Inhalation Adminitstration

Question 1

can salbutamol (Pom) be supplied without prescription ?

Answer 1

Yes, at request of a relevant prescriber or a patient

Question 2

Describe the steps to using a salbutamol inhaler (pMDI) …

Answer 2

1)Remove cap (some must be squeezed at the sides to release)
2)Check dose counter (if device has one)
3)Hold inhaler upright and shake well
4)Breathe out gently (away frominhaler)
5)Put mouthpiece between teeth (without biting) and close lips to form good seal
6)Start to breathe in slowly through mouth and at the same timepress down firmly on canister
7)Continue to breathe in slowly and deeply
8)Hold breath for about 5 – 10 seconds or as long as comfortable
9)While holding breath, remove inhaler from mouth
10)Breathe out gently (away from inhaler)
11)If more than onedose is needed, repeat all steps starting fromstep 3
12)Replace cap

Question 3

What are the two routes of administration ?

Answer 3

-local or topical drug administration
- systemic application via the lung

Question 4

How are drugs delivered via the lungs ?

Answer 4

• solid in gas
• liquid in gas
• gases

Question 5

What happens to airflow with increased branching of lungs ?

Answer 5

It decreases

Question 6

What causes obstructive lung disease ?

Answer 6

Asthma
COPD
Cystic fibrosis

Question 7

What causes restrictive lung disease ?

Answer 7

Interstitial lung disease, such asidiopathic pulmonary fibrosis
Obesity

Question 8

Where does inertial impaction occur ?

Answer 8

Inertial impaction tends to occur in the upper airways when the velocity and mass of the particles cause them to impact the airway surface

Question 9

What does inertial impaction depend upon in order to occur ?

Answer 9

• The particle’s momentum (dependent upon size!)
• The position of the particle in the airstream of the parent branch
• The angle of bifurcation (°θ)

Question 10

What is sedimentation ?

Answer 10

Sedimentation is the dominant mechanism for particles depositing in the lower/peripheral airways

It is due to particles suspended in a gas being subject to the vertical gravitational force

Question 11

What is sedimentation influenced by ?

Answer 11

Tends to be influenced by breath-holding, which allows more time for gravity to have an effect

Question 12

What is aerodynamic diameter dependent on ?

Answer 12

dae = dg (ρ0.5)
Aerodynamic diameter (dae) is dependent on the geometric diameter (dg), shape factor (1 for spheres) and density (ρ) of the particle

Question 13

What factors influence lung deposition ?

Answer 13

-Particle size
-Particle size distribution
-Particle density
-Particle shape
-Particle hygroscopicity

Question 14

List the inhaler types :

Answer 14

-Inhaler types
-Pressurized metered-dose inhaler + (spacer)
-Accuhaler / Diskus
-Handihaler
-Respimat
-Turbohaler
-(Nebuliser)

Question 15

How do the cilia prevent absorption ?

Answer 15

They waft the drug away

Question 16

What are the advantages of local frug delivery of drugs to the lungs ?

Answer 16

-Drug delivered directly to target organ
-Lower doses may be required for optimal effect
-Rapid onset of action
-Fewer systemic side effects
-Non-invasive delivery

Question 17

What are disadvantages of local delivery of drugs to the lungs ?

Answer 17

-Low efficiency of delivery
-Difficulty in breath coordination, manual handling of -device, or breathing through the device
-Corticosteroid use can suppress immune response (brown inhaler)
-Throat irritation is possible

Question 18

What are advantages of systemic delivery of drugs via the lungs ?

Answer 18

-Very rapid onset of action
-Circumvents first pass effect
-Non-invasive delivery route
-Good for biopharmaceuticals

Question 19

Disadvantages of systemic delivery of drugs via the lungs …

Answer 19

-Low efficiency of delivery
-Some patients may have difficulty using some devices (handling and coordination)
-Some patients may have difficulty breathing (through the device)
-May need very low or very exact doses or special devices
-Expensive compared with oral therapies

Question 20

Where is the drug delivered from an inhalator?

Answer 20

Via the cheek not into the lungs but is absorbed by the buccal mucosa into the bloodstream

Question 21

How do you use a Nicorette inhalator ?

Answer 21

1)Line up the markers and pull each end in the opposite direction
2)Insert the cartridge into the mouthpiece and twist to close securely
3)When you have a craving take a shallow puff about every 4 seconds or take 2 deep puffs every minute. Each cartridge lasts for approximately 40 minutes of frequent puffing