China
Africa
Explore chapters and articles related to this topic
Medicines management
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Kirsty Andrews, Martina O’Brien
The nebulised route is the passage of medication directly to the bronchioles, as with inhalers, but by vapourising the particles in a stream of air or oxygen. Nebulised particles are much smaller in diameter than inhaled particles (British Thoracic Society/Scottish Intercollegiate Guidelines Network [BTS/SIGN] 2019). Medication for nebulisers is normally supplied in solution in single-use plastic sealed containers called nebules. As with inhalers, the most common drugs given by nebuliser are bronchodilators and steroids (NICE 2019b).
Overview of the delivery technologies for inhalation aerosols
Published in Anthony J. Hickey, Heidi M. Mansour, Inhalation Aerosols, 2019
Daniel F. Moraga-Espinoza, Ashlee D. Brunaugh, Silvia Ferrati, Lara A. Heersema, Matthew J. Herpin, Patricia P. Martins, Hairui Zhang, Hugh D.C. Smyth
The design of this type of nebulizer allows devices to sense the respiratory pattern of patients and deliver aerosol only during the inhalation process. For example, AeroEclipse II® has a breath-actuated valve that can move up and down to trigger the delivery of drug aerosol. When patients exhale, the valve is closed, resulting in no generation or delivery of drug aerosol, which significantly decreases the loss of drug to the environment. In addition, both the breath-enhanced and breath-actuated nebulizers enhance efficiency of delivery of aerosol and reduce nebulization time compared with other jet nebulizers (97).
Nanosuspensions as Nanomedicine: Current Status and Future Prospects
Published in Debarshi Kar Mahapatra, Sanjay Kumar Bharti, Medicinal Chemistry with Pharmaceutical Product Development, 2019
Shobha Ubgade, Vaishali Kilor, Abhay Ittadwar, Alok Ubgade
Nanosuspensions may prove to be an ideal approach for delivering drugs that exhibit poor pulmonary absorption. Current formulations like suspension aerosols, inhalers shows a limited diffusion and dissolution of the drug at the site of action because of its poor solubility and microparticulate nature, which may affect the bioavailability of the drug, rapid clearance of the drug from the lungs because of ciliary movements [148], less residence time for the drugs, leading to absence of prolonged effect, unwanted deposition of the drug particles in pharynx and mouth. Nanosuspensions can solve the problems associated with conventional systems because of their versatile nature. The nanoparticulate nature of the drug allows the rapid diffusion and dissolution of the drug at the site of action. At the same time, the increased adhesiveness of the drug to mucosal surfaces [149] offers a prolonged residence time for the drug at the absorption site. They prevent unwanted deposition of particles in the mouth and pharynx, leading to decreased local and systemic side effects of the drug. Nanosuspensions could be used in all available types of nebulizer. However, the extent of influence exerted by the nebulizer type as well as the nebulization process on the particle size of nanosuspensions should be ascertained.
Small airways targeted treatment with smart nebulizer technology could improve severe asthma in children: a retrospective analysis
Published in Journal of Asthma, 2022
Wytse B. van den Bosch,, Sanne F. Kloosterman,, Eleni-Rosalina Andrinopoulou,, Rients Greidanus,, Mariëlle W. H. Pijnenburg,, Harm A. W. M. Tiddens,, Hettie M. Janssens,
In adults with oral corticosteroid (OCS)-dependent asthma and in children with cystic fibrosis, small airways targeted treatment with smart nebulizer technology (e.g. Akita®Jet) has proved to be highly effective (20,21). A pilot study in children with mild asthma showed a slightly higher increase in asthma control and lung function in patients using the Akita® Jet in comparison to a conventional nebulizer (22). However, to date, there is little experience in clinical practice on the use of smart nebulizer technology for treatment of SA in children. At the Erasmus MC—Sophia Children’s Hospital, we started treatment with high dose ICS using the Akita® jet nebulizer in children with SA who had uncontrolled asthma despite step 4 or 5 treatment according to Global Initiative for Asthma (GINA) guidelines (23), as a ‘last resort’ treatment before starting OCS maintenance treatment. We performed a retrospective study in this group to examine the effects of small airways targeted treatment with the Akita® jet nebulizer at population level. We hypothesized that high-dose ICS treatment targeted to the small airways would decrease exacerbations rate, decrease number of hospital admissions and would improve small airways function measured using spirometry.
Continuous infusion aerosol delivery of prostacyclins during mechanical ventilation: challenges, limitations, and recent advances
Published in Expert Opinion on Drug Delivery, 2022
Michael McPeck, Gerald C. Smaldone
Contemporary continuous infusion aerosol delivery during mechanical ventilation is a technologically complex procedure employing specialized equipment [5]. The nebulizer is replenished continuously by a calibrated infusion pump and delivers its aerosol output into the heated and humidified ventilator circuit in a manner that enables a portion of the nebulizer output to be inhaled by the patient. The portion of aerosol drug inhaled is termed Inhaled Mass, IM, and is expressed as the percentage of drug mass delivered to the nebulizer with respect to time. Traditionally, drug dose delivered in this manner may also be expressed as the actual drug mass (in mg or µg) delivered during a specific time. However, also expressing it as a percentage of the volume infused into the nebulizer provides a measure of the efficiency of the complete drug delivery system.
Estimating the impact of self-management education, influenza vaccines, nebulizers, and spacers on health utilization and expenditures for Medicaid-enrolled children with asthma
Published in Journal of Asthma, 2021
Melike Yildirim, Paul Griffin, Pinar Keskinocak, Jean C. O’Connor, Julie L. Swann
A nebulizer is a device to deliver liquid medication to the lungs accurately, and spacers are recommended to use with inhalers to provide a required amount of medication, especially by children who have difficulty inhaling correctly. Proper usage of medications and required dose leads to a better response (8). Two types of medications (controllers and relievers) are commonly used for asthma treatments. Relievers work on acute symptoms and provide quick relief, whereas controller medications are used regularly to prevent asthma attacks. Improving adherence to asthma medications and devices can reduce the utilization cost of visits due to fewer ED visits and hospitalizations (9). For patients whose asthma remains uncontrolled despite medical management, AS-ME helps patients manage asthma triggers and symptoms and reduce asthma exacerbation (10). Patients with asthma have an increased risk of severe symptoms with influenza. Flu vaccines can decrease the risk of asthma attacks, which is triggered by flu infection (11). Although clinical guidelines have recommended AS-ME and prescription of a spacer with an inhaler (7), they are not widely implemented, and their net benefits are uncertain.