Ways to Administer Respiratory Medications (Nursing)

00:00 Hi! and welcome to one of our videos on respiratory medications.

00:05 We're gonna talk about the unique ways that you have options to give patients respiratory medications.

00:10 So, first of all inhalation is usually the main goal.

00:14 Now the reason this is so cool is because I'm gonna get the medication directly to the target site which is the lungs.

00:21 We can use something called an MDI, that's a metered dose inhaler.

00:27 So you might want to consider using a spacer with that and I'll talk to you about that.

00:30 But sometimes people have a hard time with a metered dose inhaler because more ends up at the side of their mouth or on their tongue.

00:40 So all a spacer does is help them get more of that medication all the way down into their lungs instead of it ending up on the side of their mouth.

00:50 So first stop, we've talked about metered dose inhalers and you've seen those in multiple places.

00:56 Those are the small little canisters that have a mouthpiece on them and patients push the top of it and it squirts the medication aerosolized into the lungs.

01:05 Also we're gonna talk about nebulizers.

01:07 Now this one is not as portable.

01:09 Our little MDI is this big, a nebulizer requires a mechanical piece of equipment.

01:15 And I'll show you a picture of one of those in just a minute.

01:18 We also have dry micronized powder inhalers.

01:21 You don't need to use a spacer for these, but those also help us get medicine into the lungs.

01:27 So you've got 3 main ways to deliver medication.

01:31 A metered dose inhaler, a nebulizer or a dry micronized powder inhaler.

01:37 Now you can take oral medications but once you start taking oral medications that'll go to the mouth, the stomach to the rest of the system.

01:45 So you have more systemic effects.

01:48 So it's a great idea if I can give the medication as an inhaler.

01:53 I'll have less systemic effects and I really care about systemic effects when I'm dealing with things like glucocorticoids.

02:00 Because those can do all kinds of things in the rest of your body.

02:03 So a couple of takeaway points.

02:05 If we can handle the medication or the medication route with inhaled medications that means your asthma patient is doing fairly well.

02:14 If they start to have more and more attacks, we're gonna have to add oral medications on top of that.

02:19 That's a sign that asthma is getting more difficult to handle.

02:23 So if a patient becomes so severe they might need to be hospitalized, we'll likely add oral medications.

02:29 Why are we hesitant to add oral medications? Remember because that will give us more systematic effects, So when inhalers alone aren't effective, we add an oral medication but we're also adding more systemic effects that the patient is going to experience.

02:46 So keep that in mind, our goal is to try and keep the patient just on inhaled medications.

02:52 If things are progressing and it just doesn't manage our asthma then we'll add oral medications.

02:57 Now if the oral medications and the inhaled medications are not enough, we'll add IV medications, now you'll have to be hospitalized for this, usually.

03:06 These has even more systemic effects because remember, given at an IV route, so there's no absorption.

03:13 One of those pharmacokinetic processes, it goes directly into the vein.

03:18 So we use IV medications when the patient, when the inhaled meds alone and the oral medications are not enough, we'll switch to IV medications.

03:26 Now there's one medication that can be given subq and that's just with an injection and that is a tongue twister.

03:33 See it right there? OMALIZUMAB.

03:37 That is a fun one for you to try with your friends later on.

03:40 That's an IgE antagonist.

03:43 Now if you haven't watched our video, remember, IgE antagonist will block the action of IgE in the body, which is gonna stop that process, that inflammatory process.

03:54 So, three routes of medication that we can give.

03:58 We can give it here oral, IV or subq.

04:02 But the number one preferred route if we can control the medication, control asthma attacks with the medication, is inhaled.

04:10 So these are signs of oral and IV that the patient is not doing as well or not able to control the medications with straight inhaled.