PHRD5925 Lecture 13 - Respiratory Drug Delivery

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daynuhmay
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271281
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PHRD5925 Lecture 13 - Respiratory Drug Delivery
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2014-04-21 01:25:43
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Respiratory Drug Delivery
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Respiratory Drug Delivery
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  1. barriers to respiratory delivery
    • 1) physical barriers to drug absorption
    • 2) proteolytic degradation
    • 3) particle clearance
  2. proper aerosol administration technique
    • 1) remove dust cap
    • 2) shake
    • 3) exhale
    • 4) mouthpiece into mouth, close lips around
    • 5) inhale slowly & deeply while depressing actuator
    • 6) remove from mouth & hold breath
    • 7) allow 5 (FIVE) minutes between doses
  3. how to improve deposition during inhalation
    • slow, large volume breathing
    • control cough
  4. 5 factors influencing particle deposition in lungs
    • 1) physical properties of the aerosol
    • 2) device
    • 3) patient related factors
  5. 2 types of patient related factors influencing particle deposition in lungs
    • 1) lung geometry¬†
    • 2) breathing pattern
  6. 3 mechanisms of particle deposition in lungs
    • 1) impaction
    • 2) sedimentation
    • 3) diffusion
  7. 5 impaction characteristics
    • 1) occurs in upper/large conducting airways
    • 2) favored by high flow velocities & rapid changes in flow directions
    • 3) significant for particles >2m

    • 4) increases with particle size
    • 5) DUE TO INERTIA
  8. 6 sedimentation characteristics
    • 1) primarily in small conducting airways & alveolar region
    • 2) favored by deep, slow breathing
    • 3) negligible for particles <0.5m
    • 4) rate is proportional to square of the diameter of the particle & density difference between particle & air
    • 5) ***main mechanism of deposition of respiratory aerosols
    • 6) DUE TO GRAVITATIONAL FORCES
  9. 5 characteristics of diffusion
    • 1) occurs in lung periphery w/ small airway dimensions
    • 2) favored by breath-holding
    • 3) effective for particles <0.5m
    • 4) increases w/ decreasing particle size
    • 5) may be exhaled before deposition
  10. mechanism of extrathoracic deposition
    mainly inertial impaction
  11. mechanisms of tracheobronchial deposition
    • inertial impaction
    • sedimentation
  12. mechanisms of alveolar deposition
    • primarily sedimentation
    • diffusion for very small particles
  13. drug delivery system that depends on the power of a compressed/liquefied gas to expel the active ingredients from the container
    aerosol device
  14. drug delivery system from which the drug is inhaled when the patient inhales (activated only when the patient breathes in)
    inhaler
  15. mechanical device which generates a very fine mist (wet aerosol) which is inhaled by the patient using a mask over a period of 10-15min
    nebulizer
  16. very finely subdivided liquid or solid particles dispersed in and surrounded by air
    aerosol
  17. high pressure aerosols which contain ~85% propellant & dispense a finely divided spray w/ particles 50m
    space sprays
  18. contain 30-70% propellant & produce wet/coarse sprays w/ larger particles
    surface sprays
  19. example of a surface spray
    dermatological sprays
  20. contain 6-10% propellant & produce emulsions of propellants w/ the product concentrate
    foam sprays
  21. 3 examples of foam sprays
    • medicated foams
    • vaginal foams
    • shaving cream
  22. mainstay of successful asthma therapy
    pMDI
  23. formulation of pMDI (3)
    • 1) drug substance
    • 2) propellant
    • 3) surfactant/co-solvent
  24. single homogenous liquid in equilibrium w/ vapor
    homogenous (two-phase) aerosol
  25. suspension or emulsion in equilibrium w/ vapor
    heterogeneous (three-phase) aerosol
  26. 2 ways to fill aerosols
    • 1) cold filling¬†
    • 2) pressure filling (better bc less danger of moisture contamination & less propellant lost)
  27. components of aerosol product concentrate (4_
    • 1) active ingredients
    • 2) antioxidants
    • 3) surfactants
    • 4) solvent
  28. HFA
    hydrofluoroalkane (replaces CFC's)
  29. uses capsules of the medication powder, which you insert every time
    rotahaler DPI
  30. does not require loading w/ capsules (powder reservoir for 200 doses); has a window which counts doses left
    turbuhaler DPI
  31. uses medication powder in a blister pack (contains 4 doses), which is pierced to release a dose
    diskhaler DPI
  32. uses medication in foil pouches (contains 60 doses), which are pierced; has dose number indicator; doses 5-0 in red
    diskus or accuhaler DPI
  33. 3 populations that usually use a nebulizer
    • 1) children <5yo
    • 2) problems using MDI
    • 3) severe asthma
  34. purpose of spacer (3)
    • reduces...
    • 1) aerosol velocity
    • 2) droplet size
    • 3) impaction on pt

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