When administering aerosolized pentamidine, what should the respiratory care practitioner do?

1. Use a nebulizer that produces particles in the 1- to 2-µm mean mass aerodynamic diameter (MMAD) range.
2. Use a nebulizer system with one-way valves and scavenging expiratory filters.
3. Provide isolation and an environmental containment system.
4. Screen patients for human immunodeficiency virus (HIV).
a. 1 and 2 only
b. 2 and 4 only
c. 1, 2, and 3 only
d. 1, 2, 3, and 4

ANS: C
When administering aerosolized pentamidine, isolation, an environmental containment system (e.g., a booth or negative pressure room), and personnel barrier protection should be provided. Subjects should be screened for tuberculosis. The drug is given using a nebulizer system with one-way valves and scavenging expiratory filters (e.g., the Respirgard). This reduces environ-mental contamination. Nebulizer systems capable of producing an MMAD of 1 to 2 µm for pe-ripheral lung deposition may reduce coughing.