breathing treatments

aerosol drug delivery devices

metered dose inhalers, dry powder inhalers, nebulizers

metered dose inhaler

uses propellant to deliver medication, should use spacer

MDI advantages

portable, multidose delivery capability, lower risk of contamination

MDI disadvantages

need for correct actuation and inhalation coordination, oropharyngeal drug deposition (thrush)

DPIs

breath actuated device that delivers the drug in the form of particles contained in a capsule or blister that is punctured before use

DPI advantages

breath actuated, no spacer, no holding breath, portable, no propellant

DPI disadvantages

adequate inspiratory flow required for medication delivery, may result in high pharyngeal deposition, humidity can cause powder to clump

nebulizers

transform solutions or suspensions of medications into aerosols that are optimal for deposition in lower airway

nebulizer advantages

provide therapy for pts who cannot use other methods, allow administration of large doses of medicine, no patient coordination

nebulizer disadvantages

not portable, longer setup and administration, higher cost, may need compressed air/O2

how to administer nebulized meds

put med in cup and close, attach cup to mask, activate pressure source, tell patient to breathe normally