Inhaling Medication with Colistin

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Many medications are available as inhaled treatments. Inhaled methods deliver medication directly to the airway, which is useful for respiratory problems.

An inhaled medication delivery system consists of a nebulizer cup and a source for compressed air. The airflow from the compressor to the nebulizer changes the medication solution to a mist. When inhaled correctly, the medication has a better chance to reach the small airways. This increases the medication's effectiveness.

Supplies You Will Need:

  • Nebulizer compressor
  • Reusable AeroEclipse® XL BAN (Breath Actuated Nebulizer)
  • Pre-treatment medicine/Bronchodilator
  • Sterile water vial
  • Colistin (Colistimethate Sodium) 150mg / Vial, Powder Form
  • Sterile Water / Vial (Reconstitute)
  • Normal saline 0.9% / 2-5mls of normal saline
  • Syringes with needles
  • Alcohol pads
  • Sharps container

Take the inhaled bronchodilator medication if this is prescribed 15 minutes before the inhaled colistin.

Assembling the Air Compressor

  1. Place the compressor and nebulizer on a clean, flat, hard surface. The compressor should be placed where it can safely reach its power source and where you can reach the ON/OFF switch.
  2. Plug the power cord into an electrical outlet.
  3. Connect the air tubing to the compressor.

Preparing the Nebulized Medication using Colistin

  1. Wash your hands prior to preparing each treatment.
  2. Always use a clean nebulizer.
  3. Colistin comes in a 150mg vial, Power Form
  4. Check the label to make sure you have the right medicine.
  5. Check the expiration date. Do not use the medicine if the expiration date has passed.
  6. You will need to add 2 ml of sterile water to the colistin vial to turn the powder into a liquid.
  7. Wipe the top of the sterile water vial with an alcohol swab.
  8. Hold the syringe. Pull off the needle cover with your other hand. Do not touch the needle or lay the syringe down when the needle is uncovered.
  9. Pull back the end of the plunger to 2 ml mark.
  10. Amikacin-2
  11. Place the vial securely on the table, holding it with one hand.
  12. Push the needle through the rubber stopper on top of the vial.
  13. Invert the vial of medicine so the rubber stopper is facing down.
  14. Push the plunger so the air in the syringe goes into the vial.
  15. Let go of the plunger and allow the sterile water to flow into the syringe on its own. Pull down the plunger to 2 ml.
  16. Take the needle out of the sterile water vial.
  17. Wipe the colistin vial with the alcohol swab.
  18. Push the sterile saline needle through the rubber stopper on the top of the colistin vial. Inject 2 ml sterile water into the Colistin vial.
  19. Reconstitute by swirling the vial gently between both palms to avoid frothing.
  20. As prescribed by the physician: Draw up 1 ml of Colistin solution for 75 mg. Draw up 2ml of Colistin solution for 150 mg.
  21. Inject the correct dose of Colistin slowly into the nebulizer cup.
  22. Add 2 - 5 ml of normal saline 0.9% slowly to the nebulizer cup to avoid foaming.
  23. Aero Eclipse
  24. Check to make sure the indicator on top of the AeroEclipse XL is pointing to the “dotted arrow.” This will take the place of having to use a filter system.
  25. Connect the tubing to the bottom of the nebulizer.
  26. Turn the compressor on and check the nebulizer for misting.

If the Nebulizer Is Not Misting

  1. Check all of the connections.
  2. Refer to the manufacturer's instructions.

Taking a Nebulized Treatment Using a Mouthpiece

  1. NOTE: Remember to take the pre-treatment bronchodilator medicine before the nebulized treatment.
  2. Sitting in a comfortable position will allow you to take a full breath.
  3. Turn the compressor on. The nebulizer will begin to mist.
  4. Put the mouthpiece in your mouth, creating a tight seal.
  5. Hold in an upright position. This prevents spilling and promotes nebulization.
  6. Slowly take a normal to full breath in with an intermittent breath hold for 2-3 seconds before you slowly exhale out through your mouth.
  7. Continue these steps until completed.

Care and Cleaning of Nebulizer Equipment

Please follow the manufacturer’s instructions for cleaning the nebulizer equipment. Suggested guidelines include the following:

  1. Take apart the nebulizer. Wash all parts (except tubing) in liquid dish soap, rinse well and let air dry completely before storing.
  2. Place the nebulizer parts (except mask and tubing) in a dishwasher basket, and place on the top rack of the dishwasher.

Disinfection of Nebulizer Equipment Every Other Treatment Day

Boiling Water

  1. Wash your hands.
  2. Take the nebulizer apart.
  3. Put all the parts except the tubing in boiling water for 5-10 minutes.
  4. After boiling the nebulizer, shake off any excess water.
  5. Make sure the nebulizer is completely dry before storing.

Remember to change the nebulizer tubing every 2-4 weeks.

Care of the Compressor

Check the manufacturer's instructions for cleaning and care of the compressor you are using.

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