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74 Cards in this Set
- Front
- Back
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Provide an example of a pulmonary drug that is used for systemic reasons
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Insulin
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Name the two main methods of pulmonary drug delivery
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Intratracheal Instillation
Aerosol Inhalation |
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Surfactant therapy for neonatal RDS is an example of what type of pulmonary drug delivery?
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Intratracheal instillation
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How may aerosol be delivered?
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Aerosol may be delivered intratracheally and via oral inhalation
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What are the types of oral aerosols?
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Inhalers
Nebulizers |
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What are the types of Inhalers?
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Propellant driven and dry powder
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What are the types of nebulizers?
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Air-jet and ultrasonic
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The upper airway consist of what structures?
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The nose and the nasal cavity
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The upper airway and the tracheo-bronchial tree makes up what?
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The respiratory tract
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Name the components of the tracheo-bronchial tree
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1.Segmental bronchi
2.Non respiratory bronchioles 3.Respiratory Bronchioles 4.Alveolar Ducts 5. Alveoli |
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At the beginning of the branching of the trachea, the primary function is to...
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Conduct air to the respiratory region
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What is the function of the bronchi at the respiratory region?
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Gas Exchage
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The nasal cavity, nasopharynx, larynx, trachea and bronchi are lined with what type of epithelia? cells?
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Pseudostratified ciliated columnar epithelial cells alond with goblet cells.
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Function of mucus in the upper airway and the trachea bronchial tree
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1. Prevents epithelial dehydration
2. Traps foreign particles. |
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T or F
In the upper airway and the trachea, Cilia moves mucus towards the larynx where it is swallowed. |
F. It is swallowed in in the pharynx.
Process is known as an effective cleaning mechanism known as the "mucociliary escalator" which traps and remove particles. |
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Describe the surface area at the alveolar level.
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At the alveolar level, surface area increases dramatically and the distance to the circulation is short About 100 m sq.
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Describe the distance to the circulation at the alveolar level.
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the distance to the circulation is short About 100 m sq.
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How are particles (i.e. bacteria and undissolved drugs) removed from the alveoli?
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Macrophages
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The surface lining layer (SLL) covers the epithelium of the alveoli with what?
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Amorphous hypophase and alveolar surfactants
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What happens to a drug which is deposited to the oropharynx?
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Some drug absorption possible, but drug deposited here will likely pass into teh GI tract where it may be absorbed and is subjected to hepatic first pass.
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T or F
Drugs which deposit in the tracheobronchial region or alveoli that are absorbed systemically will undergo hepatic first pass. |
False. Will not undergo hepatic first pass.
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Name the three mechanism of aerosol deposition.
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Inertial Impaction
Sedimentation Diffusion |
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What are the primary aerosol-related factors affecting particle deposition?
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The size and teh speed of the particles.
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Aerosol particles are measured by what?
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Areosol particles are measured by their aerodynamic diameter.
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Aerodynamic diameter takes into consideration what?
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Particle Size
Partcle Shape Particle Desity |
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What is the most important size range for deep penetration?
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1-5 micrometer
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What is the deposition site for submicron aerosols?
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Alveolar or exhalation particle ....diffusion dominates
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Particles with a mean aerodynamic mass of > 10 will have what as a deposition site?
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Extrathoracic
Particles are too big..many will impact orapharynx and upper airway. |
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The Upper Tracheobronchial as a deposition site is for particles with a mean mass aerodynamic diametor of?
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5-10
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What is an important MMAD for deeper penetration?
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1-5
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Particles with a MMAD mass of 1-5 usually deposits where?
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Bronchioles, alveolar ducts, alveoli
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Particles with a MMAD mass of 1-5 usually settle and diffuse how?
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Settles and diffuses as airstream slows down.
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Deposition for submicron products?
What dominates? |
Alveolar or exhalation of particle.
Diffusion dominates. |
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Increase particle velocity favor deposition by ____?
Why? |
Impaction
The particle can't stay with the bending airstream. |
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What patient-related factors will affect the fate of the aerosol cloud (i.e particle deposition)?
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Disease state and breathing pattern
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T or F
The rate of breathing is the only factor that can affect particle deposition. |
False.
Both rate and depth of patient breathing can affect particle deposition. |
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For small respirable particles (1-5 micrometer) what type breathing patterns favor
a. deep penetration b. tracheobronchial deposition |
a. Slow/deep breaths
b. Rapid/shallow breaths |
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Holding ones breath favors deposition by ?
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Sedimentation and Diffusion
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Breathe holding is important because?
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1. It allows time for sedimentation
2. It minimize exhalation of particles. |
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What type of diseases can affect aerosol flow through the Lungs?
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Diseases that can affect caliber and tortuosity of the airway.
May affect aerosol flow and turbulence....i.e.asthma |
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What % of drug delivered via pulmonary drug delivery ends up in teh GI tract?
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80-95%
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Describe the effiency of pulmonary drug delivery.
Why? |
Poor
Suboptimal aerosol generation and Suboptimal inhalation technique |
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What is the most commonly prescribe pulmonary aerosol device?
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pMDI
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What are four essential components to to an MDI delivery system?
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1. The container
2. The metering Valve 3. The actuator 4. The propellant |
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What are the characteristics of the contaianer of pMDI?
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Must be strong enough to the contents under pressure.
Most are aluminum. Must be able to hole 15 to 30 ml |
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How is the metering valve attached to the actuator?
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It is attached to the actuator via the valve stem.
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Main function of a metering valve?
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To reproducibly deliver a portion of the liquid phase of the formulation
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What allows the pMDI to deliver a very accurate volume?
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The metering valve has a metering chamber of a specified volume, that empties upon actuation, and refill thereafter
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Function and shape of an actuator?
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Serves to depress the valve stem and acts as the mouth piece.
Most commonly L shaped |
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What is the physical feature of propellants at ambient temperature and pressure?
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Gas
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What is the physical feature of propellants at low temperature and high pressure?
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Liquid
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What are the two roles of the propellant?
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-It is the power source for aerosolization
- The vehicle for the drug |
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What is know as the power source for aerosolization?
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Propellant
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What are the two main types of propellants used for MDIs?
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CFCs and HFCs
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What must happen in order for the propellent to optimize?
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Must be mixed
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Describe CFC vs HCF.
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The usen of HFC compared to CFC reduces ozone depletion.
HCF are finer less forceful and warmer |
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Cosolvents are sometimes used in solutions of pMDI because...
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They can help make the solvent more POLAR
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Why are suspension formulations of pMDI very common?
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Because of the poor solubilizing capacity of propellents.
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What is a major disadvantage of suspentions?
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Potentially physically unstable. (Particles can aggregate, becoming to large)
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What are examples of excipients used in suspensions?
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SURFACTANTS
sorbitan triloeate (SPAN 85), oleic acids, lecitins |
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Why are excipients used in suspensions?
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Dispersing (suspending) agents
Can also help aerosol pass through the valve |
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Describe plume?
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Drug is in Propellent droplets
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Aerosols is release at 50 m/sec. What is it at 10 cm?
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10 m/sec
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Because the distant between the valve-outlet and oropharynyx is about 10 cm what is still high?
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The impact velocity is still high
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When can a "cold freon" effect happen?
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Sometimes when a plume reaches the oropharynx, often not all the propellant has been evaporated
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What is the MMAD the valve outlet?
How much does this reduce at about 12 cm from the outlet? |
30-40 micrometer
2-5 micrometer |
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Describe the loss of prime?
How long does it take to occur? |
The loss of propellant from the metering valve, it leaks into the bulk liquid.
days or weeks |
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Describe the loss of dose?
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an aerosol dose that is less than the label claim
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a loss of dose can result from?
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a loss of prime or phase seperation in a heterogeneus system
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Recommendation for a loss of dose?
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Shake and immediately fire
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What is the recommendation for a loss of prime?
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After a period of non use, shake and waste
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What are problems associated with pMDIs?
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1. coordination of inhalation with actuation
2. Orapharyngeal deposition problems ("cold freon", hoarseness, thrush) 3. Poor lung targeting |
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The reservior devices differ in what categories?
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-Volume, presence of inspiratory valve, spray directions, presences of flow indicator sount, presence of an integral actuator
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Inspirease is an example of
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a collapsible reservior bag
a reservior bag is inflated with the aerosol upon actuation |
