Aerosols Flashcards
What conditions general make use of aerosols?
angina, COPD, asthma
What are desirable features of aerosols for a patient?
counter, easy, portable, safe, low cost, quick, WORKS
What is the definition of an aerosol (what is particle size)?
dispersion of solid or liquid in a gas
size of <50 mcm
What are pros of aerosols?
local, rapid, metered, no contamination, easy
Cons of aerosols?
variability of bioavailability, penetration issues, low duration
What does insufflators mean?
powder blower
What does inhalant mean?
drugs with high vapour pressure= wants to change into gas or vapour stat
What are the components of a pressurized aerosol?
propellant
product concentrate
container
valve and actuator
Why do we need a propellant?
need proper pressure in it and to expel the product
What are some examples of propellants?
Chloro-fluoro hydrocarbons
hydrofluroalkane
hydrocarbons
compressed gas
What is the most common propellant used?
HFA- less ozone hurting
True or false CFH are miscible with water?
false
Why arent CFH not used anymore?
hurts ozone
When are we allowed to use CFH products?
if no feasible alternative, significant benefit, no significant release into atmosphere
What characteristic must all propellants have?
INERT and tox safe
What is an issue with using hydrocarbons as a propellant?
flammable
What type of aerosols are made with hydrocarbons?
foam or water based
What are some hydrocarbons?
propane, butane, isobutane
When do we use compressed gases for aerosols?
usually topical
Examples of compressed gases used as propellants?
N2, NO, CO2
What is an issue with using compressed gas as a propellant?
as you use it up the pressure goes down and works less
In what condition may the product concentrate be in for pressurized?
solution, suspensioon, or emulsion
What is a solution system for aerosols?
two phases= solution of active and liquid propellant and vapor propellant
when activated the pressure of vapour causes liquid to rise and be expelled
What is a suspension system for aerosols?
2 phases= active dispersed in propellant, surfactant to lower agglomeration
What is an issue with suspension systems?
valve can clog up= innacurate so you need a surfactant or lube
What are the surfactants/ lubes used for suspension systems?
non-ionic surfactants HLB<10, mineral oil, isopropyl myristate
What are the two emuslsion systems and how many phases do they have?
foam and spray
3 phases
What are foam systems?
propellant is internal phase (o/w)
- usually topical
What are spray emulsions system?
propellant is external phase (w/o)
NO foaming
Which type of emulsion system has no foam?
spray emulsions
Which type of emulsion system is o/w emulsions?
foam
Which type of emulsions system is w/o emulsions?
spray emulsions
Which type of emulsions system has propellant as the external phase?
spray
Which type of emulsions system has propellant as the internal phase?
foam
What are some key characteristics of containers for pressurized aerosols?
ok with high pressure
metal/glass
When is the container glass for pressurized aerosols?
topical
How can we prevent glass containers from breaking for a pressurized aerosol?
plastic coating
What metals are used for containers of pressurized aerosols?
steel
aluminum
stainless steel-NO cause$$$$
WHy is aluminum sometimes not used as a container for pressurized aerosols?
if CHF may react with water to form HCl
What is a continuous valve and what preparations utilize this usually?
as long as it is pressed it will release- topical
When does a metered valve need a dip tub?
if upright= NOT like a asthma inhaler
What is the role of a metered chamber?
determines the volume of the product delivered
What is a limitation of a metered valve?
loss of product during actuation- loss to inner surface, not all reaches lungs
How much drug gets to the lungs with perfect technique?
25%
When are inhalation aids used?
for MDI- gets into lungs NOT mouth
What are non pressurized devices?
breathe activated and nebulizers
WHat are some breathe activated devices?
respimat
turbuhaler
handihaler
diskus
What are two counsel tips for Respimat?
prime
What medicinal ingredients are repsimat?
tiotropium
olodaterol
What are some non medical ingredients of respimat?
benzalkonium, HCL, water
True or false breathe actuated devices have preloaded doses?
True
How do you actuate turbuhaler?
twist bottom
How do you actuate handihaler?
break capsule
What is a unique feature of genuair?
feeback to tell that you took it right (clicks)
Pros of MDI?
portable, easy
Cons of MDI
high loss, coordination, need technique, reaction to propellant, no counter
Pros of DPI?
easy coordination
counter
no propellant
Cons of DPI
need DEEP inhalation= no for young or old
loss of powder
gritty taste
What are pros of respimat?
soft mist= low coordination and less lung breathe
Cons of Respimat
cost and need to prime
When should you use a nebulizer?
NO need of patient coordination at all= for children
if VERY low lung use= AECOPD
How do nebulizers work?
compressed air/oxygen or ultrasonic to deliver solution
Cons of nebulizers
not portable
expensive
need lots of volume of drug solution, long times
How do jet nebulizers work and what is the venturi effect?
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
How do you change particle size with a ultrasonic nebulizer?
change frequency
Which is preffered mouth piece or mask for nebulizers
mouthpiece
What is issue with facemasks for nebulizers?
gets on skin, near eye
Counsel tips for MDI
use spacer, clean space, shake, prime
If patients inhaler does not seem to be working what should a pharmacist ALWAYS do?
check technique
What device should be used if cystic fibrosis?
nebulizers
What is the path of the respiratory system?
pharynx- voice
trachea
bronchi
bronchioli
alveloar sac
alveoli
True or false inhaltion drugs will have no systemic absorption.
false
Where are macrophages only present in the lung?
peripheral lung
What should be the range of drug sizes for inhaltation therapy?
1-5 mcm
What kind of clearance does the central lung have?
mucocilliary
True or false: the central lung has bigger mucos layer alveoli?
true
What are the three ways of deposition of drug in the lung and explain them?
inertial impaction= >3 mcm, fast moving
gravitational settling= depends on size
diffusion= <1 mcm
If a particle is 11 mcm where does it end up?
lost through inertial impaction at nose or throat
If a particle is 6 mcm where does it end up?
lower resp tract
If the particle is 1-5 mcm where does it end up?
lung periphery
What is mass median aerodynamic diameter and what does a high number mean?
MMAD= particle size that is 50% of the amount of drug
higher= More particles are larger
If i am a particle that is 0.1 mcm where do I go?
doesnt deposit in lungs= exhaled
If correct technique how much of a 200 mcg MDI gets to the lung?
20-40 mcg
How does speed effect deposition?
fast= inertial impaction
slow/steady= get to periphery
holding breathe= enables them to settle by gravity
How long should you hold your breathe for after dose?
10 seconds
If holding your breath is beneficial, is 20 seconds better than 10?
NO
Inhaler technique?
breathe out, tilt head back, inhale deep and slo, hold, breathe out
How long should you wait between doses?
30 seconds
Which devices are patient complient more often?
MDI, respimat
If hospitalized which device is generally used?
nebulizer
If patient has difficulty coordinating which device?
NOT MDI
If low ability for deep breathe which device?
NOT DPI
What age should not get DPI?
<6
When does Raoult’s law apply?
liquified gas systems
What is Raoult’s law?
mixture of volatile in liquid state, partial pressure of propellant can be approximated
What does Ideal gas law state?
increased temp/moles= higher pressure and volume
When should you prime for ventolin and flovent?
V= 5 days
F= 7 days
How much can not shaking MDI lower your dose?
25-35%
Can temperature effect dose of MDI?
yes, >20 and <-20
Dose a smaller nozzel of an MDI improve delivery?
yes <1mm
What should be done if ICS inhalation?
wash mouth
Should you use close mouth or open mouth technique?
closed
What is an autohaler? How do you prime it?
push lever up for activation then same MDI steps
prime by psuh white test fire slide
WHAT NON MEDICAL INGREDIENT SHOULD YOU KNOW FOR RESPIMAT?
benzalkonium chloride= cationic surfactant
Do you need to shake respimat?
No
How long does cartidge last for respimat?
3 months when inserted
How do you use respimat?
turn, open, breathe out breathe and press button
Which DPIs are single dose?
Breezhaler and handihaler
Which DPIs need to be primed?
no for single dose
Is it a good thing to have high inspiritory effort for DPI?
no- hits back of throat
What is carrier for DPIs?
lactose
Dose carrier for DPI cause a problem for lactose intolerant people?
NO
How do you use turbuhaler?
open cap, turn to right then left until click then use
What happens when using a breezhaler or handihaler?
vibrates= good rate
How do you use diskus?
open cap, push lever down until clock, use
What does red mean on diskus?
less than 5 doses left
What is nonmedicinal ingredient of ellipta you should know?
mag stearate= flowability
How to use ellipta?
load dose by sliding cover then use
