Association for Respiratory Care Supported by an ...

1 Produced by the American Association for Respiratory CareCopyright 2010 by the American Association for Respiratory CareSupported by an educational grant from Philips RespironicsMedication delivery, with few exceptions, is oftentaken for granted by many health care providers,patients, and health care delivery systems most instances this is understandable and notproblematic. However, a notable exception exists inthe treatment of pulmonary patients. Throughoutmedicine, no medication delivery is as challenging, confusing, and in many instances routes of medication delivery include oralpills or capsules, injection, intravenous, topical, andaerosol inhalation. Only one of the foregoing routesrequires expertise by all attending physician must be knowledgeable,not only about the medication but also how to matchthe appropriate delivery device with each patient sabilities.

2 Other health care professionals such as Respiratory therapists and nurses must also have profound insight into the characteristics of the medication as well as the technical limitations andabilities of the wide variety of different aerosol delivery devices. We must always be aware of the onesize fits all approach to aerosol therapy whichactually fits no one. These professionals must tailorthe medication and delivery device to each and everypatient. And most importantly, our patients mustbecome skilled in the appropriate use and techniqueof their aerosol delivery devices. All patients shouldknow what their medications can do for them, whatthe risks are, and how to use them in their own surrounding aerosol delivery continue togrow with the increasing variety of aerosol deliverydevices.

3 Many medications are available in only onedelivery device, but this device may not be a good fitfor certain patients even though the medication available through the device is optimum for medications are only available through dry-powder inhalers, while others are liquid and canbe made available through small-volume others use metered-dose inhalers, which can varyfrom medication brand to medication brand sincestandardization has not been set in this area. How dowe sort through these issues? By educating all players,that s , over the last several years we haveavailable a growing list of outstanding aerosol medications. They not only help lessen symptoms ofpulmonary disorders but also help control thosesymptoms and promote a higher Respiratory quality oflife for our patients.

4 That s the pay-off for you!In order to take full advantage of this tremendousresource, it is imperative that patients and their families who help them thoroughly understand theart and science of aerosol delivery. This booklet isdesigned to take much of the mystery out of aerosol delivery for patients and loved ones. The AmericanAssociation for Respiratory care is committed toimproving effectiveness of aerosol delivery and thusimproving the health status of the tens of millions ofpatients who suffer from Respiratory , this booklet is designed for you in order tohelp you help yourself and make fewer trips to the doctor or care professionals may know what medications are indicated.

5 They may also know howto select and match the appropriate delivery devicewith the patient after assessing the patient s abilitiesand capabilities. But, health care professionals cannottake the treatment for you. We can deliver other medications via the routes I mentioned previously, butwe cannot always assure effective aerosol deliverybecause the patients are in the driver s seat whenwe aren t around to help. It is these patients whomust understand the appropriate technique to optimize the effect of the medications ordered regardless of whether they are controller medications or symptom-relievers. Far too manypatients are given the right order with the rightaerosol device but are not able to capitalize on thistremendous asset because they simply don t knowenough about the operation of the device or thebreathing techniques they ll have to use to get themost out of their American Association for Respiratory care ( and ) hascreated this education resource to help you overcomethis challenge.

6 This booklet was written for you notdoctors, nurses, or Respiratory therapists, but for youand your family members. We want to empower youwith knowledge so that you can control your treatment and improve your Respiratory health carestatus. Many patient reviewers have found the bookletto be user friendly. We hope you do, too. Please feelfree to share this resource with family and Giordano, MBA, RRT, FAARCE xecutive Director/CEOA merican Association for Respiratory CareForewordTable of ContentsTable of ContentsPageIntroduction .. 3 ..1. Aerosol Drug Delivery: The Basics .. 4 2. Aerosol Drugs: The Major Categories ..123. Aerosol Drug Delivery Devices: Small-Volume Nebulizers.

7 174. Aerosol Drug Delivery Devices: Inhalers .. 245. Aerosol Drug Delivery Devices: Pressurized Metered-Dose Inhalers .. 266. Aerosol Drug Delivery Devices: Dry-Powder Inhalers .. 377. Aerosol Drug Delivery Devices: Special Applications .. 468. Aerosol Drug Delivery: Maintenance and Problem Solving .. 49A Patient s Guide to Aerosol Drug DeliveryAmerican Association for Respiratory care 1 I like the Patient s Guide to Aerosol Drug Delivery and think that it is going to be very helpful not onlyto patients but to medical professionals as good job. Vlady Rozenbaum, PhDFounder-AdministratorCOPD-ALERT My first reaction was who is going to read 50-pluspages?

8 After reading it my reaction is: Where wasthis when I was first given an inhaler with noinstructions. Kenneth BensonPatientQuotesAcknowledgementsThe American Association for Respiratory care would like to formally thank and acknowledge the following individuals for theirreview of A Patient s Guide to Aerosol Drug Delivery. Their uniqueknowledge of the cardiopulmonary patient, their disease process,and aerosol delivery devices were invaluable in the writing andpublication of this B. Op t Holt, EdD, RRT, AE-C, FAARCK aren Gregory, MS, APRN-BC, CNS, RRT, AE-CIntroductionPerhaps the shortness of breath, coughing, excessive phlegm, chest tightness and/or difficulty in catching your breath that you ve been experiencing has recently been diagnosed as an obstructive airway good news is that your physician, Respiratory therapist, or nurse professional provided you with a brief description of your condition explained what it is, the causes, and the treatment options.

9 He/she also probably recommended that you start taking regular breathing ve probably already had a few treatments and find that they make yourbreathing easier. You may also have learned by now that taking control ofyour obstructive airway disease is the only way to improve your health to thepoint where you can do all the things you need and want to do. You may alsoknow that controlling your condition will involve understanding as much aspossible about these breathing you no doubt still have a lot of questions: What is an aerosol? What arethese breathing devices? Why do I have to use them? What s in them? And,how do they work? These are just a few of the questions that this PatientGuide will help address.

10 It is written in language easy to understand and in aconversational style that s easy to Patient Guide was prepared for you by the American Association forRespiratory care (AARC), a professional organization of over 50,000 Respiratory therapists who are competent, caring, and compassionate individuals dedicated to the detection and treatment of lung therapists (RRTs) are at the front lines in the care of patients withasthma, bronchitis, emphysema, chronic obstructive pulmonary disease(COPD), and many other Respiratory diseases. They are committed to helpingyou control your condition. We hope you will find our Patient Guide a valuableresource to help you understand basic aerosol drug delivery for better symptom is important to note that this Patient Guide is nota substitute for medical information or treatment options provided by your physician.