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Drew 924 > 4_1Pumps > Flashcards

4_1Pumps Flashcards

1
Q

What is a pump?

A

small biocompatible device for administration of drug solution to cell matrix or vascular system

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2
Q

Who regulates pumps?

A

CDER - Center for Drug Evaluation and Research

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3
Q

How are pumps categorized?

A

by point of entry

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4
Q

What are the types of pumps?

A

implantable and external

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5
Q

What is the Baxter pump?

A

the acute care iv tree pump, not related

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6
Q

What are the common features of the two types of pumps?

A

1) durable, 2) biocompatible, 3) drug solution reservoir, 4) energy source required, 5) controlled rate of delivery

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7
Q

What are the main advantages of implantable pumps?

A

1) decreased infection risk, 2) convenience

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8
Q

What is the Codman 3000?

A

A type of propellant driven implantable pump

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9
Q

What are the types of implantable pumps?

A

1) propellant driven 2) osmotic

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10
Q

What equation describes flow through a tube?

A

poiseuille’s law

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11
Q

What is the propellant in a propellant-driven pump?

A

perflurocarbon with a low BP

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12
Q

What are the range of volumes available in the Codman 3000?

A

16-50 mL

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13
Q

What is the range of delivery rates available by the Codman?

A

1 - 2.5 mL/day

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14
Q

How long between refills with the Codman?

A

4 weeks

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15
Q

Codman diameter

A

20-85 mm

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16
Q

Codman height

A

32mm

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17
Q

Codman mass

A

100-175 g

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18
Q

On what does the vapor pressor of the Codman’s propellant depend?

A

temperature only

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19
Q

What structural aspects does the Codman have?

A

1) solution filter, 2) flow restrictor, 3) expanding drug reservoir - no mechanical moving parts

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20
Q

What makes up the biocompatible container of the Codman?

A

polished Ti

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21
Q

Describe the kinetics of drug delivery with the Codman?

A

long-term 0 order

22
Q

What are the 3 sizes of osmotic pumps?

A

100 uL, 200 uL, 2 mL

23
Q

What are the ranges of rates and treatment durations with a 100 uL osmotic pump?

A

0.1 - 1 uL/h for 3-28 days

24
Q

What are the ranges of rates and treatment durations with a 200 uL osmotic pump?

A

0.15 - 8 uL/h for 1-42 days

25
Q

What are the ranges of rates and treatment durations with a 2 mL osmotic pump?

A

2.5 - 10 uL/h for 1-4 weeks

26
Q

What is the rate-limiting step of osmotic pumps?

A

semi-permeable membrane and size of orifice

27
Q

Describe the release kinetics of osmotic pumps.

A

zero order as long as the osmotic salt layer is supersaturated

28
Q

Describe the structure of an osmotic pump.

A

1) drug surrounded by impermeable reservoir; 2) reservoir surrounded by osmotic salt layer; 3) salt layer surrounded by semi-permeable membrane

29
Q

How is the osmotic pump delivered to the body?

A

It’s embedded in tissue or tied to vessel via tube from orifice

30
Q

What are the challenges to implantable pumps?

A

1) volume, 2) biocompatibility, 3) emboli, 4) dose dumping, 5) pocket fill

31
Q

How can emboli risk be minimized?

A

1) anticoag therapy, 2) bond hydrophilic polymer to surface, 3) mimic membrane surface with phospholipids

32
Q

What can cause dose dumping an an implantable pump?

A

1) trauma to energy source; 2) mechanical or material malfunction

33
Q

What is “pocket fill”?

A

refill injected into surrounding SQ pocket

34
Q

What are the characteristics of drug formulations that can be given in implantable pumps?

A

1) solutions only; 2) soluble and stable at physio conditions; 3) small volume

35
Q

What are the possible consequences for a non-biocompatible implantable pump?

A

1) immunological response forms fibrotic capsule; 2) drug precipitates at release point

36
Q

What was the first external pump?

A

Kadish artificial pancreas in 1963

37
Q

What kind of external pump was the Kadish artificial pump?

A

closed-loop

38
Q

What are the characteristics of an open-loop external pump?

A

1) basal rate; 2) on-demand variation ability; 3) patient uses in vitro test to determine action

39
Q

How do external insulin pumps vary?

A

1) volume, 2) rate/timing, 3) bolus ability, 4) memory, 5) PC interface, 6) alarm, 7) waterproofing

40
Q

What are the types of external pumps?

A

1) open loop; 2) closed loop

41
Q

What are the disadvantages to continuous glucose monitors?

A

1) frequent calibration; 2) wound care; 3) variable acceptability

42
Q

Describe the glucose testing of a continuous glucose monitor?

A

SQ sensor test q 1-5 mins; sensor changes q 3-7 days

43
Q

What are the disadvantages for external insulin pumps?

A

1) catheter care, 2) bothersome for sports & H2O; 3) training requires hospital or outpatient day; 4) expensive

44
Q

What are the advantages to external insulin pumps?

A

1) fewer glucose fluctuations improves A1c; 2) eliminates individual injections; 3) more accurate; 4) flexibility in diet and exercise

45
Q

How is insulin delivered from an external insulin pump?

A

catheter to SQ tissue

46
Q

What proteins may absorb to a non-biocompatible device?

A

albumin, acid glycoprotein, and fibrinogen

47
Q

What causes the release of a thrombus from a device?

A

thrombus aging and thrombolytic enzymes

48
Q

How is a thrombus formed on an implantable device?

A

1) adsorption and denaturation of proteins; 2) platelet adhesion and flattening; 3) Vit. K dependent clotting cascade

49
Q

What are the future developments in external pumps?

A

closed loop systems (MedTronic Revel for insulin)

50
Q

What is an advantage to a continuous glucose monitor?

A

data display and storage viewable by physician

51
Q

What are advantages of external pumps when compared to internal pumps?

A

1) less costly, 2) less dose-dumping, 3) easy access for refill

52
Q

What are disadvantages for external pumps compared to internal pumps?

A

1) indwelling catheter can cause infection; 2) worn externally; 3) patient monitoring affects compliance

Drew 924 (16 decks)

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