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ch 36 > Aersol Drug Therapy > Flashcards

Aersol Drug Therapy Flashcards

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1
Q

Which of the following best describes an aerosol?
A. Suspension of liquid or gas particles in a gas
B. Molecular Water dispersed throughout a carrier gas
C. Suspension of particulate matter in a gas
D. Suspension of liquid or solid particles in a gas

A

An aerosol is a suspension of solid or liquid particles in a gas.

D.

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2
Q

With what devices are therapeutic aerosols generated?
A. Atomizers
B. Nebulizers
C. Humidifiers

A

All of the items listed.

In a clinical setting, medical aerosols are generated with atomizers, nebulizers, or inhalers

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3
Q 
The mass of aerosol particles produced by a nebulizer in a given unit of time best describes which quality of the aerosol.
A.  Stability
B.  Density
C.  Output
D.  Deposition
A

C. Output

Aerosol output is defined as the mass of fluid or drug contained in aerosol produced by a nebulizer generated per unit of time

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4
Q

What describes the mass of drug leaving the mouthpiece of a nebulizer as aerosol?

A

Emitted Dose

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5
Q

What is a common method to measure aerosol particle size?

A

Cascade impaction

Laser diffraction

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6
Q

What measure is used to identify the particle diameter, which corresponds to the most typical settling behavior of an aerosol?
A. Mean Mass Velocity Coefficient (MMVC)
B. Logarithmic standard diameter (LSD)
C. Mean Mass aerodynamic diameter (MMAD)
D. Geometric standard deviation

A

C. Mean mass aerodynamic diameter

The average particle size is express with a measure of central tendency, such as MMAD for cascade impaction or volume median diameter (VMD) for laser diffraction

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7
Q 
What measure is used to describe the variability of particle diameters in an aerosol?
A.  MMVC
B.  LSD
C.  MMAD
D.  GSD
A

D. GSD

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8
Q

What are the two most common methods for measuring aerosol particle size?

A

Cascade impaction & laser diffraction

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9
Q

What is MMAD & which type of measurement system is it used for?

A

Mass median aerodynamic diameter for cascade impaction

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10
Q

What is VMD & what type of measurement system is it used for?

A

Volume Median Diameter; used with laser diffraction

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11
Q

What type of measurement system of particle size is used where the range & frequency of droplet volumes crossing a threshold?

A

Laser Diffraction

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12
Q

Measurement system used to collect particles in which the mass are deposited on a drug assay and drug mass across particle sizes in calculated.

A

Cascade impaction

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13
Q

What does GSD stand for & describe?

A

Geometric standard deviation; Describes the variability of particle sizes in an aerosol distribution set at 1 standard deviation above or below the median

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14
Q

Aerosols consisting of particles of similar size are called?

A

Monodispersed

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15
Q

What are the key concepts needed to know with the use of medical aerosols?

A

Aerosol Output
Particle Size
Deposition
Aging

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16
Q

What measure is used to describe the variability of particle diameter in an aerosol?

A

GSD

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17
Q 
Most nebulizers used in respiratory care produce which type of aerosol suspension?
A.  Monodisperse
B.  Heterodisperse
C.  Microaerosol
D.  Multidispersed
A

B. Heterodispersed

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18
Q

What is the retention of aerosol particles resulting from contact with the respiratory tract mucosa called?

A

Deposition

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19
Q

Output rate is:
A. The speed at which the particles flow
B. The amount of medication that makes it to the alveoli
C. Different according to the individual
D. Mass of fluid or drug contained in aerosol produced by nebulizer

A

D. Mass of fluid or drug contained in an aerosol produced by a nebulizer. Output rate is the mass of aersol generated per unit of time

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20
Q 
What is the mass of the drug leaving the mouthpiece of nebulizer or inhaler as aerosol?
A.  Aerosol output
B.  MMAD
C.  Emitted Dose
D.  Mass leaving the nebulizer
A

C. Emitted Dose

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21
Q

Which of the following factors affect pulmonary deposition of an aerosol?
A. Pressure gradient
B. Gravity
C. Size of particles
D. Shape & motion of particles
E. Physical characteristics of the airways

A

C, D, E

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22
Q 
The amount of drug inhaled is called?
A.  Inertial impaction
B.  Emitted Dose
C.  Inhaled mass
D.  Respirable Mass
A

C. Inhaled Mass is the amount of drug inhaled

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23
Q 
The proportion of drug mass in particles that are small enough to reach the lower respiratory tract are called?
A.  Emitted Dose
B.  Inhaled Mass
C.  Small Particles
D.  Respirable Mass
A

D. Respirable mass

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24
Q 
Key mechanisms of aerosol deposition include what factors:
A.  Diffusion
B.  Inertial Impaction
C.  Gravimetric Sedimentation
D.  B & C
E.  All of the above
A

All of the above–E

Key mechanisms of aerosol deposition include inertial impaction, gravimetric sedimentation, and Brownian diffusion

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25
Q 
What is the primary mechanism for deposition of large, high mass particles (greater than 5 um) in the respiratory tract?
A.  inertial impaction
B.  Sedimentation
C.  Diffusion
D.  Brownian motion
A

A. Inertial impaction occurs when suspended particles in motion collide with and are deposited on a surface. This is the primary mechanism for particles large then 5 um

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26
Q

Because inertia involves both mass & velocity, the higher the flow of a gas stream the greater the tendency for:
A. particles to impact and be deposited in the airways.
B. Particles to travel deep to alveoli
C. the patient to lose his medication
D. The patient to receive most of his medication.

A

A. The particles to impact & be deposited in airways

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27
Q 
Turbulent flow patterns, obstructed or tortuous pathways and inspiratory flow rates greater than 30 L/min are associated with?
A.  Decreased inertial impaction
B.  Increased inertial impaction
C.  Has no effect on inertial impaction
D.  No loss of medication
A

B. Increased inertial impaction

28
Q 
This occurs when aerosol particles settle out of suspension & are deposited owing to gravity?
A.  Inertial impaction
B.  Brownian diffusion
C.  Sedimentation
D.  Deposition
A

C. Sedimentation;

29
Q 
What is the primary mechanism for the deposition of small particles?
A.  inertial impaction
B.  Brownian Diffusion
C.  Sedimentation
D.  Deposition
A

B. Brownian diffusion

30
Q 
Which of the following will increase aerosol deposition by inertial impaction?
A.  High velocity gas flow
B.  Variable or irregular passages
C.  Turbulent gas flow
D.  Particles of high mass
A

B & C

31
Q 
What occurs when suspended particles in motion collide with and are deposited on the surface?
A.  Deposition
B.  Inertial impaction
C.  Sedimentation
D.  Brownian Diffusion
A

Inertial Impaction

32
Q 
The greater the mass & velocity of a moving object, the greater its inertia this will result in the tendency of that object to:
A.  Settle
B.  Impact
C.  Disperse
D.  Continue moving along its set path
A

D. Continue moving along its set path

33
Q 
Where do most aerosol particles in the 5 um to 10 um deposit?
A.  Alveoli
B.  Bronchioles
C.  Central Airways
D.  Upper airways
A

D. Upper airways

34
Q 
What is the primary mechanism for central airway deposition of particles in the 1 to 5 um range?
A.  Impaction
B.  Sedimentation
C.  Diffusion
D.  Brownian Motion
A

B. Sedimentation

During normal breathing, sedimentation is the primary mechanism for deposition of particles in the 1 to 5 um range

35
Q 
Where do most aerosol particles in the 1 to 5 um range deposit?
A.  Alveoli
B.  Bronchioles
C.  Central Airways
D.  Upper Airways
A

C. Central airways

36
Q 
What mechanism does particles in the 1 to 5 um range use?
A.  Inertial impaction
B.  Sedimentation
C.  Brownian Diffusion
D.  Deposition
A

B. Sedimentation

37
Q 
Which of the following techniques will increase aerosol deposition by sedimentation in the lungs?
A.  High inspiratory flow
B.  Short inspiratory flow
C.  10 second breath hold
D.  Short expiratory time
A

C. 10 second breath hold can increase aerosol deposition as much as 10% and increase the ratio of aerosol deposited in lung parenchyma to central airway by fourfold

38
Q 
This can increase aerosol deposition by as much as 10% and increase the ratio of aerosol deposited in lung parenchyma to central airway by fourfold?
A.  High inspiratory flow
B.  Slow expiratory flow
C.  10 second breath hold
D.  Deep breaths
A

A. 10 second breath hold

39
Q 
What size particle is needed if your desired location is in the lower airways?
A.  5 to 50 um
B.  2 to 5 um
C.  1 to 3 um
D.  Less than .1 um
A

B. 2 to 5 um

40
Q 
What is the recommended MMAD particle size for deposition in alveolar region?
A.  5 to 50 um
B.  2 to 5 um
C.  1 to 3 um
D.  Less than .1 um
A

C. 1 to 3 um

41
Q 
Where does a particle size of less than .1 um normally deposit?
A.  Upper airway, nose, larynx, trachea
B.  Lower airways
C.  Parenchyma:  Alveolor region
D.  Parenchyma
A

D Parenchyma

42
Q 
Where does a particle size of 5 to 50 um normally deposit?
A.  Upper airway, nose, larynx, trachea
B.  Lower airways
C.  Parenchyma:  Alveolor region
D.  Parenchyma
A

A. Upper Airway

43
Q 
What term describes the primary mechanism for deposition of small particles?
A.  hygroscopic condensation
B.  Gravity sedimentation
C.  Brownian diffusion
D.  Inertial impaction
A

C. Brownian diffusion

44
Q 
What is the primary fate of inhaled aerosol particles that are between 1 and .5 um?
A.  Most are cleared during exhalation
B.  Most deposit in central airways
C.  Most deposit in upper airway
D.  Most deposit in the alveoli
A

A. Most are cleared during exhalation

Particles between 1 and .5 um are so stable that most remain in suspension and are cleared with exhaled gas

45
Q 
Which of the following aerosols would have the highest rate of deposition by diffusion?
A.  MMAD of 0.1 um
B.  MMAD of 3.0 um
C.  MMAD of 10.0 um
D.  MMAD of 50.0 um
A

A. MMAD of 0.1 um;

particles smaller than 0.5 have a greater retention rate in the lungs

46
Q 
Where do most aerosol particles that are less than 3 um deposit?
A.  Alveoli
B.  Bronchioles
C.  Central airways
D.  Upper airways
A

A. Alveoli

47
Q 
A physician wants to deliver a therapeutic aerosol to the upper airway (nose, larynx, trachea).  To help maximum deposition in the are, you would select an aerosol generator with an MMAD in what range?
A.  5 to 50 um
B.  2 to 5 um
C.  1 to 3 um
D.  Less than 1 um
A

A. 5 to 50 um

48
Q 
A physician wants to deliver a therapeutic aerosol to the central and lower airways.  To help ensure maximum deposition in this area you would select an aerosol generator with an MMAD in what range?
A.  5 to 20 um
B.  2 to 5 um
C.  1 to 3 um
D.  Less than 1 um
A

B. 2 to 5 um

49
Q 
What is the process by which aerosol suspension changes over time?
A.  evaporation
B.  deposition
C.  aging
D.  Sublimination
A

C. Aging

50
Q 
What factors determine how an aerosol ages?
A.  Time
B.  Composition
C.  Size of the particles
D.  Conditions to which it is exposed
E.  All of the above
A

B, C, D

51
Q 
The rate of particle size is \_\_\_\_\_\_ proportional to the size of the particle.
A.  Directly
B.  Inversely
C.  Linearly
D.  Logarithmically
A

B. Inversely

52
Q 
What can cause aerosol particles to change in size?
A.  Evaporation
B.  Condensation
C.  Time
D.  Hygroscopic water absorption
A

A & D

53
Q 
What is one of the greatest factors affecting aerosol deposition?
A.  I:E rate
B.  Breath holding
C.  Deep breathing
D.  Airway obstruction
A

D. Airway obstruction

54
Q

Which of the following is false about changes in aerosol suspensions over time?
A. Liquid aerosol particles can shrink (evaporation) or grow (water absorption).
B. The rate of particle growth is directly proportional to particle size
C. Small water based particles tend to shrink when exposed to dry gas
D. Aerosols of water soluble salts tend to grow in a humidified environment.

A

B. The relative rate of particle size change is inversely proportional to the size of a particle, so the small particles grow or shrink faster than larger particles

55
Q

As hygroscopic aerosol particles enter the respiratory tract, what do they tend to do?
A. Decrease in size because of the absorption of molecular water
B. Increase in size because of the absorption of molecular water
C. Increase in size because of the evaporation of molecular water
D. Decrease in size because of the evaporation of molecular water

A

B. Increase in size because of absorption of molecular water

Aerosols of water soluble materials, especially salts, tend to be hygroscopic, absorbing water and growing when introduced into a high humidity environment.

56
Q

What is the primary hazard of drug therapy?

A

Adverse reaction to the medication being delivered

57
Q

Name other risks to aerosol drug therapy?

A

Infection, airway reactivity, systemic effects of bland aerosols, drug concentrations, & eye irritation

58
Q 
What are some of the organisms associated with drug aerosol infections?
A.  Pneumonia
B.  Pseudomonas
C.  Legionnairres
D.  Klebsiella
A

B & C

59
Q

What procedures can help prevent infections for use of nebulizers?
A. Sterilized between patients
B. Never reused
C. Frequently replaced with disinfected or sterile units
D. Always rinsed with tap water

A

A & C

60
Q 
Which route of infection does the use of aerosol generators contribute to?
A.  Contact
B.  Droplet
C.  Airborne
D.  None
A

C. Airborne

61
Q

What are the most common sources of bacteria with the use of aerosol generators?
A. Patient secretions
B. Contaminated solutions on single dose vials
C. Caregivers hands
D. Patient Coughing

A

A & C

62
Q

How frequently should nebulizers be air dried?
A. After each use
B. Once every 24 hrs
C. Never, always rinse with disinfectant due to contaminates in air
D. Always disposed, never dried

A

B. Once every 24 hrs

63
Q 
All of the following drugs or drug categories have been associated with increased airway resistance and bronchospasm during aerosol administration except:
A.  Steroids
B.  Albuterol
C.  Acetylcysteine
D.  Antibiotics
A

B. Albuterol

Medications such as acetylcysteine, antibiotics, cromolyn sodium, ribavirin, and distilled water have been associated with increased airway resistance and wheezing during aerosol therapy.

64
Q 
What two things can cause reactive bronchospasm and increased airway resistance, especially in a patient with preexisting respiratory disease?
A.  Albuterol
B.  Cold Air
C. High density aerosols
D.  Low density aerosols
E.  Warm Air
A

B & C

Cold air and high density aerosols can cause reactive bronchospasm and increased airway resistance.

65
Q

How can a RT monitor for bronchospasm?
A. Peak flow measurements before & after therapy
B. Auscultation for adventitious breath sounds
C. Breathing pattern
D. Communication with patient

A

All of the above

66
Q

A patient with chronic bronchitis is receiving heated water aerosol treatments through a jet nebulizer four times daily to aid in mobilizing retained secretions. After each treatment, you note a dramatic increase in the magnitude of coarse crackles heard on auscultation. Which of the following recommendtions would you make to the physician?
A. Discontinue the heated water aerosol treatments
B. Switch to a higher density aerosol (ultrasonic)
C. Add coughing and postural drainage to therapy
D. Consider prior treatment with a bronchodilator

A

C. For patients unable to clear their own secretions, suctioning or other airway clearance techniques may be indicated as an adjunct to aerosol therapy.

67
Q 
What type of systems can introduce less aerosols to the atmosphere?
A.  Hand held nebulizers
B.  pMDI
C.  DPI's
D.  breath actuated nebulizers
A

B, C, D

ch 36 (1 decks)

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