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Pharmacology > Chap 1 and 2 > Flashcards

Chap 1 and 2 Flashcards

1
Q

Resp. Care Pharmacology

A

The application of pharmacology to cardio pulm disease and critical care

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2
Q

Drug definition

A

Any chemical that alters the organisms functions or processes

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3
Q

Drug examples

A

O2, alcohol, lysergic acid diethylamide (LSD), heparin, epinephrine, and vitamins

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4
Q

Pharmacology

A

study of drugs (chemicals), including their orgins, properties, and interactions with living organism

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5
Q

Pharmacology subdivided more specialized topics (5)

A

Pharmacy, Pharmacognosy, Pharmacogenetics, Therapeutics, Toxicology

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6
Q

Pharmacy

A

Preparing and dispensing of drugs

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7
Q

Pharmacognosy

A

Identification of sources of drugs, from plants, and animals

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8
Q

Pharmacogenetics

A

Study of the interrelationship of genetic differences and drug effects

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9
Q

Therapeutics

A

art of treating disease with drugs

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10
Q

Toxicology

A

Study of toxic substances and their pharmacologic actions- antidotes and poison control

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11
Q

Drug administration/ Pharmacokinetics/ Pharmacodynamics

A

Principles of drug action from dose administration to effect and clearance from the body

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12
Q

FDA

A

Food and Drug administration

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13
Q

FDA steps (naming)

A

Chemical name, code name, generic name, official name, trade name

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14
Q

Chemical name

A

name indicating drugs chemical structure

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15
Q

code name

A

name assigned by manufacture to an experimental chemical that shows potential as a drug

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16
Q

Generic name

A

name assigned by US adopted name (USAN) council when the chemical appears to have therapeutic use and markets out

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17
Q

Generic name also =

A

nonproprietary name, in contrast to the brand name

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18
Q

Official name

A

event experimented drug is fully approved for general use, and is admitted to the US pharmacopicia - National Formulary (USP-NF)

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19
Q

Generic name becomes

A

official name

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20
Q

Trade name

A

Brand name, or proprietary name, given by a particular manufacturer

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21
Q

Sources of drug info

A

USP-NF, PDR, NDC

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22
Q

USP-NF

A

Book of standards containing info about meds, dietary supplements, and medical devices- official standard for drugs marketed in US (“FDA”)

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23
Q

Physicians’ Desk Reference

A

(PDR) another source of drug info. provides useful info, including descriptive color charts for drug identification, names of manufacturers, and general drug actions

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24
Q

National Drug Code

A

(NDC), 3 segment number which serves as a product identifier for drugs

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25
Q

3 sources for drugs

A

Animal, plant, Mineral

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26
Q

Animal

A

Thyroid hormone, insuline, pancreatic dornase

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27
Q

Plant

A

Khellin, atrophine, digitalis, reserpine, volatile oils of eucalyptus, pine , anise

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28
Q

Mineral

A

Copper sulfate, magnesium sulfate, mineral oil

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29
Q

Approval of drug by FDA (US)

A

-Identify drug (chemical), Animal studies/ toxicology studies, investicational new drug, New drug application

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30
Q

Identify drug (chemical)

A

With the potential for useful physiologic effects- exemplified by plant product

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31
Q

animal studies

A

after chemical is isolated and identified- examines its general effect on the animal and effects on specific organs- liver/ kidney

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32
Q

Toxicology studies

A

examines mutagenicity, teratogenicity, effect on reproductive fertility, and carcinogenicity

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33
Q

Investigational new drug (IND)

A

phase 1, 2, 3

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34
Q

Phase 1

A

Test on healthy individuals (volunteers)- basis for pharmacokinetic desc. of drug= rates of absorption, distribution, metabolism, elimination

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35
Q

Phase 2

A

Small group with targeted disease

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36
Q

Phase 3

A

Large, multi-center studies to establish safety and efficiency

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37
Q

What comes after successful IND

A

New drug application (NDA) is filed with the FDA

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38
Q

NDA

A

Detailed reporting system for 6 months to track

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39
Q

Orphan drug

A

drug or biologic product for the diagnosis or treatmetn of a rare disease

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40
Q

Rare

A

disease that affects fewer than 200,000 persons in US

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41
Q

Prescription

A

Written order for a drug, along with any specific instructions for compounding, dispensing, and taking the drug- written by physician, ostepath, dentist, veterinarian, and other health care practitioners

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42
Q

Prescription includes

A
  1. Pts name and address and date orders written, 2.Rx (superscription) 3. Inscription lists the name and quantity of drug 4. Subscription (directions to pharmacist on how to prepare) 5. Signa- directions to patients 6. Name of prescriber- signature
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43
Q

signa- example

A

Take 1 p.o QID

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44
Q

Acute respiratory distress syndrome (ARDS)

A

Respiratory disorder characterized by respiratory insufficiency that may occur as a result of trauma, pneumonia, oxygen toxicity, gram-negative sepsis, and systemic inflammatory response

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45
Q

Aerosolized agents

A

group of aerosol drugs for pulmonary applications that includes adrenergic, anticholinergic, mucoactive, corticosteroid, antiasthmatic, and antiinfective agents and surfactants instilled directly into the trachea

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46
Q

Airway Resistance (RAW)

A

Measure of the impedance to ventilation caused by the movement of gas through the airway

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47
Q

Cystic fibrosis (CF)

A

Inherited disease of the exocrine glands affecting the pancrease, respiratory system, and apocrine glands. Symptoms usually begin in infancy and are characterized by increased electrolytes in the sweat, chronic resp. infection, and pancreatic insufficiency

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48
Q

Agonist

A

Chemical or drug that binds to a receptor and creates an effect on the body

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49
Q

Antagonist

A

Chemical or drug that binds to a receptor but does not create an effect on the body; it blocks the receptor site from accepting an agonist

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50
Q

Bioavailability

A

Amount of drug that reacehs the systemic circulation

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51
Q

Drug administration

A

method by which a drug is made available to the body

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52
Q

Enternal

A

Use of the intestine

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53
Q

First pass effect

A

Initial metabolism in the liver of a drug taken orally before the drug reaches the systemic circulation

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54
Q

Hypersensitivity

A

Allergic or immune mediated raction to a drug, which can be serious, requiring airway maintenance or ventilatory assistance

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55
Q

Idiosyncratic effect

A

abnormal or unexpected reaction to a drug, other than an allergic reaction, compared with the predicted effect

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56
Q

Inhalation

A

Taking a substance, typically in the form of gases, fumes, vapors, mists, aerosols, or dusts, into the body by breathing in

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57
Q

Local Effect

A

Limited to the area of treatment (e.g. inhaled drug to treat constricted airways)

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58
Q

Lung availability/ total systemic availability ratio (L/T ratio)

A

Amount of drug that is made available to the lung out of the total available to the body

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59
Q

Parenteral

A

Administration of a substance in any way other than the intestine, most commonly an injection

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60
Q

Pharmacodynamics

A

Mechanisms of drug action by which a drug molecule causes its effect in the body

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61
Q

The entire course of action of a drug, from dose to effect, can be understood in three phases:

A

The drug administration, pharmacokinetic, and pharmacodynamic phases

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62
Q

Drug administration

A

method by which a drug dose is made available to the body

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63
Q

Drug Administration Phase

A

Entails the interrelated concepts of drug formulation (e.g. compounding a tablet for particular dissolution properties) and drug deliver (e.g. designing an inhaler to deliver a unit dose)

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64
Q

Two key topics pf the Drug Administration Phase are

A

drug dosage form and the route of administration

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65
Q

Drug dosage form

A

the physical state of the drug in association with nondrug components Tablets, capsules, and injectable solutions are common drug dosage forms.

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66
Q

The route of administration is the

A

portal of entry for the drug into the body, such as oral (enternal), injection, or inhalation

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67
Q

Injectable route (e.g. intravenous route) requires

A

a liquid solution of a drug

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68
Q

whereas the oral route can accomodate

A

capsules, tablets or liquid solution

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69
Q

Active ingredient in a dosage formulation

A

drug

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70
Q

Aerosolized agents for inhalation have ingredients that control rates such as

A

Preservatives, Propellants for MDI formulations, dispersants (surfactants), and carrier agents for dry powder inhalers (DPIs)

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71
Q

Routes of administration have been divided into five broad categories

A

Enternal, Parenteral, Transdermal, inhalation, and topical

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72
Q

Enternal

A

Refers literally to the small intestine, but the enternal route of administration is more broadly applicable to administration of drugs intended for absorption anywhere along the gastrointestinal tract

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73
Q

Most common enteral route is

A

by mouth (oral) because it is convenient, is painless, and offers flexibility in possible dosage forms of the drug

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74
Q

Systemic effect can be achieved when

A

the drug is not destroyed or inactivated in the stomach and is absorbed into the bloodstream, distribution throughout the body

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75
Q

Other enteral routes of administration include

A

suppositories inserted in the rectum, tablets placed under the tongue (sublingual), and drug solutions introduced through an indwelling gastric tube

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76
Q

Parenteral (injectable)

A

“besides the intestine” which implies any route of administration other than enternal. Commonly refers to injection of a drug.

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77
Q

Most common parenteral

A

Intravenous (IV), Intramuscular (IM), Subcutaneous (SC), Intrathecal (IT), Intraosseous (IO)

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78
Q

Intravenous (IV)

A

Injected directly into the vein, allowing nearly instataneous access to systemic circulation.

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79
Q

Intramusclular (IM)

A

Injected deep into a skeletal muscle.

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80
Q

Subcutaneous (SC)

A

Injected into the subcutaneous tissue beneath the epidermis and the dermis

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81
Q

Intrathecal (IT)

A

Injected into the arachnoid membrane of the spinal cord to diffuse throughout the spinal fluid

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82
Q

Intraosseous (IO)

A

Injected into the marrow of the bone

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83
Q

Transdermal

A

application to the skin to produce a systemic effect. Advantage of this route is that it can supply long-term continuous delivery to the systemic circulation. The drug is absorbed percutaneously, obviating the need for a hypodermic needle and decreasing the fluctuations in plasma drug levels that can occur with repeated oral administration

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84
Q

Inhalation

A

given for either a systemic effect or a local effect in the lung.

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85
Q

Two of the most common drug formulations given by inhalation

A

Gases (anesthesia-systemic effect), and aerosolized agents intended to target the lung or respiratory tract in the treatment of resp. disease (local effect)

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86
Q

Topical

A

Directly to skin or mucous membranes to produce a local effect. Such drugs are often formulated to minimize systemic absorption- corticosteroid cream to an area of contact dermatitis

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87
Q

Pharmacokinetic Phase

A

time course and disposition of a drug in the body, based on its absorption, distribution, metabolism, and elimination (describes what the body does to a drug)

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88
Q

Pharmacodynamics

A

Describes what the drug does to the body

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89
Q

Systemic effect steps, a pill must first

A

dissolve to liberate the active ingredient. The free drug must then reach to the epithelial lining of the stomach or intestine and traverse the lipid membrane barriers of the gastric and vascular cells before reaching the bloodstream for distribution throughout the body. The lining of the lower resp tract also presents barriers to drug absorption. After transversign these layers, a drug can reach the smooth muscle or glands of the airway

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90
Q

The lining of the lower resp tract also presents barriers to drug absorption. This mucosal barrier consists of five identifiable elements

A
  1. Airway surface liquid 2. Epithelial cells 3. Basement membrane 4. interstitium 5. Capillary vascular network
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91
Q

Aqueous diffusion

A

Occurs in the aqueous compartments of the body, such as the interstitial spaces or within a cell transport across epithelial linings is restricted because of small pore size; capillaries have larger pores, allowing passage of most drug molecules. Diffusion occurs by a concentration gradient

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92
Q

Lipid diffusion is an important mechanism for

A

drug absorption because of the many epithelial membranes that must be crossed if a drug is to distribute in the body and reach its target organ

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93
Q

Epithelial cells have lipid membranes, and a drug must be what to diffuse across such a membrane

A

Lipid-soluble (nonionized, nonpolar)

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94
Q

Lipid insoluble drugs tend to be

A

ionized, or have a positive and negative charges separated on the molecule (polar), and are water- soluble

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95
Q

Carrier-Mediated Transport

A

Special carrier molecules embedded in the lipid membrane can transport some substances, such as amino acids, sugars, or naturally occurring peptides, and the drugs that resemble these substances.

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96
Q

Pinocytosis

A

Refers to the incorporation of a substance into a cell by a process of membrane engulfment and transport of the substance within vesicles, allowing translocation across a membrane barrier.

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97
Q

Bioavailability

A

indicates the proportion of a drug that reaches the systemic circulation. Is influenced not only by absorption but also by inactivation caused by stomach acids and by metabolic degradation, which can occur before the drug reaches the main systemic compartment

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98
Q

Minimal Inhibitory Concentration (MIC)

A

The lowest concentration of a drug at which a microbial population is inhibited

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99
Q

Drug distribution is

A

the process by which a drug is transported to its sites of action, is eliminated, or is stored

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100
Q

The plasma concentration of a drug is partially determined by

A

the rate and extent of absorption versus the rate of elimination for a given dose amount

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101
Q

The volume of the compartment in which the drug is distributed also determines the

A

concentration achieved in plasma

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102
Q

Volume of distribution (VD)

A

is the same as the volume of the plasma compartment

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103
Q

VD=

A

Drug amount/ Plasma Concentration

104
Q

VD may change as a funtion of

A

age or disease state

105
Q

Common pathways for the biotransformation of drugs are

A

Phase 1- Biochemical reactions convert the active drug to a more polar (water-soluble)form, which can be excreted by the kidneys. Phase 2- combines (conjugates) a substance with the metabolite to form a highly polar conjugate.

106
Q

The principle organ for drug metabolism

A

liver

107
Q

liver contains

A

intracellular enzymes that usually convert lipophilic (lipid soluble) drug molecules into water- soluble metabolites that are more easily excreted.

108
Q

Enzyme induction can affect

A

the therapeutic doses of drugs required

109
Q

First- Pass effect

A

If a drug is highly metabolized by the liver enzymes and is administered orally, most of the drugs activity is terminated in its passage through the liver before it ever reaches the general circulation and the rest of the body

110
Q

First- Pass effect must be overcome by

A

increasing the oral dose (compared with the parenteral dose) or by using a delivery system that circumvents first pass metabolism

111
Q

Following routes avoid first pass circulation through the liver

A

injection, buccal or sublingual (tablets), transdermal (patch), rectal (suppositories), and inhalation

112
Q

Just as the liver is the site of much drug metabolism, the primary site of drug excretion in the body is the

A

kidney

113
Q

Kidney is important for

A

removing drug metabolites produced by the liver

114
Q

Clearance

A

is a measure of the ability of the body to rid itself of a drug. Most often clearance, is expressed as total systemic or plasma clearance to emphasize that all of the various mechanisms by which a given drug is cleared are taken into account

115
Q

Plasma Clearance (CLp)

A

Refers to a hypothetical volume of plasma that is completely cleared of a drug over a given period. Expressed as liters per hour (L/hr), or if body weight is taken into account, liters per hour per kilogram

116
Q

CLp can be used to estimate

A

the rate at which a drug must be replaced to maintain a steady plasma level

117
Q

To achieve a steady level of drug in the body, dosing must equal

A

the rate of elimination: Dosing rate (mg/hr)= (CLp)(L/hr) x Plasma Concentration (mg/L)

118
Q

Dosing rate (mg/hr)=

A

(CLp) (L/hr) x Plasma Concentration (mg/L)

119
Q

Plasma Half- Life (T1/2)

A

The time required for the plasma concentration of a drug to decrease by one half. Is a measure of how quickly a drug is eliminated from the body

120
Q

Time-Plasma Curve

A

Graph of the concentration of a drug in the plasma over time. These curves can indicate whether the dose given is sufficient to reach and maintain the critical threshold of concentration needed for the desired therapeutic effect

121
Q

Kinetic factors of Time-Plasma Curve

A

Absorption, distribution, metabolism, and elimination

122
Q

The rationale for the inhalation route in therapy of the lung is to

A

maximize lung deposition while minimizing body (systemic) exposure and unwanted side effects.

123
Q

MDI traditional percentages given for stomach and airway proportions

A

90% stomach, 10% airway

124
Q

Lung availability/ total systemic availability ratio (L/T ratio)

A

Quantifies the efficiency of aerosol drug delivery to the lung and is based on the distribution to the airway and gastrointestinal tract just described

125
Q

The clinical or therapeutic effect of a bronchoactive aerosol comes from the

A

inhaled drug deposited in the airways

126
Q

The systemic or extrapulmonary side effects come from the

A

total amount of drug absorbed into the system

127
Q

Factors Increasing lung availability/ total systemic availability ration with inhaled drugs

A

Efficient delivery devices, Inhaled drugs with high first pass metabolism, mouthwashing, Use of a reservoir device

128
Q

Lung availability =

A

total systemic availability; all systemic drug comes only from the lung absorption

129
Q

Using a MDI approx % of the inhaled drug reaches the lung, with % going to the stomach

A

30% lung, 70% stomach (35% reaches systemic circulation

130
Q

Because 30% out of 65% of the MDI reaches the systemic circulation by lung, this gives an L/T ratio of 30/65=

A

0.46

131
Q

a receptor

A

is any cell component that combines with a drug to change or enhance the function of the cell

132
Q

Structure - activity relationship (SAR)

A

Relationship between the chemical structure of a drug and its clinical effect or activity

133
Q

Three phases of drug action

A

pharmaceutical, pharmocokinetics, pharmacodynamics

134
Q

Pharmaceutical

A

Disintegration and dissolution

135
Q

Pharmacokinetics

A

absoprtion, distribution, metabolism, and elimination

136
Q

pharmacodynamics

A

-drug- receptor interaction at target site

137
Q

Two factors influence drug availability to the body

A

Drug dose form (tablet, liquid, ect), Route of administration- IV, oral, etc

138
Q

When determining route of administration

A

Systemic or local effect (pill vs. inhaled), Rate of onset and duration (pill vs. IV), Stability of drug in gastric fluids, pts ability to swallow, retain, and absorb (GI upset, diarrhea, etc), Convenience vs. safety of routes (invasive vs. noninvasive), amount of drug

139
Q

Oral

A

Route safest and most convenient and economical

140
Q

Parental

A

any internal means besides GI tract- solution, suspension, depot (injectable)

141
Q

Subcutaneous

A

under skin (epidermis and dermis)

142
Q

Intramuscular

A

shot- skeletal muscle

143
Q

Intravenous

A

IV- directly into vein= instataneous access to systemic circulation

144
Q

intrathecal (spinal)

A

arachnoid membrane of the spinal cord - spinal fluid

145
Q

Topical

A

effects can be local or systemic- powder, lotion, ointment, solution

146
Q

Transdermal

A

Absorbed through skin ex. patch, paste

147
Q

Topicals

A

Suppositores, sublingual, eyes and ears

148
Q

Inhalation

A

Systemic or local effect in lung. SVN, MDI, DPI, USN (ultrasonic neb), SPAG (Small particle aerosol generator, anesthesia gases

149
Q

Pharmacokinetics

A

(what body does to drug) time course and disposition of a drug in the body, based on its absorption, distribution, metabolism, and elimination

150
Q

Absorption

A

Aqueous-simple diffusion with higher concentrations diffusing to lower concentrations

151
Q

Lipid vs drug

A

some cells have lipid membranes, drug needs to be lipid soluble to cross membrane

152
Q

Active transport

A

Requires energy to transport drug across membrane

153
Q

First pass effect

A

GI tract– blood system, first route of transfer- portal vein to liver = metabolizes drug

154
Q

Distribution

A

getting to target organ, generally systemic

155
Q

volume of distribution

A

amount of blood reflective of total amount in body

156
Q

1st pass of albuterol

A

50% loss = 2.5 (PO 5 mg)

157
Q

Metabolism

A

converts drug into inactive form. One way the drug is used.

158
Q

Most common place for drug metabolism

A

liver

159
Q

Chronic abuse of a drug can cause

A

the drug to be metabolized faster so more drug is needed to get the desired effect

160
Q

Elimination

A

through urine (some through feces)

161
Q

Major site of excretion of drugs

A

renal

162
Q

Drug clearance and half life,

A

ways to measure how long the drug will last in the system

163
Q

Maintenance dose

A

amount of drug to keep an effective amount in system

164
Q

time plasma curve

A

graft of plasma levels over time (keep at plateau with doses administered)

165
Q

Plasma half life

A

amount of time for drug to be 50% in system

166
Q

First pass effect definition

A

Initial metabolism in the liver of a drug taken orally before the drug reaches the systemic circulation

167
Q

Less systemic absorption=

A

less side effects ( some of the drug is absorbed systemically via mouth, stomach, and lungs)

168
Q

L/T ratio

A

lung availability/ total systemic availability (get high as possible)

169
Q

Want more local or systemic effect

A

local effect with less systemic effect

170
Q

Pharmacodynamic

A

what drug does to body, the “how”. Defined as Mechanisms of drug action by which a drug molecule causes its effect in body. Lock and key

171
Q

Lock and key

A

the drug has to reach the receptor, the drug has to mach the intended receptor, this is based on the chemical structure of the drug, the more specific the drug the more useful the drug and less side effects, the receptor is a concept making it difficult to find the right combination

172
Q

Potency

A

how much drug needed to get response

173
Q

Maximum effect

A

dose at which greatest response is produced

174
Q

Therapeutic index

A

dose at which 1/2 the subjects respond

175
Q

agonist

A

Chemical or drug that binds to a receptor and creates an effect on the body (has affinity and efficacy- causes a response) ex. albuterol

176
Q

Albuterol has what kind of response

A

agonist

177
Q

Antagonist

A

Chemical or drug that binds to a receptor but doesnt create an effect on the body, it blocks the receptor site from accepting an agonist. (has affinity but no efficacy) blocks/ reverses response… ex. duoneb

178
Q

Drug interactions

A

additive, synergism, antagonism, potentiation

179
Q

1+1=2

A

additive= double response

180
Q

1+1=3

A

Synergism = higher responses

181
Q

1+1=0

A

Antagonism = Effects block

182
Q

1+1= 1.5

A

Potentiation

183
Q

Idiosyncratic

A

not the usual effect, abnormal or unexpected reaction to a drug other than an allergic reaction, comp. with predicted effect

184
Q

Hypersensitivity

A

allergic reaction or immune- mediated reaction to a drug

185
Q

Tolerance

A

Increased amount to get same effect

186
Q

Tachyphylaxis

A

Rapid decrease in response to a drug

187
Q

Advantages of aerosol therapy

A

Smaller dose than systemic, Rapid onset, Target lungs!!, Fewer side effects, Painless and easy, Can be used to deliver systemic drug

188
Q

3 main uses of Aerosol Therapy

A

Humidification of dry inspired gas, Improveded mobilization and clearance of resp. secretions, DELIVERY of aerosolized drugs to the resp tract

189
Q

Disadvantages of aerosol therapy

A

Difficult to estimate/ reproduce dose, Co-ordination with MDI, Variables affecting particle size and deliver, Knowledge of proper techniques, Lack of technical info on devices

190
Q

Physical Principles of inhaled Aerosol Drugs

A

Aerosol particle size dist., Measurement of particle size distributions- aerodynamic diameter

191
Q

Aerosol particle size dist

A

count mode, count median diam (CMD), Mass median diam (MMD/MMAD), Geometric standard deviation (GSD)

192
Q

Aerosol

A

Suspension of liquid carried in a gas

193
Q

Stability

A

Tendency of aerosol particles to stay in suspension

194
Q

Penetration

A

Depth of aerosol deposit

195
Q

Deposition

A

moving from suspension to lungs

196
Q

Nebulizer

A

Device to create an aerosol

197
Q

A MDI neb creates what size particle size

A

Range (not just one size)

198
Q

MMD

A

Mass median diameter; Mass divided by particle size. Used as the standard to measure efficacy of nebulizers

199
Q

Mouth Particle Size

A

> 15 u

200
Q

Nose Particle Size, ex

A

> 10 u, ex corticoid steroids

201
Q

Large airways particle size (first 6 generations)

A

5-10 u

202
Q

Alveoli and terminal bronchi particle size

A

0.8-3 u

203
Q

Autonomic receptors in both large and small airways

A

Beta-adrenergic receptors denser in small bronchioles, Cholinergic receptors denser in larger airways, Both effective if given in the 2-5 u range

204
Q

Mechanisms of deposition

A

Inertia, Gravity, Diffusion

205
Q

Inertia

A

large airways

206
Q

Gravity

A

small airways, aided by breath hold

207
Q

Diffusion

A

very small particles, questionable deposition

208
Q

Temp and humidity

A

Increases as enters body to BTPS, Increases size of particle, Humidity increases particle size

209
Q

Pattern of breathing

A

Inspiratory time, flow rate, mouth vs nose, inspiratory hold, all affect deposition

210
Q

Factors affecting performance

A

Dead volume, filling volume and time, Effect of flow rate and pressure, Device interface, Type of solution

211
Q

Dead space

A

residual volume, 0.5 ml to 1 ml

212
Q

What percent delivers at sputtering point

A

35% to 53%, increases to 53% to 72% with vigorous agitation

213
Q

What percent on ventilator circuit (dead volume)

A

30%

214
Q

Filling volume and time

A

Deliver a dose diluted to 3-5 ml, takes approx 10min

215
Q

Effect of flow rate and pressure

A

Deliver with a flowrate of 6-10lpm, 50 psi gas outlet and approx 13 psi for home compressors

216
Q

Device interface (method)

A

Mouthpiece!!, Aerosol mask, Endotracheal tube, Blow by

217
Q

Type of solution that affects performance

A

Particle size differs with type of drug, and even preservatives

218
Q

Small Particle Aerosol Generator (SPAG)

A

Large volume, small particles. Used to deliver Ribaviron- large volume

219
Q

Respiragard

A

fitted with both inspiratory and expiratory valves with a filter so aerosol exhaled to the environment is minimized. Used to delver Pentamidine

220
Q

Ultrasonic Nebulizers

A

Servo i ventilators, Portable neb, Electric

221
Q

MDI have 5 major components

A
  1. Canister 2. Propellant (CFC vs HFA) 3. Drug Formulary 4. Metered Valve “110 micrograms” 5. Actuator and dose counter, also exp date
222
Q

MDI flow rate

A

slow, less than 60lpm

223
Q

Factors Affecting MDI Performance

A

Loss of dose, Shake the canister, Timing of actuation intervals, Loss of prime, Storage temp, Nozzle size and cleanliness, Breathing technique, Patient Characteristics

224
Q

Loss of dose

A

caused from position and time in between use. Store with valve up when you can, Waste a dose if not used sooner than 4 hours

225
Q

Correct use of an MDI

A

Closed Mouth, Open Mouth, With an Accessory device, Electrostatic charge, Dose counters

226
Q

MDI Accessory Devices

A

Spacer, Valve holding chamber

227
Q

Valve holding chamber

A

one way valve- cant blow dose out. stays in chamber for 5 sec

228
Q

Spacer

A

adds length with no valves

229
Q

Accessory device cc

A

less than 200cc in size

230
Q

Flow indicator

A

whistles if breathing in too fast

231
Q

Inhalation on MDI

A

Laminar

232
Q

Electrostatic Charge

A

keeps particle size small

233
Q

DPI advantages and disadvantages

A

Main advantage is hand-breathing coordination is not needed, does require high inspiratory flow rates, Children and ill patients may not be able to use

234
Q

Types of DPI

A

Unit-dose, Multiple unit dose DPI, Multiple-dose DPI

235
Q

Spiriva

A

Unit dose dry powder inhalers

236
Q

Advair

A

Multiple unit dose DPI

237
Q

Azmanex

A

Multiple dose DPI

238
Q

Factors affecting DPI performance and delivery

A

Intrinsic resistance, Inspiratory flow rate!!, Humidity

239
Q

Lung Deposition

A

10-15% to target airways, Newer devices are improving and need to be considering increase in dose

240
Q

Equivalent Doses

A

e.g. 2 puffs MDI vs. 2.5mg unit dose Albuterol

241
Q

2 puffs MDI=

A

2.5 mg neb

242
Q

Face mask administration

A

make sure not misting in eyes, pinch nose piece to get seal

243
Q

35 yr old with albuterol, best method?

A

MDI best choice

244
Q

MEDICATION DELIVER FIVE RIGHTS

A

The right drug, dose, route, patient, time

245
Q

A rapid decrease in response to a drug

A

tachyphylaxis

246
Q

A drug interaction that occurs from combined drug effects that are greater than if the drugs were given alone

A

Synergism

247
Q

Drug administration in any way other than by the intestine, most commonly by intravenous, intramuscular, or subcutaneous injection

A

Parenteral

248
Q

Taking a substance, typically in the form of gases, fumes, vapors, mists, aerosols, or dusts, into the body by breathing in

A

inhalation

249
Q

Administration of a drug by use of the intestine

A

Enteral

250
Q

Difference between the minimal therapeutic and toxic concentrations of a drug; the smaller the difference, the greater the chance the drug will be toxic

A

therapeutic index

251
Q

a chemical or drug that binds to a receptor and creates an effect on the body

A

agonist

252
Q

an abnormal or unexpected reaction to a drug, other than an allergic reaction, as compared with the predicted effect

A

idosyncratic effect

253
Q

Amount of drug that is made available out of the total available to the lung

A

L/t ratio

254
Q

Use of a patch on the skin to deliver a drug

A

transdermal

255
Q

Tablets, capsules, and injectable solutions are examples of

A

enternal forms

Pharmacology (10 decks)

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