Inhalers, drug delivery with

Wilkes W, Fink J, Dhand R. Selecting an accessory device with a metered-dose inhaler variable influence of accessory devices on fine particle dose, throat deposition, and drug delivery with asynchronous actuation from a metered-dose inhaler. J Aerosol Med 2001 14(3)251-360. 

M. Hill, Effect of delivery mode on pharmacokinetics of inhaled drugs Experience with beclomethasone, Respiratory Drug Delivery VI. (R. Dalby, P. Byron, and S. J. Farr, eds.), Interpharm Press, Englewood, CO, 1998, p. 53. 

Newman, S. P., Weisz, A. W., Talaee, N., and Clarke, S. W. (1991), Improvement of drug delivery with a breath actuated pressurised aerosol for patients with poor inhaler technique, Thorax, 46, 712-716. 

Patients switched from an MDI to a DPI should be counseled that the DPI requires a rapid and forceful inhalation as compared to the slow inhalation used for an MDI. Patients using a DPI should also be counseled not to exhale into the device, as it will cause a loss of dose or decreased drug delivery. Because delivery technique with inhalers deteriorates over time, the health care provider should take every opportunity to reinforce appropriate inhaler technique. 

DRUG DELIVERY SYSTEM INHALER METERED DOSE KIT WITH CARRYING CASE 6515013200225 EA 7.82 ... 

Administration Iloprost is intended for inhalation administration only via the Prodose AAD system, a pulmonary drug delivery device. It has not been studied with any other nebulizers. 

The use of inhalational anesthetics is generally reserved for maintenance of anesthesia. The development of an anesthetic concentration in the brain occurs more slowly with inhalational anesthetics than with IV drugs. Once an anesthetic level has been achieved, however, it is easily adjusted by controlling the rate or concentration of gas delivery from the anesthesia machine. The rate of recovery from a lengthy procedure in which inhalational agents are used is reasonably rapid, since inhalational anesthetics are eliminated by the lungs and do not depend on a slow rate of metabolism for their tissue clearance. Thus, inhalational drugs meet the requirement for a relatively prompt return of the patient s psychomotor competence. 

Geriatric Considerations - Summary Ensure that the older adult can adequately use the inhalation device. A spacer maybe beneficial in fhose unable fo coordinate device operation and inhalation. Spacer devices improve drug delivery to the lungs, therefore monitor closely as the patient may also experience increased systemic side effects with improved exposure to albuterol. Monitor cardiac status. 

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