How various lung pathology are treated using inhalation therapy is explained properly all the procedures drugs etc has been given in details

2. INTRODUCTION
Inhalation is the process of entry of air into the
alveoli through the airway from the external
environment.
Today, inhalation represents the route of choice for
the delivery of drugs to treat various respiratory
disorders.
With this therapy, drugs are delivered directly to
the site of action of the lungs for localized effect
at lower doses for getting a rapid response with
fewer adverse effects compared to systemic
administration of the same agent.

3. DEFINITION
Inhalation therapies are a group of respiratory
treatments designed to help restore or improve
breathing function in patients with a variety of
disease.

4. Anatomy of Respiratory System

16. TYPES OF INHALATIONS
1.Moist/ wet inhalation-
 Steam inhalation
 Nebulization
2.Metered dose inhaler
3.Dry inhalation-Aerosol inhalers

17. PARTICLE SIZE
 <1 micrometer reach upto the alveoli
 0.5-5 micrometer beyond the 10th generation of
bronchi
 >5 micrometer oropharynx

18. INHALANT DRUGS
 Antiallergic agents- budesonide (glucocorticoids)
 Bronchodilaters- Salbutamol (beta-2 agonist)
 Anaesthetics- opioids
 Mucolytic agents- Acetylcysteine
 Antimicrobials- tobramycin (antibacterial)
pentamidine(antifungal)

19. STEAM INHALATION
 Deep breathing of warm and moist air(vapour)
into the lungs for local effect on the air passage or
for a systemic effect.

21. PURPOSE-
 To relieve inflammation and congestion of the
mucous membranes of respiratory tract and
paranasal sinuses.
 To soften thick tenacious mucous
 To prevent dryness of the mucous membrane
following tracheostomy.
 To relieve spastic conditions of larynx and
bronchi.
 To provide antiseptic action on the respiratory
tract.

22. INDICATIONS-
 Sinusitis
 Edema of larynx
 Thick mucous in the chest
 Whooping cough
 Acute bronchitis
 After tracheostomy
 Spasm of mucous membrane of larynx

23. CONTRAINDICATIONS-
 Carcinoma of lungs
 Very young and very old patients
 High fever patients
 Patients with severe headache

24. DRUGS USED
 Eucalyptus 2 ml per 500 ml of boiling
water
 Methyl salicylate few drops per 500ml of
boiling water
 Menthol few crystals per 500 ml of
boiling water

25. ARTICLES
 TRAY containing-
a. Towel
b. Nelson’s inhaler
c. Sputum cup with antiseptic solution
d. Inhaler mouthpiece
e. gauze piece
f. Cotton balls
g. Ounce glass
h. Face towel
i. Kidney tray
 Cardiac table
 Pillows
 Medication if ordered
 Boiling water (160 F)

26. PROCEDURE
 Explain procedure
 Screen the patient
 Auscultate patients lung fields
 Place him in a sitting position
 Cover the patient with a blanket to avoid chills
or drought
 Bring the prepared inhaler to bed side
 Place the inhaler on the cardiac table
 Instruct the patient to inhale by mouth &
exhale through the nose for 15-20 minutes

27.  Keep a sputum cup & face towel near patient
 Remove the inhaler, keep the patient in a
comfortable position & well covered for an
hour
 Wash the mouth piece of the inhaler with a
swab & running water
 Replace all the articles & record it.

28. POINTS TO REMEMBER
 Avoid spilling & prevent scalding the
patient
 Never leave babies or a helpless patient
along with inhaler
 Check the inhaler & mouth piece for
cracks & leakages before use
 Give treatment regularly as ordered

29. NEBULIZATION
Means of administering drugs by inhalation.
The equalizer breaks the solution to be inhaled into
fine droplets which are then suspended in a steam
of gas and the patient actively inhales this gas
steam containing the drug.

32. FOR TRACHEOSTOMY PATIENT

33. SWIVEL CONNECTOR

34. T - PIECE CONNECTOR

35. FOR VENTILATOR PATIENT

38. Respules
 Levolin- levosalbutamol inhalation solution
 Budecort-Budesonide
 Asthalin- salbutamol
 Ipravent- ipratropium bromide
 Duolin/Iprazest-Levosalbutamol and ipratropium
bromide respirator solution

40. PURPOSE
 Delivery of bronchodilators in patients with acute
asthma attack and dyspnoea.
 Administration of antibiotics and antifungal
agents.
 To aid in expectoration
 Local analgesia to relieve dyspnoea in terminally
ill pts.

41. Types of nebulizer
 Jet nebulizer-

43.  Ultrasonic nebulizer

44.  Ultrazonic nebulizer is a humidifier using high
frequency electricity to power a transducer and
divides water up into 0.5-3 mcm particles in its
nebulizing chamber used in inhalation therapy
 The use of this ultrazonic nebulizer benefits the
user because the medicated water mist can be
deposited deep inside the respiratory tract,which
achieves more effective treatment of asthma and
other respiratory ailments

45. ARTICLES
 Air compressor
 Connecting tube
 Nebulizer
 Medication and saline solution
 Sterile water
 Cotton balls
 Sputum cup with disinfectant
 Kidney tray

46. PROCEDURE
 Identify the patient
 Monitor heart rate before & after the treatment
for patients using bronchodilator drugs
 Explain procedure to the patient
 Place the patient in semi fowlers position
 Add the prescribed medication or saline or sterile
water to the nebulizer
 Place mask on patients face to cover his mouth &
nose & instruct him to inhale deeply & slowly
through mouth , hold breath & then exhale
several times

47. Continue…………..
 Observe expansion of chest to ascertain that
patient is taking deep breaths
 Instruct the patient to breathe slowly & deeply
until all the medication is nebulized
 On completion of the treatment encourage the
patient to cough after several deep breaths and for
facilitating cough chest physiotherapy can be
done
 Observe patient for any adverse reactions

48. Continue….
 Record medication used and descriptios of
secretions expectorated
 Disassemble and clear nebulizer after each
use,keep the equipment in patients room.the
tubing is changed every 24 hours
 Wash hands
 Special consideration ; if indicated provide
nebulization using oxygen source

49. Care And Maintenance Of Nebulizer
 Nebulizer should be cleaned using warm water .
 Soak the device mouthpiece or mask in warm
soapy water for minimum 5 mins.
 Rinse thoroughly (using boiled then cooled
water)and allow parts to dry
 Should be done atleast once daily
 Nebulizer must be replaced every 6 months to
ensure optimum functioning and decrease
chances of colonization.

50. METERED – DOSE INHALERS
Definition : Process by which the
patient inhales a specific or
premeasured dose of aerosol
medication by means of an inhaler

51.  A liquid propellant
 A metering valve that
dispenses a constant
volume of a solution
in the propellant
 Dose of inhalation
will involve > 1 puff
 The length of time
between inhalation is
15 -20 seconds

53. PURPOSES
 To relieve inflammation and congestion
of mucous membrane
 To improve clearance of pulmonary
secretions
 To act as a bronchodilator and mucolytic
agent

54. ARTICLES
MDI (METERED DOSE
INHALER
Facial tissues

55. PROCEDURE
Identify the patient
Assess the patients ability to hold and
manipulate inhaler
Instruct the patient to be in a
comfortable environment by sitting in
a chair
Explain to the patient & demonstrate to
the patient how to use this

56.  Remove cap & hold inhaler upright, grasping
it with thumb and first two fingers
 Shake inhaler
 Tilt head back slightly and breath out
 Position inhaler.
 hold the inhaler .5-1 inch / attach spacer to
mouthpiece of inhaler /place the mouthpiece
or spacer in mouth

57. Continue………..
 Press down on inhaler to release medication
while inhaling slowly
 Breath in slowly for 2-3 seconds
 Hold breath for approximately for 10 seconds
 Repeat puffs as ordered, waiting 1 minute
between puffs

58. Procedure continues………
 If two inhaled medications are prescribed wait 5-
10minutes between inhalations as ordered by
physician
 Explain patient may feel gagging sensation in
throat caused by droplets of medication on
pharynx or tongue
 Instruct patient in removing medication canister
and cleaning inhaler in warm water

62. Cleansing and maintenance
 It is essential to keep plastic mouthpiece clean to
ensure proper functioning of inhaler. Clean the
inhaler at least once in a week as follows-
1. Gently pull the metal canister out of the plastic body
of the inhaler. Remove the mouthpiece cover.
2. Immerse the plastic body and the mouthpiece cover
in warm water. Do not put the metal cannister in the
water.
3. Next, wash the plastic body and mouthpiece cover in
running tape water.
4. Shake well to remove excess water. Leave to dry.
Avoid the use of heat to dry the parts.
5. When the plastic body is dry replace the canister an
the mouthpiece cover correctly.

63. SPECIAL CONSIDERATIONS
Gargle with plain water after steroid
inhalations to reduce chances of
infections
Do not put inhaler in water.
The metal cannister is pressurized so
do not puncture or burn it even when
empty.
Keep away from eyes.
Keep away from children.

65. DRY POWDER INHALER
 No propellant
 Breath activated and patient coordination is not
an important issue
 The drug is formulated in a filler and contained in
a capsule that is placed in the device and
punctured to release the powder