Nebuliser therapy

Keywords Anti-microbial treatment Intensive care Nebuliser therapy... 

These patients were divided into two groups the 1st, main group comprised 20 patients who received nebuliser therapy with FarGALS (1 4 dilution) and the 2nd, control group of 32 patients who received standard nebuliser therapy [7, 8]. The average age of patients was 39.4 15.4 years. 

Driving gas for nebulised therapy must be specified in the prescription. If oxygen is needed during nebuliser therapy, nasal cannulae should be used. Care must be taken with the nasal route, as it is difficult to predict the amount of oxygen inspired. 

Nebuliser therapy is different, from the developer s perspective, to DPIs or pMDIs, in that neb-uliser formulations and machines are developed and sold by independent companies. Hence, the formulator will take an existing commercial nebuliser machine(s) and will ensure that the formulation performs satisfactorily. Also, the target population is different, with nebulisers often being used in the hospital setting and for paediatric and geriatric patients. 

Where this combination is not clinically effective for the child and, depending on the child s condition, nebulised therapy may be considered. In the case of children aged 3-5, a dry powder inhaler (DPI) may also be considered but usually DPIs are used in school-age children (>5 years old). 

Clay, M.M. Pavia, D. Newman, S.P. Lennard-Jones, T. Clarke, S.W. Assessment of jet nebulisers for lung aerosol therapy. Lancet 1983, 2, 592-594. 

Lewis, R.A. Nebulisers for lung aerosol therapy. Lancet 1983, 2, 849... 

Modern nebulisers for domestic and hospital use generate aerosols continuously for chronic therapy of respiratory disorders. A Venturi-type system is shown in Fig. 9.48(a) and an ultrasonic device in Fig. 9.48(b). The particle size distribution and hence efficiency of such... 

Newman SP, Pellow PGD, Clarke SW. Droplet size distributions of nebulised aerosols for inhalation therapy. Phys Physiol Meas 1986 7 139-146. 

Draft European Nebuliser Standard. prEN13544 13544-1. Respiratory Therapy Equipment Part 1 Nebulizing Systems (available through all national European Standards bodies, e.g., in UK available through BSI ref BS 99/5662734DC). 

Administration devices for medicines used to treat asthma and COPD are prescriptirm products, with an exception for some nebulised (medicine) formulations. Medicines such as amphotericin B or antibiotics (coUstimethate sodium, tobramycin sulphate or gentamicin) for nebulisation in CF therapy are sometimes stUl partly prepared by hospital pharmacists, and so are nebulised solutions for bronchial challenge testing. Although product formulation and the method of preparation of formulations for inhalation are not the main subjects of this chapter, recommendations are given in the subparagraphs about nebulisation. 

Jet nebulisers in the home situation are increasingly replaced by (vibrating) membrane inhalers which give better control over the medicine delivery to the respiratory tract than the classic jet and ultrasonic nebulisers, and may increase the adherence to the therapy. 

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