Inhaled monitoring

Inhalation. Monitor arterial blood gases and obtain chest x-ray. Observe for at least 6-8 hours and treat wheezing and pulmonary edema (see pp 7-8) if they occur. After significant exposure, it may be necessary to observe for 1-2 days for delayed-onset noncardiogenic pulmonary edema. 

Over the past 10 years, electronic inhaler monitoring devices have been developed which record the date and time of actuations and can then be downloaded onto a computer. A record can then be printed which reflects a patient s pattern of inhaler use over a period of time. Electronic peak flow meters are also available which record and store peak flow values, along with date and time information. While these devices have generally been utilized exclusively for research, improved technologies are increasingly making their clinical application feasible. 

Some niekel eompounds may be irritant to skin and eyes and dermal eontaet with niekel ean result in allergie eontaet dermatitis. Niekel earbonyl is extremely toxie by inhalation and should be handled in totally enelosed systems or with extremely effieient ventilation. Air monitors linked to alarms may be required to deteet leaks. Respiratory equipment must be available for dealing with leaks. Biologieal eheeks (e.g. niekel in urine) should be eonsidered for routine operations involving niekel eatalysts. 

Beeause the diisoeyanate is used in exeess, there is usually free monomer present. Isoeyanates are hazardous materials particularly upon inhalation and skin contact. Chronic exposure ean lead to sensitization. The adhesives must therefore be used with proper ventilation and should not come in eontact with the skin in the unreaeted state. Vapor monitoring badges for employees and periodie real time vapor monitoring around process equipment is reeommended. 

To monitor the amount of drug in a metered-dose inhaler, you can periodically place the canister in a container of water. The figure shows the positioning of the canister with various amounts of medication remaining in the canister. (Adapted from the American Uung Assoaation. [1993]. Understanding lung medications How they work—how to use them, p. 4)... 

Absorption kinetics of trichloroethylene are often monitored by measuring levels in the blood during and after exposure. Volunteers who inhaled 100 ppm for 6 hours showed a peak blood trichloroethylene level of approximately 1 pg/L after 2 hours (Muller et al. 1974). These levels fell rapidly when exposure ceased. Trichloroethylene levels in blood and breath increased rapidly in another study after initiation of a 4-hour exposure to 100 ppm, reaching near steady-state within an hour from the start of the exposure (Sato and... 

Educate patients on the use of inhaled drug delivery devices, peak flow monitors, and asthma education plans. 

Monitor and maintain PEF above 80% of personal best PEF variability should be less than 20%. Patients with PEF rates consistently greater than 80% over several months should be evaluated for a step down in long-term control therapy. Patients with a PEF less than 80% of personal best should begin to monitor PEF twice daily and consult their asthma action plan. Patients with a PEF less than 50% of personal best should immediately use their short-acting inhaled 32-agonist and consult their asthma action plan. 

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