Metered-Dose Inhaler and Small-Volume Nebulizer

Inhaled Beta-Agonists

Common medications for shortness of breath that dilate breathing passages, administered via metered-dose inhaler or small-volume nebulizer.

Metered-Dose Inhaler (MDI) Medications

Medications include Albuterol (Proventil, Ventolin), Albuterol/ipratropium (Combivent), Metaproterenol (Alupent, Metaprel), and Terbutaline (Brethine).

Small-Volume Nebulizer Medications

Medications typically administered include Albuterol, Metaproterenol, and Epinephrine.

Medical Control for Medication Administration

Consult medical control or follow standing orders. Report the medication, when the patient last self-administered a treatment, how much was used, and the labeled dosage.

Pre-Administration Checks for Patient Medication

Ensure the inhaler belongs to the patient, it contains the correct medication, the expiration date has not passed, and the correct dose is being administered. If the dose is not listed, ask the patient.

Administering Repeated Doses

Administer repeated doses if the maximum dose has not been exceeded and the patient is still experiencing shortness of breath.

Small-Volume Nebulizer Setup

A small-volume nebulizer must be assembled prior to use and requires an oxygen tank to administer the aerosolized medication.

Indications for MDI and Nebulizer

The most common use for an MDI is asthma. A small-volume nebulizer is typically used for asthma, bronchiolitis, COPD, and anaphylaxis.

Contraindications for MDI and Nebulizer Use

Contraindications include the patient being unable to coordinate inhalation, too confused, in respiratory failure with minimal air movement, the device is not prescribed for the patient, no permission from medical control, maximum dose already taken, or expired medication.

Action of Respiratory Inhalation Medications

They relax the muscles surrounding the air passages, leading to dilation of the airways and easier movement of air.

Acute vs. Chronic Respiratory Medications

Medications for acute symptoms provide rapid relief if the condition is reversible. Medications for long-term use are preventive and provide little relief for acute symptoms.

Side Effects of Inhalers

Common side effects include increased pulse rate, nervousness, muscle tremors, and coughing as airways open and secretions loosen.

Dose and Route for Inhalers

Medication is delivered through the respiratory tract. The dose is one puff for an MDI and continuation of the nebulizer until all medication is administered or the patient no longer needs it.