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PHAR 224 > Aerosols > Flashcards

Aerosols Flashcards

1
Q

What conditions general make use of aerosols?

A

angina, COPD, asthma

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2
Q

What are desirable features of aerosols for a patient?

A

counter, easy, portable, safe, low cost, quick, WORKS

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3
Q

What is the definition of an aerosol (what is particle size)?

A

dispersion of solid or liquid in a gas
size of <50 mcm

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4
Q

What are pros of aerosols?

A

local, rapid, metered, no contamination, easy

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5
Q

Cons of aerosols?

A

variability of bioavailability, penetration issues, low duration

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6
Q

What does insufflators mean?

A

powder blower

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7
Q

What does inhalant mean?

A

drugs with high vapour pressure= wants to change into gas or vapour stat

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8
Q

What are the components of a pressurized aerosol?

A

propellant
product concentrate
container
valve and actuator

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9
Q

Why do we need a propellant?

A

need proper pressure in it and to expel the product

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10
Q

What are some examples of propellants?

A

Chloro-fluoro hydrocarbons
hydrofluroalkane
hydrocarbons
compressed gas

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11
Q

What is the most common propellant used?

A

HFA- less ozone hurting

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12
Q

True or false CFH are miscible with water?

A

false

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13
Q

Why arent CFH not used anymore?

A

hurts ozone

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14
Q

When are we allowed to use CFH products?

A

if no feasible alternative, significant benefit, no significant release into atmosphere

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15
Q

What characteristic must all propellants have?

A

INERT and tox safe

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16
Q

What is an issue with using hydrocarbons as a propellant?

A

flammable

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17
Q

What type of aerosols are made with hydrocarbons?

A

foam or water based

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18
Q

What are some hydrocarbons?

A

propane, butane, isobutane

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19
Q

When do we use compressed gases for aerosols?

A

usually topical

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20
Q

Examples of compressed gases used as propellants?

A

N2, NO, CO2

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21
Q

What is an issue with using compressed gas as a propellant?

A

as you use it up the pressure goes down and works less

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22
Q

In what condition may the product concentrate be in for pressurized?

A

solution, suspensioon, or emulsion

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23
Q

What is a solution system for aerosols?

A

two phases= solution of active and liquid propellant and vapor propellant
when activated the pressure of vapour causes liquid to rise and be expelled

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24
Q

What is a suspension system for aerosols?

A

2 phases= active dispersed in propellant, surfactant to lower agglomeration

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25
Q

What is an issue with suspension systems?

A

valve can clog up= innacurate so you need a surfactant or lube

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26
Q

What are the surfactants/ lubes used for suspension systems?

A

non-ionic surfactants HLB<10, mineral oil, isopropyl myristate

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27
Q

What are the two emuslsion systems and how many phases do they have?

A

foam and spray
3 phases

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28
Q

What are foam systems?

A

propellant is internal phase (o/w)
- usually topical

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29
Q

What are spray emulsions system?

A

propellant is external phase (w/o)
NO foaming

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30
Q

Which type of emulsion system has no foam?

A

spray emulsions

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31
Q

Which type of emulsion system is o/w emulsions?

A

foam

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32
Q

Which type of emulsions system is w/o emulsions?

A

spray emulsions

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33
Q

Which type of emulsions system has propellant as the external phase?

A

spray

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34
Q

Which type of emulsions system has propellant as the internal phase?

A

foam

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35
Q

What are some key characteristics of containers for pressurized aerosols?

A

ok with high pressure
metal/glass

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36
Q

When is the container glass for pressurized aerosols?

A

topical

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37
Q

How can we prevent glass containers from breaking for a pressurized aerosol?

A

plastic coating

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38
Q

What metals are used for containers of pressurized aerosols?

A

steel
aluminum
stainless steel-NO cause$$$$

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39
Q

WHy is aluminum sometimes not used as a container for pressurized aerosols?

A

if CHF may react with water to form HCl

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40
Q

What is a continuous valve and what preparations utilize this usually?

A

as long as it is pressed it will release- topical

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41
Q

When does a metered valve need a dip tub?

A

if upright= NOT like a asthma inhaler

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42
Q

What is the role of a metered chamber?

A

determines the volume of the product delivered

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43
Q

What is a limitation of a metered valve?

A

loss of product during actuation- loss to inner surface, not all reaches lungs

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44
Q

How much drug gets to the lungs with perfect technique?

A

25%

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45
Q

When are inhalation aids used?

A

for MDI- gets into lungs NOT mouth

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46
Q

What are non pressurized devices?

A

breathe activated and nebulizers

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47
Q

WHat are some breathe activated devices?

A

respimat
turbuhaler
handihaler
diskus

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48
Q

What are two counsel tips for Respimat?

A

prime

49
Q

What medicinal ingredients are repsimat?

A

tiotropium
olodaterol

50
Q

What are some non medical ingredients of respimat?

A

benzalkonium, HCL, water

51
Q

True or false breathe actuated devices have preloaded doses?

A

True

52
Q

How do you actuate turbuhaler?

A

twist bottom

53
Q

How do you actuate handihaler?

A

break capsule

54
Q

What is a unique feature of genuair?

A

feeback to tell that you took it right (clicks)

55
Q

Pros of MDI?

A

portable, easy

56
Q

Cons of MDI

A

high loss, coordination, need technique, reaction to propellant, no counter

57
Q

Pros of DPI?

A

easy coordination
counter
no propellant

58
Q

Cons of DPI

A

need DEEP inhalation= no for young or old
loss of powder
gritty taste

59
Q

What are pros of respimat?

A

soft mist= low coordination and less lung breathe

60
Q

Cons of Respimat

A

cost and need to prime

61
Q

When should you use a nebulizer?

A

NO need of patient coordination at all= for children
if VERY low lung use= AECOPD

62
Q

How do nebulizers work?

A

compressed air/oxygen or ultrasonic to deliver solution

63
Q

Cons of nebulizers

A

not portable
expensive
need lots of volume of drug solution, long times

64
Q

How do jet nebulizers work and what is the venturi effect?

A

pressurized jet air enters narrow tube through the venturi (narrow opening), this causes a drop in pressure and a vaccume effect sucks liquid drug up the tube

65
Q

How do you change particle size with a ultrasonic nebulizer?

A

change frequency

66
Q

Which is preffered mouth piece or mask for nebulizers

A

mouthpiece

67
Q

What is issue with facemasks for nebulizers?

A

gets on skin, near eye

68
Q

Counsel tips for MDI

A

use spacer, clean space, shake, prime

69
Q

If patients inhaler does not seem to be working what should a pharmacist ALWAYS do?

A

check technique

70
Q

What device should be used if cystic fibrosis?

A

nebulizers

71
Q

What is the path of the respiratory system?

A

pharynx- voice
trachea
bronchi
bronchioli
alveloar sac
alveoli

72
Q

True or false inhaltion drugs will have no systemic absorption.

A

false

73
Q

Where are macrophages only present in the lung?

A

peripheral lung

74
Q

What should be the range of drug sizes for inhaltation therapy?

A

1-5 mcm

75
Q

What kind of clearance does the central lung have?

A

mucocilliary

76
Q

True or false: the central lung has bigger mucos layer alveoli?

A

true

77
Q

What are the three ways of deposition of drug in the lung and explain them?

A

inertial impaction= >3 mcm, fast moving
gravitational settling= depends on size
diffusion= <1 mcm

78
Q

If a particle is 11 mcm where does it end up?

A

lost through inertial impaction at nose or throat

79
Q

If a particle is 6 mcm where does it end up?

A

lower resp tract

80
Q

If the particle is 1-5 mcm where does it end up?

A

lung periphery

81
Q

What is mass median aerodynamic diameter and what does a high number mean?

A

MMAD= particle size that is 50% of the amount of drug
higher= More particles are larger

82
Q

If i am a particle that is 0.1 mcm where do I go?

A

doesnt deposit in lungs= exhaled

83
Q

If correct technique how much of a 200 mcg MDI gets to the lung?

A

20-40 mcg

84
Q

How does speed effect deposition?

A

fast= inertial impaction
slow/steady= get to periphery
holding breathe= enables them to settle by gravity

85
Q

How long should you hold your breathe for after dose?

A

10 seconds

86
Q

If holding your breath is beneficial, is 20 seconds better than 10?

A

NO

87
Q

Inhaler technique?

A

breathe out, tilt head back, inhale deep and slo, hold, breathe out

88
Q

How long should you wait between doses?

A

30 seconds

89
Q

Which devices are patient complient more often?

A

MDI, respimat

90
Q

If hospitalized which device is generally used?

A

nebulizer

91
Q

If patient has difficulty coordinating which device?

A

NOT MDI

92
Q

If low ability for deep breathe which device?

A

NOT DPI

93
Q

What age should not get DPI?

A

<6

94
Q

When does Raoult’s law apply?

A

liquified gas systems

95
Q

What is Raoult’s law?

A

mixture of volatile in liquid state, partial pressure of propellant can be approximated

96
Q

What does Ideal gas law state?

A

increased temp/moles= higher pressure and volume

97
Q

When should you prime for ventolin and flovent?

A

V= 5 days
F= 7 days

98
Q

How much can not shaking MDI lower your dose?

A

25-35%

99
Q

Can temperature effect dose of MDI?

A

yes, >20 and <-20

100
Q

Dose a smaller nozzel of an MDI improve delivery?

A

yes <1mm

101
Q

What should be done if ICS inhalation?

A

wash mouth

102
Q

Should you use close mouth or open mouth technique?

A

closed

103
Q

What is an autohaler? How do you prime it?

A

push lever up for activation then same MDI steps
prime by psuh white test fire slide

104
Q

WHAT NON MEDICAL INGREDIENT SHOULD YOU KNOW FOR RESPIMAT?

A

benzalkonium chloride= cationic surfactant

105
Q

Do you need to shake respimat?

A

No

106
Q

How long does cartidge last for respimat?

A

3 months when inserted

107
Q

How do you use respimat?

A

turn, open, breathe out breathe and press button

108
Q

Which DPIs are single dose?

A

Breezhaler and handihaler

109
Q

Which DPIs need to be primed?

A

no for single dose

110
Q

Is it a good thing to have high inspiritory effort for DPI?

A

no- hits back of throat

111
Q

What is carrier for DPIs?

A

lactose

112
Q

Dose carrier for DPI cause a problem for lactose intolerant people?

A

NO

113
Q

How do you use turbuhaler?

A

open cap, turn to right then left until click then use

114
Q

What happens when using a breezhaler or handihaler?

A

vibrates= good rate

115
Q

How do you use diskus?

A

open cap, push lever down until clock, use

116
Q

What does red mean on diskus?

A

less than 5 doses left

117
Q

What is nonmedicinal ingredient of ellipta you should know?

A

mag stearate= flowability

118
Q

How to use ellipta?

A

load dose by sliding cover then use

119
Q
A

PHAR 224 (7 decks)

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