15. Inhalation pharmacotherapy Flashcards
What are the advantages of giving drugs in inhaled form?
Effective, rapid effect, safety.
What are the disadvantages of giving drugs in inhaled form?
Need for a device, depends on patients’ compliance, depends on inhalation technique, oral candidiasis can occur.
What are the inhaled agents used in pharmacotherapy?
Corticosteroids, Beta-2 agonists (SABA/LABA), Muscarinic antagonists, Antibiotics.
What are the influencing factors of deposition in the respiratory system?
- Agent size,
- inhalation flow + PIF,
- inhalation and breath-hold timing,
- respiratory anatomy,
- inhaler characteristics.
What are the indications for inhaled pharmacotherapy?
COPD or asthma +/- acute exacerbations, respiratory disease + expiratory wheezing.
What are the types of inhalers?
- Metered dose inhalers (MDI)
- Dry powder inhalers (DPI)
- Soft mist inhalers (SMI)
- Nebulizers
What is the propellant used in MDIs?
HFA (hydrofluoroalkane).
What percentage of the drug reaches the lower airways when using an MDI?
10%.
What is the advantage of using an MDI?
Small particle size, effective deposition, and cheap.
What is the disadvantage of using an MDI?
Need for accurate coordination and high particle velocity.
What is the drug formulation used in DPIs?
Dry powder.
What is required for proper effectiveness when using a DPI?
Sufficiently strong inhalation.
What determines the particle size in DPIs?
Peak inspiratory flow (PIF).
the faster the inhalation, the smaller the particles
What is the disadvantage of using a Soft mist inhaler (SMI)?
Expensive.
What is the name of the device that uses LABA or LAMA in SMI?
Respimat.
What is a nebulizer?
A device that turns liquid medicine into a mist for inhalation through a mouthpiece or mask.
What are the advantages of using a nebulizer?
No need for coordination, applicable in emergency situations, and can be used with SABA + saline.
What are the disadvantages of using a nebulizer?
Inaccurate dosing, expensive, and requires maintenance.
What is the difference between a metered dose inhaler and a dry powder inhaler?
A metered dose inhaler requires coordination, while a dry powder inhaler does not require coordination but requires deep inspiration.
Who is a nebulizer suitable for?
Elderly, children, and unconscious patients who can use a mask.
What are the factors that influence the effectiveness of inhalation devices?
- Age,
- education,
- socio-economic status,
- physical condition,
- comorbidities,
- lifestyle,
- family support,
- psychological status,
- dosage,
- ease of use,
- patient education,
- appearance,
- size
- taste.
What are some determinants of poor inhaler techniques?
Older age, use of multiple devices, co-morbidities (arthritis, stroke, neuropathy), lack of previous education on inhaler techniques.
What is considered good education on inhaler techniques?
Minimum 6 months, combined with practice, repeated education.
What is the importance of educating patients on inhaler techniques?
The therapeutic successfulness of the patients depends on the efficient molecules and the correct use of the inhaler.
