請問。inhalation的藥劑、準備時為什麼需要再加額外的dis water霧化，不能純藥霧化？
因爲有管路有死腔的問題，純藥物只有2.5ml，藥物會殘留在管路，無法到達病患，建議要額外加3ml的液體。普遍來說，霧化的器材容許的最大液體容量為5ml。
Dead volume – The volume of medication trapped inside the nebulizer, and therefore not available for inhalation, is referred to as the dead volume of the device. The dead volume is typically in the range of 1 to 3 mL. Increasing the amount of solution within the nebulizer (the fill volume) reduces the proportion of the dose lost as dead volume. Although nebulizer output increases with a greater fill volume, this also results in an increase in nebulization time. Considering both factors, an initial nebulizer fill volume of 3 to 6 mL is typically used [22]. The maximum fill volume of the nebulizer is manufacturer-determined; most do not exceed 5 mL, but some accept a volume as great as 10 mL. Unit dose ampules of bronchodilators (eg, albuterol and ipratropium) are typically 2.5 to 3 mL, which may not be ideal in terms of the proportion of dead volume to the total dose. However, the value of adding additional diluent to minimize the dead volume effect has not been studied.
Unit dose ampules of antibiotics (eg, tobramycin) are 5 mL, which may be more suitable to minimize the dead volume effect. When combining drug solutions in the nebulizer to minimize the time required for treatment, it is important to avoid a drug volume that exceeds the labeled maximum volume of the nebulizer and to avoid any incompatibility issues of the drugs [24].
資料來源：uptodate -Delivery of inhaled medication in adults
資料來源：uptodate -Delivery of inhaled medication in adults
