Inhalation therapy, Aerosol, Rotahaler, Spinhalers, Spacer, Nebulizer & types of nebulizer

 The inhalation therapy is used to break up the mucus and to induce the relaxation in bronchial smooth muscle by using the bronchodilators
This is done by:- 
  • Aerosol
  • Nebulizer
These both can be given during intermittent positive pressure breathing  or steam inhalation.
 
Aerosol:- 
This is the hand held device and commonly used. The patient should be trained the correct method of use of the inhalers to prevent the loss of the drug to the atmosphere. The correct technique of use of aerosol ensures the patient the maximum amount of the drugs ethers the lung. 
The effectiveness of the drug can be endured by correct release. Usually only 10% of the drug reaches the bronchi and 90% of the drug is swallowed. So drug should be released at the beginning of the inspiration to ensure maximum amount of the drugs reaches the bronchi instruct the patient to hold the breathe for about 10sec and expire quietly through the nose. The patient should take a gap of one minute before starting with the next inspiration. Few parents will be on both bronchodilators and steroid therapy used aerosols. Then the bronchodilators should be administered first so that airways get dilated. Give a gap of use 15-20 minutes then steroid therapy can be started depending upon the type of the drug used. 
Rotahaler:- 
The patient should be well trained how to handle the Rotahaler properly. Initially the capsule should be inserted. The coloured end of the capsule is inserted first and twist the Rotahaler so that the capsule will be broken and inhale deeply to get the powder into the major airways. The patient is asked to breathe several times to inhale the drug completely. 


Other types of Inhaling devices:-
  • Spinhalers:- This is the device advised for the children and the use is similar to the rotahaler. 
  • Spacer:- For patient who can't inspire because of actuator in the aerosol. So the patient puts the mouth piece and depresses the actuator and inhales the drug. 
  • Nebulizer:- This is a aerosol the mouth piece is kept when ever the drug is required this depresses the actuator and drug is released. 
Nebulizer:- 
This is the other device for inhalation therapy where the drug is broken into the fine particles to enhance the inhalation. It is administered by compressed oxygen or air. The patient position should be relaxed and comfortable with well supported by the pillows. The patient has a choice of using either face mask for the young patients or disabled breathless patients and mouth piece for the patients who can hold the mouth piece with the lips to deliver the drug. The drug inhalation takes 10-15 minutes during this period the patient is asked to relax breathing followed by 1 or 2 deep breaths. This causes drug penetration into the airways. 
The bronchodilator should be diluted. The solution of 4 ml saline is used to make the drug mild form. If still diluted solution is required then 1ml salbutamol, 3 ml saline pr 2 ml saline and 2 ml ipratropium bromide is used. 
Types of Nebulizer:- 
  • In one types of Nebulizer the steam of gas is passed through a hole creates a low pressure. This is passed through the tube where other end is immersed in bronchodilator solution. The liquid passes through the tube and get split into the small pieces and Nebulizer is ready for use. 
  • Nebulizer with piezoelectric effects:- This liquid is moved by a vibrating crystal. This type of Nebulizer is used for home purpose. This delivers high humidity for patients with thick sputum to aid expectoration. 

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