Inhaled aerosol medication, that is given by respiratory therapist, need to be mixed with another medication for quicker time, less cost, or synergic effect.

1. COMPATIBILITY
By : HIND SALMAN AL-SUBGH
Supervisor : MAHER AL-QUAIMI
University of Dammam
College of Applied Medical Science
Respiratory Care Department
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2. OUTLINES
•Compound vs Mixture
•Compatibility
•Category of respiratory medications
•Physiological effects
•Some of the Most Common drugs in
respiratory therapy
•What should we mix + Studies
•Cases
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3. Compound vs Mixture
Compound
Mixture
A compound is a substance
for med when two or mor e
elements ar e chemically
joined.
Mix tures ar e two or more
substances that are mix ed
together but not chemically
joined.
can be broken down into a
simpler type of matter
(elements) by chemical
means
can be separated into its
components by physical
means
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4. compatibility
CHAMICAL
MEDICAL
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5. CHAMICAL
a measure of how stable
a Substance is when mixed
with another substance
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6. Page 6

7. MEDICAL
Two or mor e dr ugs can be
administer ed at the same time
without pr oducing undesir ed side
effects or without canceling or
affecting the ther apeutic effects of
the other s.
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8. The Category of
Respiratory Medications
Prescription drugs and medicines for
conditions and diseases relating to the lungs
and/or breathing are :
•Antihistamines
•Antitussives
•Bronchodilators
•Decongestants
•Expectorants
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9. Antihistamines
• Histamine is a body chemical that, when released in the
body, typically causes swelling and itching. Antihistamines
counteract these allergy symptoms by blocking the effects
of histamine and are used for mild respiratory allergies,
such as hay fever
•
Diphenhydramine
•
Meclizine
•
Scopolamine
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10. Antitussives
• Medications control coughs
• These preparations must be absorbed into
the blood, circulate through the system, and
then act on the brain.
• Codeine
• Dextromethorphan
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11. Expectorants
• used to change a dry nonproductive cough
into a productive one
• Mucolytics
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12. Decongestants
• Constrict blood vessels in the nose and sinuses to
open air passages
• Oral preparations
• Nose drops
• Nasal sprays
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13. Bronchodilators
• Agents that open airways in the lungs and medications
that relax smooth-muscle tissue (such as that found in the
lungs) are used to improve breathing
• Sympathomimetic
• Anticholinergic
• Corticosteroids
• Mast Cell Stabilizers
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14. Physiological effects
•
Adrenergic bronchodilators represent the largest group
of drugs among the aerosolized used for inhalation.
• Mode of Action and Effects:
 Alpha receptor stimulation
 Beta-1-receptor stimulation
 Beta-2-receptor stimulation
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15. Sympathomimetic
Beta-Agonists
Short acting
Long acting
Epinephrine
Racemic epinephrine
SABA
Ventolin
Proventil
LABA
Formoterol
Salmeterol
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16. Page 16

17. Anticholinergic
Block parasympathetic
receptors
influences (beta2 stimulation)
Spiriva
Ipratropium bromide
(Tiotropium)
(Atrovent)
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18. Corticosteroids
Anti- inflammatory agents
Prevent or reduce airway inflammation in
asthma
 Budesonide
( Pulmicort)
Dexamethasone
sodium phosphate
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19. Some of Most Common used drugs in
respiratory therapy
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20. Ventolin
What is Ventolin
HFA?
Before using
Ventolin!
How should I use
Ventolin?
Ventolin side
effects!
What other drugs
will affect Ventolin?
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21. Atrovent
What is Atrovent?
Before using
Atrovent!
How should I use
Atrovent?
What other drugs
will affect Atrovent?
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22. Symbicort
• An asthma controller medication combining two
drugs into one inhaler
• Polmicort (Budesonide)
• Foradil (formoterol)
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23. Advair
• Advair Diskus is a controller asthma medication
that combines two drugs into one inhaler.
• Flovent
• Salmetrol
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24. What can we mix?
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25. Studies
• Physical and chemical compatibility is one consideration
when determining the appropriateness of mixing
medications for nebulization.
• Several studies have investigated the compatibility of
nebulizer solutions, including antibiotics and bronchodilators.
• Studies of the efficacy and safety of mixing
nebulizer medications have been limited, and few inhalation
solutions are approved by (FDA) to be mixed.
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26. levalbuterol
acetylcysteine
sodium
cromolyn
sodium
ipratropium budesonide
bromide
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27. Page 27

28. cases
Cases
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29. RT has administered an aerosol TX of albuterol to
67-year-old COPD pt.
CC/ acute exacerbation & SOB
When the RT returns to the pt. informs him that he began to
feel very shaky and nervous , beginning about 30 min after
the TX. He also noticed a tremor when he held his water
cup.His HR during the earlier TX. Was 84 beats/min. After
the RT did the assessment every thing was normal and stable
although the auscultation reveals mild wheezing and mild
tremor is apparent when he holds his hand out. He states that
he is now feeling better and the ‘ shakiness’ has subsided a
bit.
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30. COPD pt. receiving regular TX. Of
ipratropium bromide who require
additional bronchodilation for relief of
airflow obstruction.
Q: What do you think is the other appropriate
Bronchodilator for him?
And why did you choice it?
Albuterol
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31. 21-year male Pt. came to the ER
with a sever allergic reaction of
seafoods he was gasping for air.
Q : what would be the appropriate Tx. For him ?
Epinephrine injection
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32. Proventil
Corticosteroid
Flovent
Salmetrol
Foradil
Atrovent
Pulmicort
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33. HFA referring to…?
Propellant
“Hydrofluoroalkane”
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34. Can you tell us about your
experience in the 1st clinical practice
and what did you feel at that time
and how did you improve your self?!
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35. THaNK YOU
all
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36. Resources
-EGAN’S FUNDAMENTALS OF
RESPIRATORY CARE(TEXTBOOK)
HTTP://WWW.CDC.GOV/
HTTP://WWW.RCJOURNAL.COM/CPGS/INDEX.CFM
HTTP://WWW.DRUGS.COM/
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