• • Administration of medication to the lungs.

Absolute

• • Allergic reaction to medication.

Relative

• • Anatomic abnormalities that cause increasing symptoms with treatment.

• • Nebulizer and compressor.

  • Metered-dose inhaler with spacer.

  • Dry powder inhaler (Figure 16–1).

• • Bronchoconstriction secondary to preservative (most solutions are now preservative free).

  • Tachycardia.

  • Arrhythmia (supraventricular tachycardia).

  • Agitation.

  • Oral candidiasis.

• • If used correctly, each method of delivery of inhalation medications is equally effective.

• • When using a nebulizer, when mist starts sputtering, tapping on cup allows for aerosolization of remainder of medicine.

  • Effective administration involves transport of medication to the lower airways.

  • The medication must be aerosolized and inhaled to facilitate delivery.

  • Ineffective aerosolization as well as improper technique may result in disposition of medication onto the skin of the face or on the soft palate or posterior pharynx.

  • In some younger children, the use of a spacer with a mask may allow more effective delivery than a spacer with a mouthpiece.