Proper use of a soft mist inhaler requires that the patient be ...

[captainjonesify]

Proper use of a soft mist inhaler requires that the patient be able to do which of the following?
 
  a. Generate inspiratory flows of 60 L/min or higher.
  b. Exhale forcibly through the device before drug delivery.
  c. Requires hand-breath coordination on the part of the patient.
  d. Connect the device to the proper gas source.

Question 2

Which of the following would you recommend as initial therapy for a patient admitted to the emergency department with acute airway obstruction (wheezing, cough, dyspnea, peak expirato-ry flow rate PEFR <60 predicted)?
 
  1. Assess dose-response of metered dose inhaler (MDI) albuterol (up to 12 puffs).
  2. Provide up to three small-volume jet nebulizer (SVN) treatments with albuterol every 20 min.
  3. Immediately begin continuous albuterol therapy at 15 mg/hr.
  a. 1 or 2 only
  b. 1 or 3 only
  c. 2 or 3 only
  d. 1, 2, and 3

[yifu223]

Answer to Question 1

ANS: C
To operate the device, patients twist the body of the device to load an internal spring, place the mouthpiece of the Respimat between the lips, and press a button to release the drug through a uniblock to create the aerosol, which is released over 1.1 to 1.4 sec, depending on the formulation configuration. The Respimat requires hand-breath coordination on the part of the patient, as does a pMDI, but because of the longer aerosolization time, it seems more likely that the patient will get a greater percent of emitted dose despite coordination issues.

Answer to Question 2

ANS: A
A patient with acute airway obstruction (wheezing, cough, dyspnea, and PEFR <60 of pre-dicted value) would receive up to three SVN treatments with a standard dose of albuterol, re-peated at 20-min intervals, or four puffs of pressurized MDI albuterol with a holding chamber (up to 12 puffs).

[captainjonesify]

Thank you

[yifu223]

No problemo