Guideline Pentamidine and Salbutamol by ck4p0w

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									                           RHSC
                       Guidelines
                               6.9




HOME CARE GUIDELINES FOR THE
 ADMINISTRATION OF NEBULISED
PENTAMIDINE AND SALBUTAMOL
                                                      RHSC GUIDELINES 6.9


HOME CARE GUIDELINES FOR THE ADMINISTRATION OF NEBULISED
PENTAMIDINE AND SALBUTAMOL


STATEMENT:          The patient or their carer will learn the safe
                    administration of   nebulised  Pentamidine   &
                    Salbutamol.



Background

 Nebulised Pentamidine can be given as prophylaxis or treatment of
  Pneumocystis carinii pneumonia (PCP).

 Nebulised Pentamidine is given fortnightly, for the prevention of PCP.

 It is administered by aerosol through a Ventstream nebuliser and a Porta-
  neb compressor.

 It is a substance that requires careful handling.

 Pentamidine has an unpleasant smell and taste.

 Pentamidine can cause irritation to the eyes if allowed to blow onto the
  face. Goggles or glasses should be worn by those with contact lenses.

 Women trying to become pregnant or who are pregnant, should avoid all
  contact with Pentamidine, both during the procedure and whilst the room is
  aired.




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                                           RHSC GUIDELINES 6.9




DATE

DRUGS FOR ADMINISTRATION



DRUG AND DOSE 1 _____________________________________________

FREQUENCY __________________________________________________




DRUG AND DOSE 2 _____________________________________________

FREQUENCY __________________________________________________




DOCTOR PRESCRIBING _________________________________________




DATE THE PORTA-NEB HAS TO BE SERVICED & CLEANED___________




DATE THE MOUTHPIECE & CHAMBER HAS TO BE CHANGED__________




CONTACT FOR ADVICE:

SCHIEHALLION DAY CARE UNIT 0141 201 9300

MONDAY TO FRIDAY 0830 HOURS - 1700 HOURS




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                                                          RHSC GUIDELINES 6.9


Equipment

     Disposable gloves
     Ventstream and filter
     19ga Needle
     Vial of Pentamidine (300mg)
     Porta-neb and tubing
     5ml syringe
     Nebule of Salbutamol
     Vial of sterile water (5ml)


Method

1.       Ensure that the work surface is clean and dry.

2.       Wash your hands in soap and running water and dry your hands with a
         clean towel, before handling the equipment.

3.       Assemble Porta-neb, tubing, nebulising chamber, plastic connection (T-
         piece), filter and mouthpiece.

4.       Place contents of one dose of Salbutamol ____ into nebulising
         chamber.

5.       Place mouthpiece in position and switch on Porta-neb.

6.       Continue for approximately 5 minutes (until you hear the spitting
         sound).

7.       Switch off Porta-neb.

8.       Wash Ventstream in hot soapy water, rinse well and dry the outside.
         Switch the Porta-neb on to let air dry the chamber.

9.       Put on disposable gloves.

10.      Add 5ml of sterile water for injection to a 300mg vial of Pentamidine.

11.      Leave to dissolve.

12.      Draw up ______ mls of Pentamidine 300mg.

13.      Add _____ mls of Pentamidine 300mg to the nebuslising chamber.

14.      Pace the mouthpiece in position and switch on the Porta-neb.

15.      Continue for 10 minutes. Switch off the Porta-neb.




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                                                                      RHSC GUIDELINES 6.9


On Completion

1.    Gloves should be worn.

2.    The cotton pad from the filter, the syringe and the needle should be
      discarded into the sharps box.

3.    Wash separate parts of the chamber and mouthpiece in hot soapy
      water.

4.    Rinse in clear running water.

5.    After washing the Ventstream dry the outside. Dry the inside by
      switching the Porta-neb on. This will let the air dry the chamber.

6.    Store in Porta-neb.


Special Notes

 The patient requires to be sitting in an upright position and slow, deep
  breaths should be encouraged. This will help to expand the chest fully and
  aid better uptake of the nebulised drugs.

 When Pentamidine is being given, ensure the mouthpiece is not removed
  from the mouth until the Porta-neb has been switched off. The room used,
  must be well ventilated, i.e. window open, door closed. This will help
  reduce any unnecessary exposure of other family members.

 Please bring the Porta-neb to pharmacy 6 monthly to be serviced and
  cleaned.

 The filter, mouthpiece and chamber should be boiled after each use in
  water with 2-3 drops of washing up liquid for 6-10 minutes. (Take apart the
  Ventstream drug container before boiling).

 The set can be replaced yearly.

 Never put the long clear tubing in water.



             Ratified by the Director of Nursing and Patient Services

             Signature:     ............................................................

             Date:          .............................................................


                                                                                            April 2002



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