Pharmacology

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GOBLET CELL

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FOUND IN THE MUCOSAL EPITHELIUM,THESE SECRETORY CELLS PRODUCE GELATINOUS MUCUS. TOPICAL IRRITAION AND EXPOSURE TO IRRITANTS INCREASE THEIR SIZE AND NUMBER.

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HYDROPHILIC

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MOLECULES OR SUBSTANCE THAT IS ATTRACTED TO WATER.

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HYPERTONIC

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A SOLUTION CONTAINING A GREATER CONCENTRATION OF SALT THAT IS NORMALLY FOUNG IN THE BODY

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HYPOTONIC

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A SOLUTION CONTAINING A LOWER CONCENTRATION OF SALT THAT IS NORMALLY FOUND IN THE BODY

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ISOTONIC

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A SOLUTION CONTAINING THE SAME CONCENTRATION OF SALT AS THAT FOUND IN THE BODY

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MUCOLYSIS

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REFERS TO THE ACTUAL BREAKING APART OF MUCUS MOLECULES.

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MUCOLYTICS

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REFERS TO THE PHARMACOLOGICAL AGENTS THAT CAUSE "MUCOLYSIS" OF THE MUCUS MOLECULES IN ORDER TO ENHANCE THEIR REMOVAL FROM THE LOWER RESPIRATORY TRACT.

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RHINORRHEA

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EXCESSIVE SECRETION FROM THE NOSE.

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SEROUS CELLS

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PRODUCE LEDD VICOUS MUCUS AND IS PROBABLY RESPONSIBLE FOR THE SOL LAYER OF MUCUS.

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STOMATITIS

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INFLAMMATION OF THE MUCOUS LINING IN THE MOUTH

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SURFACE TENSION

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FORCE OF CONTRACTION AT THE SURFACE OF A LIQUID THAT PULLS THE MOLECULES AT THE SURFACE INWARD AND DOWN.

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SURFACTANT

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COMPLESX MIXTURE OF PHOSPHOLIPIDS AND PROTEINS PRODUCED IN THE LUNG BY THE TYPE II PNEUMOCYTES. IT PLAYS A CRUCIAL ROLE IN REDUCING ALVEOLAR SURFACE TENSION AND PREVENTING ALVEOLAR COLLAPSE

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VISCOSITY

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REFERS TO THE THICKNESS OF SECRETIONS WHICH REISTS FLOW OT MOVEMENT.

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THE LAYER OF MUCUS THAT COVERS THE SURFACE OF THE AIRWAYS IS HOW THICK

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5 TO 10 MICRONS

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HOW MANY LAYER OF MUCUS COVER THE AIRWAYS? WHAT ARE THERE NAMES ?

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TWO.. GEL LAYER AND SOL LAYER.. GEL LAYER IS ON TOP

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SURFACE TENSION

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FORCE OF CONTRACTION AT THE SURFACE OF A LIQUID THAT PULLS THE MOLECULES AT THE SURFACE INWARD AND DOWN.

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SURFACTANT

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COMPLESX MIXTURE OF PHOSPHOLIPIDS AND PROTEINS PRODUCED IN THE LUNG BY THE TYPE II PNEUMOCYTES. IT PLAYS A CRUCIAL ROLE IN REDUCING ALVEOLAR SURFACE TENSION AND PREVENTING ALVEOLAR COLLAPSE

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VISCOSITY

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REFERS TO THE THICKNESS OF SECRETIONS WHICH REISTS FLOW OT MOVEMENT.

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THE LAYER OF MUCUS THAT COVERS THE SURFACE OF THE AIRWAYS IS HOW THICK

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5 TO 10 MICRONS

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HOW MANY LAYER OF MUCUS COVER THE AIRWAYS? WHAT ARE THERE NAMES ?

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TWO.. GEL LAYER AND SOL LAYER.. GEL LAYER IS ON TOP

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mucus function in the Healthy lung

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preventing water form moving into and out of the epithelia , shielding epithelia from direct contact with toxic material, irritants and microorganisms preventing infection by the action of antimicrobial enzymes, lubrication of the airways

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diseases that increase the volume or thickness of mucus?

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chronic bronchitis, asthma, Cystic fibrosis, acute bronchitis, pneumonia.

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what are the factors that impair ciliary activity

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endotracheal tubes, extremes of temperature, high concentrations of oxygen , dust fumes and smoke, dehydration thick mucus infections..

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what are some factors that lead to dehydration and thick mucus

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increased respiratory rate, increased depth of breathing, systemic fluid loss, infections

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what are 3 pharmacologic approach to secretion management/

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give agents that increase the depth of the sol layer(water or saline solution)..give agents that alter the consistency of the gel layer(mucolytic)... give agents that improve ciliary activity (sympahtomimetic bronchodilators and corticosteroids)

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secrestion management appraches

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deep breathing , assisted coughing,suctioning, humidity, medicated or bland aerosols, mechanical techniques, mucus-controlling drugs (mucolytics)

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bland aerosols

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ex water normal saline , hypotonic saline, hypertonic saline,

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hypertonic saline

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any solution that contains more than 0.9% sodium chloride.most commonlu available solutions contain 5% and 10% NaCl, used for sputum induction. more likely to cause bronchospasm than normal saline

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Hypotonic Saline

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Less irritating than either sterile water or hypertonic saline.
Less likely to cause problems with sodium retention than normal saline.
Can be delivered via ultrasonic nebulizer, in any large-volume nebulizer, or as the diluent for nebulized medications.

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Mucolytic Agents

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These agents actually breakdown mucus, reducing it’s viscosity, thus making it easier to move and expectorate from the lower respiratory tract! They “directly” alter the structure of the mucus molecule!

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generic name: acetyleysteine

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trade name: mucomyst,mucosil, mucosol dosage/ route 10% and 20% solution, SVN or directly in to the trachea via ET or trach: mode of action: disrupts the disulfide bonds of the mucopolysaccharide strand

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n-acetylcysteine (Mucomyst, Adverse reactions:

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bronchospasm,Nausea
Rhinorrhea (runny nose)
Bronchorrhea (excess of thin watery secretions in the airway)
Stomatitis (inflammation of the mucous lining in the mouth)

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Dornase Alfa (Pulmozyme)

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Clone of the natural human enzyme that digests extracellular DNA.
Solution of recombinant human deoxyribonuclease (DNase).
Maintenance therapy drug.
Used to manage viscous pulmonary secretions seen in cystic fibrosis.
A proteolytic enzyme that breaks down the DNA material and therefore decreases the viscosity of the mucus.

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Dornase Alfa (Pulmozyme) (cont.)

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Dose and administration:
Available in single-dose ampules.
Administered once daily.
Should not be diluted or mixed with other medications.
Should be refrigerated and protected from light.

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dornase alfa

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pulmozyme 2.5mg/2.5ml UD SVN mouth piece qday or b.i.d this lyses the DNA debris commonly found in the infected / bacteria colonized sputum of the cystic fibrosis