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
2
Q
Newer Nasal Products
A
- Systemic effects
- Advantages: fast onset of action, avoid first pass metabolism, alternate to injections
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
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)
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
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
7
Q
Nasal Absorption Factors - Biological
A
- Mucociliary clearance
- Nasal blood flow
- Enzymatic degradation
- Physical condition of nasal membrane/mucosa
- Transporters and efflux system
- Site of deposition of formulation
8
Q
Nasal Absorption Factors - Physico/Chemical
A
- Drug solubility/rate of dissoltuion
- pKa n affects absorption
- MW = size of drug
- Lipophilicity
- Partition coefficient
- Stability
9
Q
Similarities to Otic/Eye
A
- Sterile
- Should be isotonic or close
- Generally buffered (5.5-6.5)
- Generally has preservatives
- Small volumes
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
11
Q
Plastic Squeeze Bottle Concerns
A
- Amount dispensed depends on force used (inconsistent)
- Possible drawback contamination
12
Q
Nasal Pump Sprays
A
- Each pump dispenses same amount of soution - more specific dose administered
- Prevents drawback contamination
13
Q
Nasal Absorption Factors - Product Formulation
A
- Dosage form
- [Drug]
- Viscosity
- pH
- Mucosal integrity
- Excipients
- Area of nasal membrane exposed
14
Q
Nasal Absorption Factors - Device
A
- Particle size
- Spray angle (affects absorption)
- Administration angle (affects absorption, 30 degrees, increases drug deposition in nasal cavity)
15
Q
Approaches to Increase Absorption
A
- Nasal gels/viscosity increasing agents - increases contact time and reduces mucociliary clearance
- Absorption enhancers - increases membrane fluidity, increases nasal blood flow, decreases mucous viscosity
- Enzyme inhibitors - prevent drug degradation
- Bioadhesive agents - increase contact time, slow mucociliary clearance
16
Q
Proper Use - Nasal Drops
A
- Gently blow nose before administration
- Wash hands
- Lie on back and tip head back all the way
- Put specific number of drops in nose
- Hang head backwards off edge of bed/couch to get drops all around cavity
17
Q
Proper Use - Squeeze Bottles
A
- Gently blow nose before administration
- Wash hands
- Hold head upright
- Hold one nostril closed while dosing other
- While inhaling, firmly squeeze bottle to deliver dose
- 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
- Gently blow nose before administration
- Wash hands
- Shake if suspension
- Remove safety clip
- Hold thumb at bottom; nozzle between fingers
- First time using, prime pump
- Place tip of nozzle in nose and tilt head slightly forward
- Breathe in while actuating device
19
Q
How to Give Naloxone
A
- Pull/pry off yellow caps
- Pry off red cap
- Grip clear plastic wings
- Gently screw capsule of naloxone into barrel of syringe
- Insert white cone into nostril and give a short, vigorous on end of capsule (1/2 capsule in each nostril)
- 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
