Even the doctors of the ancient world knew that it helps patients with respiratory problems to inhale medically effective substances. In modern medicine, inhalation with an aerosol device is considered to be a common form of therapy. All inhalation devices work on the same principle.

What is the aerosol therapy?

In aerosol therapy, the patient inhales liquid or solid drug particles that are typically expelled from a device. To reach the lower respiratory tract, the particles must be smaller than 10 microns.

In aerosol therapy, the patient inhales liquid or solid drug particles that are expelled in a typical manner. To reach the lower respiratory tract, the particles must be smaller than 10 microns. However, the alveoli only reach particles smaller than 3 microns. These values ​​apply to patients with a healthy lung. Lung lots that are not properly perfused, as is the case with some lung diseases, generally can not be effectively treated by the drug.

In order to achieve an optimal effect, the drug should possibly reach the respiratory tract in the whole dose. How it is distributed in the patient's respiratory system depends on several factors: the size, shape, density and electrical charge of the particles, and the patient's typical breathing patterns (respiratory flow and breath-to-volume) determine how the medication will arrive. In addition, the aerosol should also be tailored to the individual nature of the patient's lungs and other respiratory organs.

The aerosol therapy offers many benefits to those affected: In cases of acute respiratory distress, the emergency ingredient immediately reaches where it needs to help. The larger absorption surface ensures faster effectiveness. In addition, the user of an aerosol therapy requires only about 10% of the otherwise required dose, which further reduces possible side effects.

Function, effect & goals

The drug delivered with the aerosol is used for the local and systemic treatment of respiratory diseases associated with hypersecretion, secretion retention, with edema and inflammation of the mucosa or with spasms of the bronchial musculature. Most of the drugs used are glucocorticoids, beta-2 sympathomimetics and antibiotics. Aerosol therapy is indicated for bronchial asthma, acute and chronic bronchitis, COPD (chronic obstructive pulmonary disease) and cystic fibrosis.

Since there are four different aerosol application systems, and each of them has strengths as well as weaknesses, the prescribing physician should be sure to tailor the system to the specific needs of his patient. Two of the systems are additionally suitable for use on the move (metered aerosols with propellant gas and powder aerosols). The other two (jets and ultrasonic nebulizers) can only be used at the patient's home. Dosing inhalers (MDI) are usually prescribed as an emergency drug for asthma and COPD. With them, the drug is sprayed via a propellant into the respiratory tract. The inhalation system has the disadvantage that about 10% of the dose is lost for technical reasons. In addition, usually 50% of the active ingredient remain in the mouth and can not be inhaled.

Powder inhalers (DPI) are similarly effective as MDI aerosols. The prerequisite for this is that the patient has a respiratory flow volume of at least 30, better still 60 liters per minute. Nebulizer systems are optimal for patients with poor lung function. There are Nozzle Nebulizers and Ultrasonic Nebulizers. In the case of the nozzle nebulisers, the ejection of the drug solution or suspension takes place via a nozzle at the end of the mouthpiece. In it, the flow rate is reduced so that the patient receives more active ingredient per single dose.

Nebulizers are easier to use because the patient does not need to use special breathing techniques and the drugs are better distributed in the lungs. Even with the nebulizers, the patient has to close the mouthpiece tightly with his lips. He also has to hold the breath mask during use. In ultrasonic nebulizers, the distribution of the drug takes place via ultrasound.

Risks, side effects & dangers

The aerosol therapy does not show any side effects if used correctly, unless the medication prescribed by the doctor is not tolerated by the patient or the dose is too high. Infants and toddlers may occasionally experience screaming or crying. As long as he is so excited, you should not perform the application.

If the child refuses the mask, the treating parent keeps it about 1 cm away from his mouth and nose. Childlike patients need nebulizers that spray very small drops. For children under 3 years MDIs and nebulizers (both with mask) are well suited, from 3 years you can use a spacer with mouthpiece. Patients between 3 and 6 years use nebulizer with mouthpiece. For children older than 6 years, the doctor may prescribe dry powder inhalers. It is important that the little patients eat or drink something after each use, so that it does not come to Kortikoid or antibiotic deposits in the mouth. For larger children and adult patients, it is enough to rinse their mouth immediately afterwards.

It is also recommended to wash your face after inhalation. When dealing with nebulisers a lot of hygiene is required. This applies to the solution to be produced by the patient as well as to the device itself. After each use, any remaining solution must be disposed of in the container. Thereafter, all parts of the nebulizer should be thoroughly cleaned. He also needs to be disinfected once a day. All parts except the hose should be air dried and reassembled only when completely dry.

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