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Respiratory Therapeutics > 3a. Aerosol > Flashcards

3a. Aerosol Flashcards

1
Q

What is an aerosol?

A

Suspension of solid of liquid particles in gas

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2
Q

What is Aerosol Therapy?

A

Delivery of aerosol particles to the respiratory tract

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3
Q

What are the 3 main uses for aerosol therapy?

A
  1. Humidification of Dry inspired gases by using bland aerosols
  2. Airway Clearance and mobilization of respiratory secretions using bland aerosols
  3. Delivery of aerosolized drugs to respiratory tract
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4
Q

What’s a Bland Aerosol? and give 3 examples

A

Liquid particles suspended in an inspired gas

Ex) Sterile Water, Hypotonic/Isotonic/Hypertonic Saline

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5
Q

What are the 3 factors particle size depend on?

A
  1. Substance being nebulized
  2. Method of Use
  3. Environmental Conditions
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6
Q

What does GSD stand for and what does it mean?

A

Geometric Standard Deviation

Describes the variability of particle sizes in an aerosol distribution

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7
Q

What’s the difference between Heterodisperse and Monodispersed aerosols?

A

Heterodispersed : Particles with different sizes

Monodispersed: Particles with similar sizes

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8
Q

What is the relationship between GSD and the range of particle sizes?

A

The greater the GSD is, the more wider range of particles sizes ➔ heterodispersed

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9
Q

What is used to measure particle size distributions?

A

Cascade impaction (more common) and Laser Scattering

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10
Q

How does Cascade Impaction work?

A

Cascade Impactor collects aerosols of different size ranges on a series of stages or plates.
Collects large particles and whatever that’s not impacted move to next stage with smaller orifices until it is collected on a final filter with vacuum pump on the end.

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11
Q

How does Laser Scattering/Diffraction work?

A

Determines the relationship between the intensity & angle of light scattered from a particle, then calculates the particle size based on the Mie-scattering theory

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12
Q

What is particle aging?

A

When aerosol suspension is changing over time

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13
Q

What are the 4 factors that depend on particle aging?

A

Composition, Initial Size, Time in suspension, Ambient Condition

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14
Q

How can Aerosol Particles change?

A

Particle can change as a result of either evaporation or hygroscopic water absorption

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15
Q

What is the relationship with the rate of particle size change and the size of particle?

A

They are inversely proportional
Small particles grow/shrink faster than large particles
Large particles grow/shrink slower than small particles

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16
Q

What is Deposition?

A

A process where aerosol particles leave suspension in gas, they deposit on (attach to) a surface

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17
Q

What’s the major factor that influences Deposition?

A

Particle Size

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18
Q

What’s the particle size range that delivers to the Upper Airways (Nose, larynx, trachea)

A

5 - >50 um

19
Q

What’s the particle size range that delivers to the Lower Generation?

A

2-5 um

20
Q

What’s the particle size range that delivers to the Parenchyma: Alveolar Region

A

1-3 um Parenchyma: Alveolar Region

<0.1 in parenchyma

21
Q

What is Inhaled Mass?

A

Amount of emitted aerosol/dose is inhaled

22
Q

What is Respirable Mass

A

Amount of inhaled/respirable dose is deposited in lungs that can reach lower airways

23
Q

What are 3 Key Mechanisms/Motions of Deposition?

A

Inertial Impaction, Gravimetric Sedimentation, and Brownian Diffusion

24
Q

What is Inertial Impaction? and What particle size

A

Where aerosol in motion collides with and are deposited on surface
Large Particles >5um

25
Q

Inertial Impaction: What’s the theory?

A

The greater the mass and velocity of a moving droplet, the greater the inertia and tendency of that droplet to continue moving along its set path.

26
Q

What will increase aerosol deposition by inertial impaction?

A

Variable or irregular passages and turbulent gas flow.

27
Q

What is Gravimetric Sedimentation? and What particle size?

A

When aerosol particles settle out of suspension and are deposited due to the pull of gravity.
Small Particles: 1-5 um

28
Q

Gravimetric Sedimentation: What’s the theory (2)?

A

Breath-holding after inhalation increases sedimentation and distribution in the lungs.
The greater the mass of a particle, the faster it settles.

29
Q

What is Brownian Diffusion? and what particle size?

A

Primary mechanism for deposition of small particles, mainly in the respiratory region where bulk gas flow ceases and most aerosol particles reach the alveoli by diffusion
Very Small Particles: <3um

30
Q

Brownian Diffusion: What’s the theory for smaller particles (2)?

A

Particles 1 to 0.5 μm: so stable, most remain in suspension and are cleared with the exhaled gas
Particles < 0.5 μm: have a greater retention rate in the lungs

31
Q

What are therapeutic aerosol depositions influenced by? (6)

A

Inspiratory Flow Rate, Flow Pattern, RR, Inhaled Volume, I:E Ratio, and Breath Holding

32
Q

What are the hazards to Aerosol Therapy? (7)

A

Primary: Adverse reaction to the drug
Others: Infection, Risk of inducing Bronchospasm, Systemic effects of Bland Aerosols (Overhydration), Drug Reconcentration, Eye irritation
Tubing condensation draining into the airway.

33
Q

Why is particle size important for aerosol delivery?

A

Particle size will tell us how it enters the airways (mechanism) and where it will deposit in the body or lungs.

34
Q

What is the primary method of deposition of large, high mass particles?

A

Inertial impaction

35
Q

What do you to prevent bronchospasm when you nebulize reactive substances?

A

Administer a bronchodilator prior to given agents that cause spasms

36
Q

Gravimetric Sedimentation:
How long is an ideal breath hold maneuver?
How much will you increase drug deposition?
What about drug distribution?

A

Ideal breath hold maneuver: 10 seconds
How much you might increase drug deposition: 10%
Drug Distribution: Increase ratio of aerosol deposited in the lung parenchyma to the central airways

37
Q

What are the 6 aerosolized substances that are associated with increased airway resistance?

A

Acetylcysteine, Antibiotics, Steroids, Cromolyn Sodium, Ribavirin, and Distilled Water

38
Q

3 CDC recommendations to prevent nosocomial infection

A

Sterilized between patients, Replace frequently with disinfected or sterile units, or rinse with sterile water and air dry every 24 hours

39
Q

How will eye irritation occur?

A

Aerosol administration with face mask may deposit drug in eyes. Anticholinergic medications suspected to worsen preexisting eye conditions

40
Q

Advantages of Aerosol Medication Delivery (7)

A

◦ *Provides high therapeutic index
◦ Aerosol Doses are smaller than doses for systemic treatment
◦ Rapid onset of drug action
◦ Local drug delivery to the respiratory system
◦ *Fewer or less severe systemic side effects
◦ Painless and Convenient
◦ Lung provides portal to the body for inhaled aerosol agents intended for systemic effect

41
Q

Disadvantages of Aerosol Medication Delivery (5)

A

◦ Numerous variables affecting drug delivery
◦ Inconsistent dose estimation and dose reproducibility
◦ Coordination of hand action and breathing with MDIs
◦ Many nurses, physicians, and therapists lack knowledge of device use and protocols
◦ Numerous device types are confusing to patients and practitioners

42
Q

How would you do a Patient Assessment? (5)

A

Basic Assessment: HR, RR, BS, BP
Correct use of devices (technique)
Drug Effectiveness: Reversibility, Peak Flow, Spirometry
Subjective Response (Patient’s POV)
ABG and/or SpO2 in acute situations as needed

43
Q

How would you do Patient Assessment for Long Acting agents? (6)

A

‣ PFTs for long term monitoring
‣ Ongoing lung function
‣ Amount of B-Agonist Use
‣ Degree of nocturnal symptoms
‣ Number of exacerbations requiring physician consult
‣ Degree of lifestyle change due to symptoms

Respiratory Therapeutics (11 decks)

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