Chapter 16. Inhalation Medications

• • Administration of medication to the lungs.

Absolute

• • Allergic reaction to medication.

Relative

• • Anatomic abnormalities that cause increasing symptoms with treatment.

• • Nebulizer and compressor.

  • Metered-dose inhaler with spacer.

  • Dry powder inhaler (Figure 16–1).

• • Bronchoconstriction secondary to preservative (most solutions are now preservative free).

  • Tachycardia.

  • Arrhythmia (supraventricular tachycardia).

  • Agitation.

  • Oral candidiasis.

• • If used correctly, each method of delivery of inhalation medications is equally effective.

• • When using a nebulizer, when mist starts sputtering, tapping on cup allows for aerosolization of remainder of medicine.

  • Effective administration involves transport of medication to the lower airways.

  • The medication must be aerosolized and inhaled to facilitate delivery.

  • Ineffective aerosolization as well as improper technique may result in disposition of medication onto the skin of the face or on the soft palate or posterior pharynx.

  • In some younger children, the use of a spacer with a mask may allow more effective delivery than a spacer with a mouthpiece.

• • Most children who require inhalation medication for wheezing will be stable.

  • Children with severe bronchospasm or hypoxia should be placed on a cardiac monitor and pulse oximeter. They should be allowed to sit in a position of comfort, preferably upright.

• • Sitting upright is preferred.

  • Young children should be held by their caregivers.

• • Effective administration involves transport of medication to the lower airways.

  • The medication must be aerosolized and inhaled to facilitate delivery.

  • Ineffective aerosolization as well as improper technique may result in disposition of medication onto the skin of the face, or on the soft palate or posterior pharynx.

Nebulizer

• • Provide power to the compressor of the nebulizer machine (electric or battery).

  • Attach oxygen tubing to the compressor and attach the nebulizer cup to the free end of the oxygen tubing.

  • Open the top of the nebulizer cup by twisting and lifting the cap, pour medication into the cup, and reattach the top.

  • Have patient put mouthpiece in mouth with seal made by lips, or if using mask, place it on patient’s face (Figure 16–2).

  • Turn the machine on.

  • Instruct the patient to take slow deep breaths until the mist stops.

Metered-Dose Inhaler and Spacer Device

• • Shake the inhaler.

  • Remove the cap and attach it to the spacer device.

  • Have the ...