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824 > Nasal (Cut off for Exam 2) > Flashcards

Nasal (Cut off for Exam 2) Flashcards

1
Q

Nasal Drug Use

A
  • Usually used for local effects
  • Drugs are inhaled by vapor
  • Solutions: drops/sprays, nasal jellies
  • Advantages: rapid onset of action, avoid systemic effects
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2
Q

Newer Nasal Products

A
  • Systemic effects

- Advantages: fast onset of action, avoid first pass metabolism, alternate to injections

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3
Q

Nasal Drug Advantages

A
  • Fast onset of action (can be as rapid as IV)
  • Rapid absorption
  • Avoid first-pass metabolism
  • Avoid degradation in GIT (enzymes, pH)
  • Local or systemic delivery
  • Noninvasive
  • Relative ease/convenience
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4
Q

Nasal Drug Limitations

A
  • Difficult to achieve ideal drug coverage in the nasal cavity
  • Rapid removal of drug from site of absorption (mucociliary clearance)
  • Possible local tissue irritation
  • Pathologic conditions may alter nasal bioavailability (colds or allergies)
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5
Q

Nasal Airway Anatomy/Function

A
  • Breathing/olfaaction
  • Brings humidified/warm air into lungs
  • Filter out particles in breathed air
  • First line immunologic defense
  • Nasal products CAN’T interfere with airway function
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6
Q

Nasal Drug Target

A
  • Nasal cavity (includes superior, middle, and inferior turbinate)
  • Highly vascularized
  • Thin membranes
  • Relatively large SA
  • *Allows for rapid absorption/onset**
  • Barrier: nasal valve
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7
Q

Nasal Absorption Factors - Biological

A
  1. Mucociliary clearance
  2. Nasal blood flow
  3. Enzymatic degradation
  4. Physical condition of nasal membrane/mucosa
  5. Transporters and efflux system
  6. Site of deposition of formulation
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8
Q

Nasal Absorption Factors - Physico/Chemical

A
  1. Drug solubility/rate of dissoltuion
  2. pKa n affects absorption
  3. MW = size of drug
  4. Lipophilicity
  5. Partition coefficient
  6. Stability
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9
Q

Similarities to Otic/Eye

A
  • Sterile
  • Should be isotonic or close
  • Generally buffered (5.5-6.5)
  • Generally has preservatives
  • Small volumes
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10
Q

Plastic Squeeze Bottles

A
  • Container = bulb
  • Squeeze to force solution through small tip
  • Droplets are sprayed and forced into a mist in nose
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11
Q

Plastic Squeeze Bottle Concerns

A
  • Amount dispensed depends on force used (inconsistent)

- Possible drawback contamination

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12
Q

Nasal Pump Sprays

A
  • Each pump dispenses same amount of soution - more specific dose administered
  • Prevents drawback contamination
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13
Q

Nasal Absorption Factors - Product Formulation

A
  1. Dosage form
  2. [Drug]
  3. Viscosity
  4. pH
  5. Mucosal integrity
  6. Excipients
  7. Area of nasal membrane exposed
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14
Q

Nasal Absorption Factors - Device

A
  1. Particle size
  2. Spray angle (affects absorption)
  3. Administration angle (affects absorption, 30 degrees, increases drug deposition in nasal cavity)
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15
Q

Approaches to Increase Absorption

A
  1. Nasal gels/viscosity increasing agents - increases contact time and reduces mucociliary clearance
  2. Absorption enhancers - increases membrane fluidity, increases nasal blood flow, decreases mucous viscosity
  3. Enzyme inhibitors - prevent drug degradation
  4. Bioadhesive agents - increase contact time, slow mucociliary clearance
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16
Q

Proper Use - Nasal Drops

A
  1. Gently blow nose before administration
  2. Wash hands
  3. Lie on back and tip head back all the way
  4. Put specific number of drops in nose
  5. Hang head backwards off edge of bed/couch to get drops all around cavity
17
Q

Proper Use - Squeeze Bottles

A
  1. Gently blow nose before administration
  2. Wash hands
  3. Hold head upright
  4. Hold one nostril closed while dosing other
  5. While inhaling, firmly squeeze bottle to deliver dose
  6. Pull nozzle tip out of nose before releasing bottle (prevent contamination)
    * *Severe congestion - each nostril, wait 5 minutes, repeat**
18
Q

Proper Use - Pump Sprays

A
  1. Gently blow nose before administration
  2. Wash hands
  3. Shake if suspension
  4. Remove safety clip
  5. Hold thumb at bottom; nozzle between fingers
  6. First time using, prime pump
  7. Place tip of nozzle in nose and tilt head slightly forward
  8. Breathe in while actuating device
19
Q

How to Give Naloxone

A
  1. Pull/pry off yellow caps
  2. Pry off red cap
  3. Grip clear plastic wings
  4. Gently screw capsule of naloxone into barrel of syringe
  5. Insert white cone into nostril and give a short, vigorous on end of capsule (1/2 capsule in each nostril)
  6. No reaction, give dose after 2-5 minutes
20
Q

Rhinitis Medicamentosa

A
  • Chronic edema of nasal mucosa from overuse of nasal decongestants
  • Become dependent on spray
  • Minimize use to a max of 3 consecutive days
  • Treatment options: cold turkey for 2-3 weeks OR stop in one nostril at a time
21
Q

Saline Nasal Spray

A
  • Treats allergies, colds, dried out noses
  • Better for those who shouln’t use decongestants (HTN, preggo, babies)
  • Loosen nasal secretions - remove by blowing nose or nasal syringes
22
Q

Other Nasal Devices

A
  • Nebulizers
  • Dry powder inhalers
  • Bi-directional breath-powered device (mechanism expands the nasal valve)

Used in those with high vapor pressure

23
Q

High Vapor Pressure Drugs

A
  • Carried by air current into nasal passages

- Ammonia salts in first aid kits or Vick’s Vapor Inhalers are examples

24
Q

BBB

A
  • Bypassed by nasal delivery

- Provides direct access to olfactory and trigeminal nerve pathway

824 (15 decks)

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