Continuous Bronchodilator Therapy
 Used for patients who do not respond to traditional therapy
 Utilizing a special large volume nebulizer (Heart neb)
 Usually begin at a dose of 15 mg/hr
 Carefully assess patient every 30 minutes for the first two
hours and thereafter every hour
 A positive response is indicated by an increase in PEFR of at
least 10% after the first hour
o The goal is at least 50% of the predicted
 Dosages will be ordered in milligrams per hour
 Need to know the number of hours therapy is to be provided
 Need to know the nebulizer output in ml/hr
To Solve a CBT problem:
Step 1: Calculate the volume of proventil for 1 hour.
Step 2: Calculate the volume of proventil for the treatment
period.
Step 3: Calculate the amount of solution that will be nebulized
during the treatment duration
Step 4: Compute the volume of diluent required
Example:
CBT with Proventil at 10mg/hr for five hours. The nebulizer
output is 25ml/hr.
Step 1: have = desired
5mg/1ml = 10mg/(x) ml
5x = 10
x=2ml of proventil per hour
Step 2: 2ml/hr x 5 hr = 10 ml of proventil needed for treatment
Step 3: 25 ml/hr x 5 hr = 125 ml of solution nebulized during
the treatment
Step 4: 125ml – 10ml = 115 ml of normal saline needed