COPD 2 Flashcards
What is the formulation of pMDI?
-Drugs suspended or dissolved in propellant (with surfactant and cosolvent)
What is the metering system if pMDI?
-Metering valve and reservoir
What are advantages of pMDI?c
- Portable and compact
- Multidose device
- Relatively inexpensive
- Cannot contaminants contents
- Available for most inhaled medication
- Dose indicator (new generation devices)
What are the disadvantages of pMDI?
- Contains propellants
- Not breath actuated
- Many patients cannot use it correctly
- High oropharyngeal deposition
What are the advantages of pMDI and spacer?
- Low dependence on inspiratory flow rate
- Easier to coordinate
- Large drug disease delivered more conveniently
- Less oropharyngeal deposition
- Low dependance on inspiratory flow rate
- Higher lung deposition than a pMDI
What are the disadvantages of of pMDI and spacer?
- less portable than a pMDI
- Plastic spacers may acquire static charge
- Additional cost to a pMDI
What is there formulation of DPI?
Drug blend in lactose, drug alone, drug/excipient particles
What is the formulation of SMI?
Aqueous solution or suspension
What is the metering system of DPI?
-Capsules, blisters, multi dose blister packs, reservoirs
What is the metering system of SMI (Respimat) ?
-A spring loaded system provides the energy required to force aqueous solution from a reservoir through the “uniblock” to produce the soft mist
What are the advantages of DPI?
- Portable and compact
- Breath actuated (no coordination needed)
- Does not contain propellants
- Dose indicator (new generation devices)
- Locking mechanisms when empty (new generation devices)
What are the disadvantages of DPI?
- Requires a minimum inspiratory flow
- May not be appropriate for emergency situation
- Many patients cannot use it correctly
- Most types are moisture sensitive
What are the advantages of the SMI?
- Portable and compact
- Multidose device
- Low dependence on inspiratory flow rate (slow moving aerosol)
- High fine particle fraction
- High lung deposition
- Does not contain propellants
- Dose indicator
- Locking mechanism when empty
What are the disadvantages of SMI?
- Not breath actuated
What are spacers?
- Spacers (or holding chamber) are large empty devices (or tubes) that are usually made out of plastic and they help you get the best from your asthma medicine of you use a metered dose inhaler (MDI)
- Using a spacers makes it easier to get the right amount of medicine straight to your lungs, where it is needed
- Using a spacer can also reduce the risk of side effects from your medicine
How does a spacer help to manage the disease?
- Spacers make it easier to get the right amount of medicine
- Metered dose inhalers (MDIs) deliver a dose of medicine in a. fine spray (aerosol) form and it can be difficult to use them correct as you need to breath in at exactly the same time as you press down on inhaler to release medicine and breath in slowly and deeply
- Gets med straight into your lungs and you fix your inhaler on one end of spacer and use the mouthpiece at other end
and when press on inhaler medicine collects in the chamber of the spacer so you can breather it without needing to get the timing and speed exactly right - An asthma inhaler with spacer can also help if asthma attack
Why would using a spacer mean you can use less medicine?
- This is because a spacer slows down the medicine down as it comes out of the inhaler so more of it gets taken down into your lungs and makes medicine more efficient so may need to sue less of it
Why does using spacer reduce risk of side effects?
- If taking preventer (Steroid medicine)
- Because more medicine gets down to your lungs less medicine is absorbed into rest of body reducing risk of side effects
- Reduces risk of voice changes and oral thrush (side effect especially in children
What are two techniques to use with spacer?
- Tidal or multiple breathing
2. Single breath and hold
What is quick and deep inhalation manoeuvre?
Quick deep breath within 2-3 seconds
What is slow and steady inhaling manoeuvre?
Slow steady breath in over 4-5 seconds
What to do if can do only quick and deep?
DPI
What can do if do both?
DPI, pMDI, SMI
What can do only slow and steady?
pMDI or SMI
If unsure what other devices can be used?
- AIM machine
- Device training attachments
- Flo-Tone trainer
- In check DIAL Inspiratory flow meter
What are even steps for correct inhaler technique?
- Prep
- Check dose counter (where present) to confirm sufficient doses are remaining and when replacement need
- Shake inhaler - Priming
- Prime device ready for us : refer to instruct and how often need prim
- Open inhaler/ remove cat - Exhaling: exhale fully and away from mouthpiece
- Mouth: place mouthpiece in mouth and close lips around it to form tight seal
- Inhalation:
- DPI: quick and deep
- SMI/pMDI: slow steady - Breath holding: remove inhaler from mouth d hold breath for 5 sec then breath out slowly
- Closing and repeating: close inhaler/ replace cap / repeat as necessary
What is DPI?
Dry powder inhaler
What is pMDI?
Pressured metered dose inhaler
What is SMI?
Soft mist inhaler
