I. Introduction to the device: 1. Pressure Quantitative Aerosol Inhaler (pMDI) Dispensing agent: Freon (CFC), Carbon tetrachloride (HFA). Advantages: quick; easy to carry; multi-dose; inexpensive. Disadvantages: high skill (synchronization of inhalation and drug release, deep inhalation followed by as long a breath hold as possible). Parabolic agents: tracheal irritation, spasm. Poor lung sedimentation (only 10-12%), 80% deposited in oropharynx (hoarseness, mold, pharyngeal discomfort). Environmental contamination. Affected by temperature. If not good control can be added to the storage tank. 2.Pressure quantitative aerosol inhaler (pMDI) + storage tank Advantages: compared with pMDI: lung sedimentation rate increased by 1 times (up to 20%); inhalation through the one-way valve of the storage tank, do not need to synchronize with the respiratory action, and do not need to hold the breath; in the oropharyngeal region of the sedimentation rate is greatly reduced, pharyngeal adverse reactions are less. Shortcomings: the device volume is large, inconvenient to carry; plastic storage tank can have static electricity, affecting the amount of inhalation, the metal is more expensive. 3, dry powder inhaler ① quasi-nano device TM (Accuhaler), disk inhaler (Diskhaler), quasi-nano device Advantages: small inhalation volume of children, the elderly can be used; each dose is pre-set, the dose is accurate; the dose output is good; each dose of aluminum foil plastic packaging, moisture-proof good; lactose, good taste, good compliance. Shortcomings: Requires an inspiratory flow rate of more than 30L/min, lower than the 60L/min of Dupont; not applicable to children under 4 years old and severe asthma. Note: Don’t push the sliding pole arbitrarily, so as not to cause drug waste. ② Dobao device (vortex inhaler) Characteristics: Requirement for inhalation flow rate greater than 60L/min; with desiccant, shaking sound; no flavoring agent. ③ Specialized device (Silvateam special device) Features: capsules are packed independently and loaded each time; the device has a piercing button; the flow rate requirement is low, and it can be inhaled gently; the capsule should be discarded after each use. II. Use of different devices (I) Use of aerosols (multi-dose) Commonly used are salbutamol (Ventolin), beclomethasone dipropionate (Bicolone), fluticasone propionate (Coxsodone), budesonide (Pramipexole), ipratropium bromide (Aizenol), Cobit (compound ipratropium bromide), and so on. Quantitative aerosol specific operation steps are: 1, open the mouthpiece cover and shake the inhaler vigorously and fully. Especially the suspension type inhaler, due to a long time standing, the drug and the solvent is easy to stratify, dispersion is not uniform, the first time to use and more than 7 days without the user, the use of the need to carry out the ejection. 2. Exhale slowly until no more air is exhaled from the lungs. 3. Tilt your head back, put the suction nozzle into your mouth, wrap your lips tightly around the nozzle, and pay attention to your tongue and teeth not to block the nozzle. 4. While inhaling slowly through the mouth, press the canister to release the medication and continue to inhale deeply for as long as possible. 5. Withdraw the aerosol nozzle, hold your breath as long as possible for about 10 seconds, and then slowly exhale through your nose. 6.If a second inhalation is needed, it needs to be done at an interval of 1 to 3 minutes to avoid respiratory muscle fatigue caused by continuous inhalation, and at the same time, it can increase the deposition of drug particles in the surrounding airway. 7.Cover the device and rinse your mouth after using the drug. The correct process and method of aerosol: shake well – open the lid – deep exhalation – lips wrapped tightly nozzle – deep inhalation while spraying the drug – hold your breath for ten seconds – rinse your mouth. (ii) How to use DuPao (multi-dose, requires fast flow rate of more than 60L/min) 1. Unscrew the cap and pull out the bottle. 2.Check the dose indicator window to see if there is still enough dose of medication. 3.Hold the inhaler with one hand so that the handle is underneath, hold the inhaler so that it is upright, hold the bottom cap with the other hand, turn it to the right to the end and then turn it to the left to the end, and then hear the sound of “click”, that is to say, the completion of the filling of a dose. 4.Exhale: Before inhaling, gently exhale (do not blow into the mouthpiece). 5, inhalation: put the suction nozzle between the upper and lower teeth, lips wrapped around the suction nozzle, forcefully and deeply long mouth inhalation, do not chew or bite the suction nozzle, that is, to complete an inhalation action, after inhalation of the drug about breath holding 5 to 10 seconds. 6. Exhale slowly through the mouth or nose. 7.If you need to repeat the inhalation, repeat steps 2-6. 8.Cap the bottle tightly after use. 9.Rinse your mouth. (c) The use of the paranaizer: (single dose, lower flow rate requirements than the DuPont, inhalation flow rate of more than 30L/min, children over 4 years of age can be) The paranaizer is a molded plastic device with a strip of aluminum foil wrapped around it, on which 28 or 60 vesicles containing the medication are neatly arranged. Each dose of medication is accurately measured and kept clean, requiring no maintenance or refilling. Directions for use: 1. Open: Hold the collimator housing in one hand, place the thumb of the other hand on the thumb handle and push the thumb outward until it is fully open. Push open: Hold the paracetamol so that the suction nozzle is facing you, push the sliding lever outward until it makes a “click” sound, indicating that the paracetamol is ready for suction. 3. Inhalation: Hold the paracetamol and move it away from the nozzle, exhale as much as possible while ensuring smooth breathing, then put the nozzle into the mouth, inhale deeply and smoothly, inhale the medication, and take the paracetamol out of the mouth while holding your breath for about 10 seconds, and then return to slow exhalation. 4.Close: Put your thumb on the thumb handle, pull back as fast as possible, when closing the collimator, you can make a “click” sound to indicate that it is closed, and the sliding lever will automatically return to its original position and reset. 5.If you need to inhale two inhaled drugs, you must close the collimator and then repeat steps 1-4. Note: This product contains lactose, it is forbidden for patients who are allergic to lactose and milk. (D) Siliva special device: (slow deep inhalation can be, the flow rate requires the lowest) device composition: dust cap, suction nozzle, central chamber, base bracket, piercing button. Steps: 1, pull upward, open the dust cap, and then open the suction nozzle. 2. Remove one capsule from the blister pack (only immediately before use) and place it in the central chamber. 3. Close the nozzle firmly until a click is heard, keeping the dust cap open at this point. 4. Hold the HandiHaler device with the mouthpiece upwards and press the green piercing button fully once, then release it, so that a number of small holes can be pierced in the capsule and the medication can be released when you inhale. 5. Exhale completely (take a deep breath first) and exhale as much gas as possible. Note: Avoid exhaling into the suction nozzle. 6. Lift the HandiHaler device over your mouth, hold the mouthpiece firmly with your lips, keep your head vertical, and inhale slowly and deeply at a rate sufficient to hear the capsule vibrate. Inhale until your lungs are fully filled, hold your breath for as long as possible while you remove the HandiHaler device from your mouth and begin breathing normally again. Repeat steps 5 and 6 once and the medication in the capsule can be completely inhaled. 7. Open the mouthpiece again, pour out the used capsule and discard it. Close the nozzle and dust cap and store the HandiHaler device. (e) Renacort Nasal Spray Before the 1st use, shake the bottle and then spray the medicine into the air several times (5-10 times) to obtain uniform spray particles. If it is not used for a whole day, repeat the above operation before using it again, but this time you only need to spray pressure into the air once. Do not tilt your head back, but sit with your head slightly tilted forward. Insert the nozzle of the bottle into your nose, but try to avoid contact with the nasal mucosa, plug the other nostril and close your mouth, and inhale while pressing down on the nebulizer. Always press down on the sprayer until you withdraw it. Remove the nasal spray nozzle, tilt your head forward as far as possible, sit up straight after a few seconds, the liquid will flow to the pharynx while breathing through the mouth, if necessary, repeat the process with the other nostril, and finally rinse the nozzle with cold boiled water. 1. Blow your nose, shake the bottle and open the brown protective cap. 2. Hold the bottle and insert the nozzle into the nostril and spray the prescribed dose. Spray the other nostril in the same way. 3.Cap the bottle, the number of sprays should not exceed the amount prescribed by the doctor. (F) solution atomization device 1, nasal mask atomization compressed air or oxygen as a driving force, the solution or suspension in the storage tank into aerosol particles, the requirements of the gas flow rate: 6-8L/min, each time the atomization time of 5-15min, aerosol particles of 2-4um, sedimentation rate of 10%, the total amount of 2-4mL of solution, 12 years old under the mask, above the use of mouthpieces. 2, ultrasonic nebulization by the vibration of piezoelectric crystals produce high-frequency sound waves, resulting in aerosol particles, the diameter of the drug particles 3.7-10.5um, the settlement rate of about 2-12%, the speed of the general: 1-2mL/min, the total amount of solution 20ml. Shortcomings: aerosol volume is large, can aggravate pulmonary edema; the size of the fog particles are not uniform; polymer drugs can be damaged. 3, electric nebulization small size, dry battery for power, the total amount of solution 2-4mL, generally about 2mL, can be pure solution drug delivery.