Bentuk Sediaan Inhaler By: Amelia Lorensia

TARGET INHALER ...

- BENTUK SEDIAAN - Macam-macam aerosol: M D I D P I NEBULIZER Metered-dose Inhalers (MDI) Dry Powder Inhalers (DPI) Jet Nebulizer Ultrasonic Nebulizer

Partikel size: Particles > 10 microns deposit in the oropharynx. The single most important device factor determining the site of aerosol deposition is particle size. Devices for delivering therapeutic aerosols generate particles with aerodynamic diameters from 0.5 to 35 microns. In asthma, the airways, not the alveoli, are the target for delivery. Particles > 10 microns deposit in the oropharynx. Particles 5-10 microns deposit in the trachea and large bronchi. articles 1-5 microns in size reach the lower airways Particles <0.5 microns act as a gas and are exhaled.

Metered-dose Inhaler (MDI) MDI terdiri dari: Obat Tabung bertekanan (canister) Surfaktan dan/ atau pelarut Ruang dilengkapi dengan corong & tutup pelindung Propelan cair

Metered-dose Inhaler (MDI)

Metered-dose Inhaler (MDI)

Metered-dose Inhaler (MDI) Ketika tabung ditekan  metering katup satu arah dibuka oleh mekanisme pemicu dalam tubuh aktivator. Obat disemprotkan dekat pembukaan corong dan kemudian pasien dapat menghirupnya. Aerosol terdiri dari droplet-droplet dalam berbagai diameter. Ketika obat dihirup, droplet ukuran besar terdeposisi di mulut, faring, dan laring, sedangkan droplet dengan ukuran yang lebih kecil dapat masuk kedalam saluran pernafasan bawah. (Beaucage dan Nesbittt, 2002)

PRESS & BREATHE MDIs Θ: Difficulty in co-ordinating device actuation & inhalation Oropharyngeal deposition of the drug CFC devices  “cold freon effect” (1)

pMDI (Pressurized Metered Dose Inhaler) New Design  pMDI pMDI (Pressurized Metered Dose Inhaler) breath actuated inhalers

Remove the mouthpiece cap (as inhalation begins) Teknik Penggunaan MDI Cara pakai : Shake Remove the mouthpiece cap Breathe out Hold their breath Actuating the device (as inhalation begins) Slow deep breath

CLEANING YOUR MDI 5. In the morning, put the canister back inside the mouthpiece and put the cap on the inhaler. 1. Clean your inhaler mouthpiece about once a week or as often as recommended by your doctor or pharmacist. In addition to your routine cleanings, clean your inhaler if little or no medication is sprayed when you activate the inhaler. 2. Remove the metal canister from the L-shaped plastic mouthpiece. 3. Rinse only the mouthpiece and cap with warm running water for about 30 seconds. Do not wash or put the canister in water. 4. Let the mouthpiece and cap dry overnight. (2) 12 12

MDI + SPACER

AeroChamber® FISIO CHAMBER® VORTEX® OPTICHAMBER® MicroChamber® Breathe Eazy Spacer® AeroChamber® FISIO CHAMBER® VORTEX® OPTICHAMBER® MicroChamber®

SPACER for children ....

Spacer harus dibersihkan sebelum digunakan terlebih dulu dan kemudian setiap bulan dicuci dalam air hangat dengan deterjen dapur serta dikeringkan dengan udara tanpa pembilasan. Pengeringan dengan kain atau handuk kertas dapat mengakibatkan muatan elektrostatik ('statis') di bagian dalam spacer, yang dapat mengurangi ketersediaan dosis. Mouth-piece harus dibersihkan dari deterjen sebelum digunakan. Spacer harus ditinjau setiap 6-12 bulan untuk memeriksa struktur utuh (misalnya tidak ada retak) dan katup berfungsi. (National Asthma Council Australia, 2008)

a metered-dose inhaler with a spacer Using a metered-dose inhaler with a spacer http://www.health.com/health/library/mdp/0,,zm6397,00.html

Shake the inhaler and remove the inhaler cap Shake the inhaler and remove the inhaler cap. Check the inhaler instructions to see if you need to prime your inhaler before you use it. If it needs priming, follow the instructions on how to prime your inhaler.

Place the mouthpiece of the inhaler into the spacer.

Remove the cap from the spacer.

Hold the inhaler upright with the mouthpiece at the bottom.

Tilt your head back slightly and breathe out slowly and completely.

Place the spacer's mouthpiece in your mouth.

Press down on the inhaler to spray one puff of medicine into the spacer and then start breathing in slowly (press first, then breathe in).

Hold your breath for 10 seconds, to give the medicine time to settle in your lungs. If you need to take a second dose, wait 30 to 60 seconds to allow the inhaler valve to refill.

D P I (Dry Powder Inhaler) By: Amelia lorensia

a) DISKUS® / ACCUHALER®

Langkah-langkah: 1. Buka penutup 2. Geser tuas kebelakang 3. Hembuskan nafas sampai FRC, menjauh dari Diskus® 4. Hirup dosis 5. Lepaskan Diskus® dari mulut dan tahan nafas selama 10 detik. 6. Tutup penutup Diskus® 7. Jika dosis lain diperlukan, dapat mengikuti langkah 1-6.

b) TURBUHALER® / FLEXHALER®

(Beaucage dan Nesbittt, 2002) Diagram Turbuhaler (Adapted with permission from AstraZeneca, Canada.) (Beaucage dan Nesbittt, 2002)

(Beaucage dan Nesbittt, 2002) Teknik Penggunaan Turbuhaler® (Adapted from the self-management program “Living well with COPD©, Inhalation Technique Card, Turbuhaler®.”) (Beaucage dan Nesbittt, 2002)

HandiHaler®

Nebulizer