so patient with very poor
respiratory reserve and children may find this additional
effort difficult.
14. NEBLIZER PERFORMANCE
performance of nebulizer is measured with it’s respirable
output.
Respirable output: it is mass of respirable particles (<5
micrometer) produced particles minute.
Respirable fraction: percentage of respirable particles in
It must be atleast 50%
15. DRUGES DELIVERED
Wide variety of drugs can be administered
Bronchodilators
Corticosteroids
Antibiotics
Antifungal
Mucolytic
16. DRUG IS DILUTED WITH SALINE TO MAKE IT AROUNS 4 ML
For example
1ml salbutamol + 3ml saline
2ml ipratropium bromide + 2ml saline
1ml salbutamol + 2ml ipratropium bromide + 2ml saline
17. STEPS
Have the patient in side-laying or sitting in a chair
Select mask or mouthpiece according to patient preference.
Masks may cause eye irritation, and mouthpieces are not
suitable for breathless patients, but drug delivery is similar.
Ensure that there is a minimum 4ml fill,and see the flow rate
at 6-81/min
18. Ask the patient to breathe through the mouth. Nose
breathing filters the drug and reduces lung deposition by a
quarter.
ADVICE THE PATIENT TO
Breath – hold at end-inspiration at intervals.
Tap the device when the liquid is beginning to fizz, in order to
avoid drug wastages.
19. PROBLEMS WITH NEBULIZERS
mask / mouthpiece
Use of antibiotic requires filters
Actylecysteine is inactivated by oxygen. So, when it is used
the driving gas should be the air
