Hi! and welcome to one of our
videos on respiratory medications.
We're gonna talk about the unique ways that you have
options to give patients respiratory medications.
So, first of all inhalation
is usually the main goal.
Now the reason this is so cool is because
I'm gonna get the medication
directly to the target
site which is the lungs.
We can use something called an MDI,
that's a metered dose inhaler.
So you might want to consider using a spacer
with that and I'll talk to you about that.
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.
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.
So first stop, we've talked
about metered dose inhalers
and you've seen those
in multiple places.
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.
Also we're gonna talk about nebulizers.
Now this one is not as portable.
Our little MDI is this big, a nebulizer
requires a mechanical piece of equipment.
And I'll show you a picture of
one of those in just a minute.
We also have dry micronized
You don't need to use a spacer for these, but
those also help us get medicine into the lungs.
So you've got 3 main ways
to deliver medication.
A metered dose inhaler, a nebulizer
or a dry micronized powder inhaler.
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.
So you have more systemic effects.
So it's a great idea if I can give
the medication as an inhaler.
I'll have less systemic effects and I
really care about systemic effects
when I'm dealing with things
Because those can do all kinds of
things in the rest of your body.
So a couple of takeaway points.
If we can handle the medication or the
medication route with inhaled medications
that means your asthma patient
is doing fairly well.
If they start to have
more and more attacks,
we're gonna have to add oral
medications on top of that.
That's a sign that asthma is
getting more difficult to handle.
So if a patient becomes so severe
they might need to be hospitalized,
we'll likely add oral medications.
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.
So keep that in mind, our goal is to try and
keep the patient just on inhaled medications.
If things are progressing and it
just doesn't manage our asthma
then we'll add oral medications.
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.
These has even more systemic
effects because remember,
given at an IV route, so
there's no absorption.
One of those pharmacokinetic processes,
it goes directly into the vein.
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.
Now there's one medication
that can be given subq
and that's just with an injection
and that is a tongue twister.
See it right there?
That is a fun one for you to try
with your friends later on.
That's an IgE antagonist.
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.
So, three routes of
medication that we can give.
We can give it here oral,
IV or subq.
But the number one preferred route
if we can control the medication,
control asthma attacks with
the medication, is inhaled.
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.