The inhalation route is used to have the patient inhale the medication using an inhaler. This is a common route used to administer bronchodilators to patients with breathing problems such as asthma, pneumonia, and chronic obstructive pulmonary disease.
Inhalation is used to deliver antibiotics, steroids and mucolytic agents (drugs that thin secretions making it easier to clear the bronchi). The patient can experience side effects such as tremors, nausea, tachycardia, palpitations, nervousness, and dysrhythmias (see Chapter 14).
There are two commonly used inhalers. These are the hand-held nebulizer and the hand-held metered-dose device. The hand-held nebulizer changes liquid medication into a fine spray. The hand-held metered dose device is a small, metal container about 5 to 6 inches high, with a push button spray device on the top to release the medication.
Inhalers are not a very efficient way of delivering medications to the lungs because only 9% of the medication reaches the lungs. The efficiency increases by using a spacer, which delivers 21% of the medication to the lungs. The spacer is a funnel-like device that attaches to the mouthpiece of the metered dose inhaler (MDI). The medication is released into the spacer and then the patient inhales slowly and deeply to get the drug into the airway.
When administering medication using an inhaler:
• Check the prescriber's order.
• Position the patient in a semi- or high-Flower's position (sitting up).
• Teach the patient to wait 2 minutes between puffs of an MDI if the pre-scriber orders more than one puff.
• The patient should rinse his or her mouth with water and expectorate (spit) following inhalation of steroids because steroid inhalants promote oral fungal infections.
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