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Can Aerosolized Medicines Be More Effective in the ICU?

On-line self learning program:

 To view the webinar, 


Target Audience:

This activity has been designed to meet the educational needs of physicians, nurses, respiratory therapists and pharmacists

Program Description:

Delivering effective aerosol therapy to patients requiring ventilator support provides some unique challenges.  Virtually every drug approved for inhalation has been approved on the basis of clinical trials of “not very sick people at home”.

These aerosol delivery systems include nebulizers, pMDIs and DPIs, typically with lung doses of between 10 -20 % of dose.

In regards to infants, only one drug (albuterol) has been approved for inhalation with children less than 2 years of age. 

Consequently, no inhaled drugs are approved for administration during mechanical ventilation to adult, children, infants or neonates.  The approval of inhaled drugs is based on clinical response to specific amount of drug being delivered to the lungs.  This is the basis of supporting PK/PD.  Providing too little drug to the lung may reduce efficacy and possibly result in resistance to medications.

When administering inhaled drugs to patients receiving ventilator support, the goal is to administer the same or greater lung dose to patients on the ventilator as those that were shown to be effective in spontaneously breathing “not very sick patients at home.”

The objective of this program is to guide clinicians toward effective dosing of inhaled medication in critically ill patients requiring various types of ventilator support.

Learning Objectives:

      •       Discuss the relationship of aerosol dose to the lung and effect.

      •       Identify the relationship of reduced lung dose on efficacy and potential risks.

      •       Identify clinical case study situations where improved aerosol drug delivery can impact outcomes.

      •       Contrast the methods of aerosol delivery used in approval trials with ambulatory patients and then on patients in the critical care setting.



Dr. Joseph Brain
Professor of Environmental Physiology
Harvard School of Public Health

Dr. Peter Clardy
Director of Medical Critical Care
Beth Israel Deaconess Hospital and Harvard Medical School

James B Fink, PhD, RRT, FAARC

Release Date: February 18, 2015 -- Expiration Date: February 18, 2016


Estimated time to complete activity: 1.0 hours

Cost of activity: No Charge. 

Media: Web based learning activity


System Requirements


Please ensure the computer you plan to use meets the following minimum requirements:

  • Operating System: Windows 98 or higher & Macintosh 2.2 or higher
  • Internet Browser (Mac & Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher, & Opera 5 or higher
  • Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible
  • Peripherals: Computer speakers or headphones
  • Monitor Screen Resolution: 320 x 480 or higher
  • Media Viewing Requirements: Adobe Reader, Microsoft Powerpoint, Flash Player & HTML5



  • Read the learning objectives and faculty disclosures above

  • View the on-line program. You may view this is more that one session, and may pause or repeat any portion of the presentation if you need to.

  • Complete the online post-test and evaluation, see link below.  Your CE statement will be emailed to you.  Please allow 30 days for receipt.

 Complete the post-test and to request your continuing education credit, click here

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