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Website
Disclaimer
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MEDICATIONS
EMERGENCY INJECTABLE MEDICATIONS:
EPIPEN
and TWINJECT
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Epipen®
and Twinject
®
are
self-injecting forms of epinephrine or adrenalin.
It is used in cases of anaphylaxis of any cause.
 
Directions
for use:
1.
Remove safety cap and grasp Epipen with your fist
(do NOT place a thumb over either end)
2.
Press the Epipen (end opposite safety cap)
against outer thigh until you hear a click and needle
is released.
3.
Maintain Epipen in position for 10 seconds
4.
If you need to use your Epipen you MUST go to local
emergency room/call 911 for immediate follow up.
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Asthma Inhalers: How to use them
Inhaler
technique has a big influence on the dose of medication
delivered to the lungs. This will be reviewed with you
often. Please pay close attention when we give you your
breathing test since this is when we typically go over
inhaler technique.
- Remove
the cap and holder inhaler upright.
- Shake
the inhaler.
- Tilt
your head back slightly and breathe out slowly.
- Position
the inhaler in one of the following ways (A or B is
optimal, but C is acceptable for those who have difficulty
with A or B. C is required for breath-activated inhalers):
| A.
Open mouth with inhaler 1 to 2 inches away |
B.
Use spacer/holding chamber (that is recommended
especially for young children and for people using
corticosteroids). |
C.
In the mouth. Do not use for corticosteriods. |
D.
NOTE: Inhaled dry powder capsules require a different
inhalation technique. To use a dry powder inhaler,
it is important to close the mouth tightly around
the mouthpiece of the inhaler and to inhale rapidly. |
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- Press
down on the inhaler to release medication as
you start to breathe in slowly.
- Breathe
in slowly (3 to 5 seconds).
- Hold
your breath for 10 seconds to allow the medicine
to reach deeply into your lungs.
- Repeat
puff as directed. Waiting 1 minute between puffs
may permit second puff to penetrate your lungs
better.
- Spacers/holding
chambers are useful for all patients. They are
particularly recommended for young children
and older adults and for use with inhaled corticosteroids.
Avoid
common inhaler mistakes. Follow these inhaler
tips:
- Breathe
out before pressing your inhaler.
- Inhale
slowly.
- Breathe
in through your mouth, not your nose.
- Press
down on your inhaler at the start of inhalation
(or within the first second of inhalation).
- Keep
inhaling as you press down on inhaler.
- Press
your inhaler only once while you are inhaling
(one breath for each puff).
- Make
sure you breathe in evenly and deeply.
NOTE:
Other inhalers are becoming available in addition
to those illustrated above. Different types of
inhalers may require different techniques.
Source:
Expert Panel Report 2: Guidelines for the Diagnosis
and Management of Asthma. National Asthma Education
and Prevention Program, National Heart, Lung,
and Blood Institute, 1997.
Confused
about your inhalers? Consult your doctor.
You can also view a chart
of inhalers here. |
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Nasal
Sprays: How to Use Them
- Gently
blow your nose to clear it of mucus before using the medication.
- Remove
the cap. Shake the bottle. The first time you use the pump
spray each day, you may have to "prime" it by squirting
a few times into the air until a fine mist comes out.
- Tilt
your head forward slightly. Breathe out slowly.
- Hold
the pump bottle with your thumb at the bottom and your index
and middle fingers on top. Use a finger on your other hand
to close your nostril on the side not receiving the medication
(see the drawing on the right).
- Squeeze
the pump as you begin to breathe in slowly through your
nose. Repeat these steps for the other nostril. If you are
using more than one spray in each nostril, follow all these
steps again.
- Try not
to sneeze or blow your nose just after using the spray.
Helpful
hints
- Remember,
it may take up to 2 weeks of using a nasal steroid spray
before you notice the full effects.
- Wash
the canister device at least once a week.
- Be sure
you can sniff air through each nostril before spraying,
otherwise the medicine will be wasted, since it will not
go deep into the inside of your nose.
- Aim straight.
Point the nozzle of the nasal spray container toward the
back of your head. If you don't spray straight, you will
waste the medicine and may cause more irritation in your
nose.
- If the
pump spray is used correctly, the spray should not drip
from your nose or down the back of your throat.
- If your
nose hurts, if you begin to have nosebleeds or if the inside
of your nose stings, stop using the spray for 1 to 2 days.
- If you
have nosebleeds, stop using the medicine for a few days
and use a saline nasal spray instead. You can also use a
cotton swab to spread a thin layer of petroleum jelly inside
your nose right after using the saline spray. If the bleeding
or irritation continues, talk to your doctor.
- Use your
medicines just the way your doctor tells you. Most nasal
sprays work best when used regularly and consistently.
- Keep
your medicine away from sunlight.
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Side
Effects of Corticosteroids
Steroids are the most effective treatment for many allergic
diseases (asthma, hayfever) and important adjuncts for others
(anaphylaxis, sinusitis).
Side effects
of corticosteroids vary widely and their severity and specific
nature depend on form of administration:
Side Effects
of Inhaled Corticosteroids. These medications are usually
well tolerated. Some common side effects of inhaled steroids
are throat irritation, hoarseness, and dry mouth. Fungal infections
(thrush) in the mouth and throat are also possible but these
are easily treatable. You can reduce these effects by adhering
to good inhaler technique and rinsing out your mouth after
use (see How to
use your inhaler). Inhaled steroids are generally considered
safe and effective and only rarely cause any of the more serious
side effects reported with prolonged use of oral steroids.
They are considered safe for pregnant women and their babies,
according to a 1999 study, although pregnant women taking
both beta2-agonists and corticosteroids are at higher risk
for diabetes during pregnancy (gestational diabetes).
Side Effects
of Oral Corticosteroids. For short term use these are usually
well tolerated. Temporary side effects when taking steroids
for a few days may include insomnia, mood changes, increased
appetite and perhaps a few pounds of weight gain (usually
water). These should promptly resolve when the drug is stopped.
These drugs are prescribed when other drugs have failed or
when the condition warrants their use. Understandably, many
patients are concerned about steroid drugs. But it is usually
the effect of prolonged use of oral steroids in fairly
high doses that lead to long term serious effects. Such dosing
is seldom required in our practice. For your information long
term use may lead to one or multiple effects including cataracts,
glaucoma, osteoporosis, diabetes, fluid retention, susceptibility
to infections, weight gain, hypertension, capillary fragility,
acne, wasting of the muscles, menstrual irregularities, irritability,
insomnia, and other mood changes. Osteoporosis is a common
and particularly severe long-term side effect of prolonged
steroid use. Medications that can prevent osteoporosis include
calcium supplements, parathyroid hormone, alendronate etidronate,
risedronate, or hormone replacement therapy in post-menopausal
women. Vitamin C and E may help reduce the risk of cataracts.
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