INTRODUCTION
Inhalation therapy has played a pivotal role in the vistas of pulmonary drug delivery since
ancient times, as a way of relieving respiratory diseases. In this therapy, the active
pharmaceutical ingredients are administered directly to the site of action. Several classes of
drugs are available for inhalation, e.g. β2-agonist, corticosteroids, anticholinergic drugs etc.
Next to these antiasthamatic drugs, inhalation of antibiotics is frequently applied for patients
with cystic fibrosis. Nebulization is a common method of medical aerosol generation and it is
largely used by adults and children all over the world, particularly for asthma and chronic
obstructive pulmonary disease (COPD) [15]. The word “nebulizer” (from the Latin “nebula”,
mist) was first used in 1872 and was defined in 1874 as “an instrument for converting liquid
drugs into a wet mist.
Definition
Process of dispersing a liquid (medication) into microscopic particles and delivering into
lungs as patient inhales through the nebulizer.
It is used to liquefy and remove retained secretions from the respiratory tract.
Most aerosol medication have Broncho dilating effects and are administered by respiratory
therapy personnel.
Purposes
• To relieve respiratory insufficiency due to broncho spasm.
• To correct the underlying respiratory disorders responsible for broncho spasm.
• To liquefy and remove retained thick secretions
To reduce inflammatory and allergic responses of the upper respiratory tract.
• To correct humidify deficit resulting from inspired air by passing the airway during
the use of mechanical ventilation in critically and post-surgical patents.
• When a person has an acute asthma attack.
• When a person is in respiratory distress.
• If a person is unable to use an inhaler.
• If a person has stridor.
• Respiratory congestions.
• Pneumonia
• Atelectasis.
• Asthma
Types of nebulizer
• Inhaler or meterd-dose nebulizer
• Jet nebulizer
• Ultrasonic nebulizer
Functions
• A nebulizer is a device that uses a small compressor to convert liquid medication into tiny
droplets of mist that can be inhaled directly into the lungs.
• Since the medication goes straight to the lungs, onset of the medication’s action often takes
place rapidly.
• This promotes quick symptom relief in the case of illnesses such as asthma, where fast relief
is desirable
Also, it minimizes the risk of side effects of the medication, preventing the medication from
being metabolized into a less effective form by the body.
Equipments
• Nebulizer and nebulizer connecting tube.
• Mouthpiece/mask
• Respiratory medication to be administered.
• Normal saline solution.
• Sterile water
• Cotton balls
• Face mask
• Sputum mug with disinfectant
• Disposable tissues.
• Kidney tray
• Medication card
Procedure
• Identify patient and check physician’s instructions.
• Monitor heart rate before and after the treatment for patients using bronchodilator drugs.
• Explain the procedure to the patient. This therapy depends on the patient’s effort.
• Place the patient in a comfortable sitting or a semi fowlers position
• Add the prescribed amount of medications to the medicine chamber of the tubing. Connect
the
tube to the compressor. A fine mist from the device should be visible.
• Place the mask on patient’s face to cover his mouth and nose and instruct him to inhale
deeply
and slowly through mouth, hold breath and then exhale several times
• Observe expansion of chest to ascertain that patient is taking deep breaths.
• Instruct the patient to breath slowly and deeply until all the medications is nebulized.
• On completion of the treatment encourage the patient to cough after several deep breaths.
• On completion of the treatment encourage the patient to cough after several deep breaths.
• Document the medication used and the description of the secretions expectorated.
• Disassemble and clean nebulizer after each use. Keep the equipment in patient’s room.
Tubing’s to be changed in every 48 hours.
• Wash the hands.
After care
• Each time it is used, wash the nebulizer chamber in warm water or clean with a spirit swab
and then rinse thoroughly with clean water.
• Do not use a brush to clean the nebulizer chamber as it may damage it.
• Reconnect the nebulizer chamber to the tubing and blow air from it.
• This will dry the nebulizer chamber and tubing.
• Disconnect the nebulizer chamber from the tubing and allow it to dry completely.
• Disconnect the tubing from the compressor unit.
Side effects
• Dry or irritated throat, temporary or occasional cough
• Sneezing, stuffy or itchy nose, watery eyes.
• Burning or bleeding of your nose
• Nausea, heartburn, stomach pain.
• Urinating more or less than usual.
• Dizziness, drowsiness, headache.
• Unusual or unpleasant taste in your mouth.
Contraindications
In some cases, nebulization is restricted or avoided due to possible untoward results or rather
decreased effectiveness such as:
• Patients with unstable and increased blood pressure
• Individuals with cardiac irritability (may result to dysrhythmias)
• Persons with increased pulses
• Unconscious patients (inhalation may be done via mask but the therapeutic effect may be
significantly low)
Conclusion
Nebulization is a common procedure used for the management of patients with respiratory
distress.
Proper administration provides the best results. We have to look for the side effects and
contraindications also.
References
[1]N.T. Michael, Drug Delivery: Pulmonary Route In: S. James, Encyclopaedia of
Pharmaceutical Technology, 3rd Edition, Vol-2, New York, Informa Healthcare. 2007, 1279-
1286.
[2]S. Mukhopadhyay, M. Singh, JI. Cater, S. Ogston, M. Franklin, R.E. Olver, Thorax, 1996,
51, 364-368.
[3]D.J. Touw, R.W. Brimicombe, M.E. Hodson, H.G.M. Heijerman, W. Bakker, Eur. Respir.
J., 1995, 8, 1594- 1604. [
ASSIGNMENT ON NEBULIZATION
