Pharmacist Liu Yao, Deputy Director of Pharmacy Department, Wuhan Central Hospital
Atomized administration has long been considered to have a definite adjuvant therapeutic effect on respiratory diseases. Nebulized administration has the advantages of less dosage, more precise administration, faster onset of action, more effective phlegm, and less side effects. In pediatrics, this method of administration is quite common and is favored by the majority of parents.
Nebulized inhalation has two modes, nasal inhalation and oral inhalation. Due to the physiological anatomy of the nasal cavity and oral cavity, the nasal cavity diameter is smaller than that of the oral cavity, the mucosal turbinate is curved, and the atomized drug is more likely to settle, which means that it passes through the nasal cavity. The amount of waste is more, and the amount of medicine to reach the lesion is even less. Therefore, to achieve better results, for children and adults aged ≥ 6 years, nebulizer inhalation is better than nasal suction, and for ≤ 5 years old Children, because they belong to 'nose breather', cannot breathe with their mouths, so it is recommended to use a mask to inhale.
Some common drugs such as dexamethasone, ambroxol, gentamycin, α-chymotrypsin, ribavirin and various proprietary Chinese medicines are not aerosol formulations and are not recommended for use as aerosolized drugs. Also need to pay attention to the following matters:
1. Do not eat as much as half an hour before atomization to avoid irritating the airway caused by drugs, clean the mouth before inhalation, and remove oral secretions and food debris.
2. It is necessary to pay attention to body position during the atomization. It is best to choose sitting position or semi-recumbent posture in order to allow the drug to be deposited into the respiratory tract and lungs.
3. The mask should be held in place when the mouth is sprayed, or 2 to 3 cm away from the face. The medicine is sucked in from the mouth and slowly exhaled from the nose. The fogging time is usually 5 to 15 minutes.
4. Do not forcibly atomize infants and children when they cry. Observe the patient's complexion and breathing when aerosolizing. If there is paleness, severe cough, or abnormal irritability, stop atomization immediately.
5. After nebulization, rinse the face with warm boiled water and cleanse the face. After half an hour, eat again. The older children can rinse their mouths. For babies and toddlers who do not rinse their mouths, they can drink the right amount of water, or wipe the mouth with gauze and water with fingers. This will remove as much skin and oral mucous membranes as possible.
6. The atomization cup, breathing tube, and atomization mask should be used exclusively by special persons. After atomization, the atomization cup and mask should be cleaned in time to dry them. Avoid soaking and cleaning with hot water to avoid deformation. Special attention should be paid. Do not wash the pipe part with water, because the water in the pipe is difficult to dry and it is easy to breed bacteria.
