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mdrs > mucous controling agents, surfactants > Flashcards

mucous controling agents, surfactants Flashcards

1
Q

what is mucus

A

secretion from goblet cells and submucosal

glands composed of 95% water and proteins

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2
Q

What is sputum

A

expectorated secretions that contain resp.

tract, oropharyngeal and nasalpharyngeal secretions as well as bacteria and products of inflammation

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3
Q

what is Mucolytic

A

degrade mucus polymers (s-s bonds)

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4
Q

what is Mucokinetic

A

increases ciliary activity but anything

that increases the movement of sputum

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5
Q

what is expectorant

A

medicine to increase hydration

volume of secretions used to treat and cause a productive cough

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6
Q

what is Antitussive

A

cough medicine to suppress cough urge

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7
Q

what is surfactant

A

decrease surface tension, made

up of phospholipids and proteins

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8
Q

fxn of mucus

A

prevents infection with antimicrobial enzymes

protects against osmotic or inflammatory changes

lubrication (phospholipids)

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9
Q

what is the physical propertise of mucus?

A
  1. adhesion
    - -> mucus to airway surface force
  2. cohesion
    - ->mucus to mucus force
  3. viscosity
    - ->resistance to flow (thickness of mucus)
  4. elasticity
    - ->returning shape
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10
Q

what is the function of the mucoilary escalator

A

Self-cleansing (trapping and mobilizing debris)

the amount, consistency/thickness, ciliary
activity affect function

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11
Q

what are the 3 layers of the escolator?

A
  1. mucus (gel)
  2. cili(sol)
  3. epithelialhttps://www.thoughtco.com/
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12
Q

what s the funciton of the gel layer

A

mucus moves towards larynx

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13
Q

whats the function of the sol llayer

A

ion transport

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14
Q

wht is the normal daily mucus production

A

100mls/day

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15
Q

composition of mucus

A

95 % h2o

5 % glycoprotein (mucin)

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16
Q

how does pharmcological treatment help with mucociliary transport?

A
  • altering consistency of gel layer
  • mucolytics
  • improving ciliary beat
  • sympathomimetics, cholinergics, xanthines
  • increasing sol layer (more watery)
  • hyperosmolar saline, expectorants
  • improving cough
  • bronchodilators
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17
Q

the effect of beta adrenegic, xanthines and cholinergic on mucus?

A

all increase cilia beat and mucus production

  • they differ is in the transport of mucous
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18
Q

what is the effect of mucus

A

Steroids have no effect on beat, or transport but decrease mucus production

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19
Q

what s the function and MOA of mucolytics

A 
fxn:
 Degrade complex molecular
strands to thin mucous in
airways and aid in
“expectoration
MOA:
- breaks disulfide bonds in
mucous (gel layer)
- mucolytic activity of drug
increases with 7.0 - 9.0 in
local pH
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20
Q

dose/frequency of mucolytic

A
  • 10%, 20% solution; 3-5 mL
    via aerosol
  • frequency: QID, TID
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21
Q

what is the adverse effect of mucolytic

A
  • bronchospasm, cough,
  • Ventolin “cocktail”
  • Nausea
  • rhinorrhea
  • stomatitis
  • inactivated if mixed with
    antibiotics

**patient must be able to clear secretion

22
Q

what is the Non-respiratory indications for

Mucomyst®

A

acetaminophen overdose

  • anti-oxidant
  • prevents hepato-renal toxicity
23
Q

what is the indication and MOA of dorase alfa Pulmozyme®

A

FOR CF
–>clearance of secretion

DNase (pancreatic enzyme) digests extracellular DNA material found in cellular debris of infected mucous

  • reproduced by recombinant DNA techniques
  • breaks down the DNA material in enzymatic fashion; lowers viscosity and adhesiveness
24
Q

what is the dose and adminstration of Pulmozyme

A

Unit Dose Vial - 2.5mg drug in 2.5mL of clear colourless solution
(refrigerated and
protected from light)

25
Q

Adverse effects of Pulmozyme

A

dysphonia, rash, pharyngitis, chest

pain, conjunctivitis

26
Q

what is an example of mucokinectic agent

A

beta agonist(bronchdilators)

  • increase cilia beat frequency
  • improve expiratory airflow clearance
27
Q

when is mucokinectic agent not beneficial

A

patients with dynamic
airway collapse diseases
–>emphysema

28
Q

what is the function of an expectorant

A
  • pull water from airway tissues into the mucous making
    it more watery and easier to clear
  • stimulant expectorants
29
Q

what is an exmaple of expectorant?

A

guaifenesin

Benylin expectorant syrup ® or inhalational sol’n

30
Q

what is the function of bland aerosols

A

Liquid particles suspended in a gas with or without oxygen

31
Q

what is the MOA of bland aerosols?

A

Alters H2O content of mucous; not structure

32
Q

what are 4 types of bland aersols

A
  1. 0.9% N/S - physiologically
    compatible (isotonic)

2.hypotonic saline: 0.45% -
for patients who cannot
tolerate increase Na

3.sterile distilled water:
hypotonic compared with
tissue fluid

4.hypertonic saline (5% or
20% hypertonic saline)
generally used for
sputum induction

33
Q

what is the fxn of Antitussives

A

decreases cough centre activity in medulla oblongata of brain

34
Q

what is the indcaiton of Antitussives

A

Indicated for dry, unproductive (annoying)

cough only

35
Q

what is some example of Antitussives

A
  • CODEINE sulfate (narcotic)

- HYDROCODONE (narcotic)

36
Q

what is fxn of surfactant

A

lowers surface tension
increase compliance
decreased WOB

37
Q

what is the clincal application of surfactant

A

prophylaxis

rescue

38
Q

wht is the composition of lipids?

A

1 . 90-95% lipids

  • -> 80-85% phospholipids
  • Phosphatidylcholine (PC) becomes DPPC when saturated, aka lecithin (surface tension lowering component)
  • > 15- 20% phosphatidyglycerol, Sphingomyelin
  1. 5-10% proteins
    - ->Hydrophilic
    - -»Hydrophobic
39
Q

how is surfactant produced?

A
  1. Type II pneumocytes
    - ->lamella bodies
  2. lamella bodies move to lumen of alveolus
  3. LB secretes tubular myelin then unravels , which is the precusor of DPPC
40
Q

when is DPPC first seen?

A

24 wks during gestation

41
Q

wt is the metabolism/clearance of surfactant in adult

A

adult: 2.5mg /kg

50% is recycled back to type 2 cells

half life 9 - 12 hrs

42
Q

what is the metabolism/clerance of surfactantinbaby

A
  • amount is 10x that of adult
  • 90% is recycled to type 2, 10% becomes marcophages
  • half life 6 days
43
Q

what are some exogensis surfactant used

A
  1. bLES (natural)
    - ->bovine or human source of aminotic fluid
  2. Exosurf (synthetic)
44
Q

what is the indication of exogensis surfactant

A

in the neonatal population to

decrease surface tension in the treatment of RDS in premature babies

45
Q

how can exogensis surfactant ot be delivered

A
  • install via ETT

- devlier via BVM

46
Q

what is the side effect of exogensis surfactant

A
  1. rapid change in compliance

2. desaturation and bradycardia due to blocked ETT during

47
Q

what is the side effect of exogensis surfactant

A

apnea, pulmonary hemorrhage, bronchospasm

48
Q

what is some inhaled gas mixture used?

A

Nitric Oxide (NO): in pulmonary vascular endothelium

49
Q

what is the fxn of NO

A

treats pulmonary hypertension including PPHN, ARDS/hypoxia, during neonatal cardiac sx,
RDS, pulmonary disease

  • potent vasodilator
50
Q

what monitor is needed for NO?

A

analyzer required for dose & toxic byproducts NO2 (5ppm) & methemoglobin

such as co-oximeter

mdrs (23 decks)

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