Nebulization is the abbreviation of aerosol inhalation therapy. It refers to a drug administration method that uses a special device to disperse inhaled drugs into aerosol form, and the aerosol enters the respiratory system with the airflow when inhaling. It allows drugs to directly act on the respiratory mucosa to achieve the purpose of cleansing and moistening the airway for local and systemic treatment. It has now become an important treatment method for respiratory system-related diseases. Because it can directly act locally, patients have a high degree of acceptance, and more and more people are willing to use this route of administration.
As long as it is medicine, can it be used for nebulization? Of course this is wrong. There are two points that need to be paid attention to when choosing the right atomized drug. First, the drug name contains the word “inhalation”, and second, the “Usage and Dosage” item in the drug instructions indicates “administration via a suitable atomizer.”
Although injections are still used as atomized inhalation drugs in clinical practice, most of these methods are not recommended. For example, ambroxol injection, dexamethasone injection, etc. are used as The situation of aerosolized inhalation of drugs.
There are two main reasons why nebulization is not recommended for injections. First, there are specific requirements for the physical, chemical and pharmacological properties of aerosolized inhaled drugs, such as atomized particle size. The most important factor affecting the efficacy of atomized inhalation is the diameter of the effective atomized particles. The atomized particles should be able to be deposited in the airways and lungs and produce a therapeutic effect. If the diameter of the atomized particles is >5.0 microns, most of them will reach the central airway (trachea and bronchi), and most of them will be trapped in the oropharynx and eventually enter the body through swallowing; if the diameter of the atomized particles is <0.5 microns, they will reach the peripheral airways. (bronchioles, alveoli), but during tidal breathing, 90% of the drug particles can be excreted with exhalation; the diameter of atomized particles is 1.0 to 5.0 microns, which is more suitable and can reach the middle airway and below (bronchus).
Therefore, if the diameter of the effective atomized particles does not meet the requirements, the atomization treatment effect cannot be achieved; secondly, the excipients in the injection may cause airway spasm, difficulty breathing, and even induce asthma attacks, leading to serious consequences.
Common aerosolized drugs include the following four categories: inhaled glucocorticoids, inhaled beta2 receptor agonists, inhaled anticholinergic drugs, and inhaled expectorants.
It has the effects of inhibiting respiratory inflammatory response, reducing respiratory hyperresponsiveness, and relieving bronchospasm. Compared with systemic corticosteroids, inhaled glucocorticoids have smaller dosages, faster effects, fewer adverse reactions, and better safety. However, due to the special route of administration, glucocorticoids are deposited in the oropharynx after inhalation, and local adverse reactions are prone to occur in the larynx, including oropharyngeal candida infection, oral ulcers, dry mouth, hoarseness, pharyngitis, bronchospasm, etc. Washing your face and gargling your mouth immediately after atomization can avoid local adverse reactions to a certain extent.
It increases the mucociliary cleansing function that is reduced by obstructive pulmonary disease, thus accelerating the clearance of mucus secretions. However, due to its agonistic effect on β2 receptors, a small number of patients may experience adverse reactions such as skeletal muscle tremor, peripheral vasodilation, headache, and compensatory increased heart rate after use.
Inhaled anticholinergic drugs
Can play a role in bronchodilation. However, due to its antagonistic effect on cholinergic receptors, patients may experience headaches, dry mouth, tachycardia, palpitations, nausea, gastrointestinal motility disorders, urinary retention, and adverse eye reactions, such as pupil dilation and increased intraocular pressure. Highly common adverse reactions. If used by patients with glaucoma and prostatic hypertrophy, the original disease may be aggravated, and the drug can be replaced if necessary.
Mainly acetylcysteine. This is a drug that can reduce the viscosity of sputum and make it easier to cough up. It is suitable for patients with excessive mucus secretion. However, due to the smell of sulfur, it may irritate the patient’s mouth, nasopharynx, and cause symptoms such as rhinorrhea and stomatitis; it may irritate the gastrointestinal tract and cause gastrointestinal reactions such as nausea and vomiting; patients with gastric ulcer or a history of gastric ulcer Patients may even aggravate their original gastric ulcer symptoms. Therefore, patients should choose carefully when combined with other drugs that have an irritating effect on the gastric mucosa. Acetylcysteine will react with rubber, iron, copper, etc., so when patients undergo atomization inhalation treatment, they should use plastic or glass nebulizers, and the nebulizer needs to be cleaned after use.
In short, aerosol inhalation therapy is a drug delivery method that can directly act on the respiratory mucosa to achieve the purpose of cleaning and moistening the airway for local and systemic treatment. Although it is a topical medication, it also has adverse reactions, so it cannot be used by oneself. Patients need to pay attention to observe whether there are any adverse reactions when using it. It is recommended to have an empty stomach before atomizing, clear nasal secretions, and do not apply oily creams. After atomization, be sure to rinse your mouth and wash your face to reduce systemic absorption of the drug.
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