Aerosol Drug Administration Health Article

Procedure for inhalation from hand-held devices

• Again, there are many devices available that operate in different manners. A detailed description of each, however, is beyond the scope of this guide.
• For effective delivery of drug from these type of devices, it is essential that the medication is prepared properly, using the instructions supplied with the device.
• Once the medication has been prepared, the recipient must hold his or her lips one to two inches (3-5 cm) from the open mouth. The patient needs to breathe in deeply (powdered-drug-type devices), or breathe in deeply while depressing the canister (for canister/barrel type devices); this will allow the drug to be inhaled deeply into the airways and lung tissue.
• Positive responses should be observed or measured by the nurse.
• All data, as appropriate, must be recorded by the nurse. If treatment is note effective, further advice or orders should be sought.

Preparation

Generally, there are no specific pretreatment procedures, except for the set-up of equipment used for the procedure. The recipient generally requires no personal preparation in common use of this procedure.

Aftercare

Recipients should be monitored for signs of positive response to the drug. It is important to rinse the mouth following inhalation therapy, as drug residue can remain in the mouth and cause oral problems and tooth decay in some instances.

Complications

Complications are almost always related to the type of drug being delivered. Complications may also arise due to drug overdose. It is important in a hospital or clinic emergency environment, particularly with asthma sufferers, that the health care provider assess how much, and what type of medication, has been administered prior to the patient's arrival in the emergency department, to avoid such complications.

Anticipated outcome for symptom-relieving drugs

In a lung or breathing condition, the desired outcome from symptom-relieving aerosol drugs is a complete cessation of such symptoms or at least an improvement in symptoms following completion of the treatment. Failure to relieve symptoms indicates ineffective drug delivery, incorrect drug choice or strength, or deterioration of the patient's condition.

Anticipated outcome for preventive drugs

While more difficult to measure (as effects can be both short- or long-term), the goal of using preventive medications via this specific delivery route is to prevent or reduce presentation of symptoms. A reduction in the occurrence of symptoms, or a complete cessation of associated symptoms, indicates a successful preventive treatment regime.

Health care team roles

The health care team roles for successful treatment include:

• All equipment used in the procedure should be maintained and used according to the manufacturers' specifications.
• All treatment options must be explained to the patient.
• The recipient should be monitored during delivery of inhalation therapy.
• All events and observations for the procedure should be recorded.
• The recipient must be educated in all aspects of his or her condition, including the reasons for the use of specific treatments and drugs.

BOOKS

Potter, Patricia, and Anne Perry. Fundamentals of Nursing. Mosby, 2001.

"Primatene Mist." In PDR Nonprescription Drug Reference. Montvale, NJ: Medical Economics, 2001.

OTHER

"Bronchodilators, Adrenergic (Inhalation)." In United States Pharmacopeia Dispensing Information. Rockville, MD: Micromedex, 2000. <http://my.webmd.com/content/asset/uspdi.202095>.

"Medication and Delivery System Options for Asthma and Allergy Are Expanding." Asthma and Allergy Foundation of America. <http://www.aafa.org/asthmaandallergyinformation/aboutasthmaandallergies/articlesofinterest/Medication_Delivery.cfm>.

Dean Andrew Bielanowski, R.N., B.Nurs(QUT)