Routes of administration: inhaled Flashcards

1
Q

Describe the features of the lung that make it good for drug absorption.

A
  • Offers a large surface area
  • Highly vascular surface promotes rapid absorption and onset of action
  • The air-blood barrier is thinner compared to barriers in the intestine and other mucosal routes
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2
Q

Why is the inhalation route frequently used?

A
  • For local delivery of drugs to the lungs for the treatment or prophylaxis of pulmonary diseases
  • Administering a drug at its site of action can result in a
    rapid onset of action.
  • Allows smaller doses to be used thus
    reducing side effects.
  • But it can also be used to delivery
    drug systemically.
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3
Q

What are the advantages of the inhalation route?

A
  • Smaller doses compared to oral and parenteral routes:
    – Reducing systemic side effects.
    – Reducing drug costs.
    – E.g. salbutamol requires 4mg orally vs 200μg via
    inhalation.
  • Rapid absorption lead to fast onset of action.
  • Avoids harsh GI environment thus minimises chemical
    and enzymatic drug degradation.
  • Avoids GI upset.
  • Avoids hepatic first-pass metabolism.
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4
Q

What are the disadvantages of the inhalation route?

A
  • Requires complex delivery devices – high costs.
  • Aerosol devices can be difficult to use, even for adults.
  • Reproducibility of dose delivery is low due to various factors
    e.g. incorrect use of device, lung capacity, breathing pattern.
  • Drug absorption may be limited by the mucus layer.
  • Mucociliary clearance reduces the retention time of drugs
    within the lungs – not suited for long-acting formulations.
  • Oropharyngeal deposition may give rise to local side effects.
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5
Q

Describe inhalation aerosols.

A
  • A two phase system of solid particles or liquid droplets dispersed in the air
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6
Q

State the fate of particles in the airways.

A

Deposition > Dissolution > Absorption

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7
Q

State the patient factors affecting particle deposition.

A

Lung physiology e.g. lung capacity
Breathing patterns
Co-ordiantion of aerosol generation with inspiration
- Breath holding

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8
Q

Explain how breathing patterns affects particle deposition.

A

– The larger the inhaled volume, the greater the peripheral
distribution of particles.
– Increasing inhalation flow rate enhances impaction in
upper airway.

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9
Q

Explain how breath holding affects particle deposition.

A

– Breath holding after inhalation enhances deposition by sedimentation and diffusion.

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10
Q

State the physiochemical factors affecting drug deposition.

A
  • the aerodynamic size of the drug particle
  • Shape and physical stability of particles also affect deposition to lesser extent
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11
Q

What are the three main mechanisms responsible for drug deposition?

A

– Inertial impaction,
– Gravitational sedimentation,
– Brownian diffusion.

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12
Q

Describe inertial impaction.

A
  • Particles within the air stream having high momentum will impact on the airway’s walls rather than following the changing air flow
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13
Q

Describe gravitational sedimentation.

A
  • Sedimentation is dependent on particle size and density
    and residence time in the airways
  • Occur in the small airways and alveoli, where the
    velocity is much lower.
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14
Q

Describe brownian diffusion.

A
  • Small particles <1 μm are bombarded by random gas
    molecules and produce Brownian motion. This results in particle collision with the airway walls.
  • Common in regions where airflow is very low e.g. alveoli.
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15
Q

Describe the effect of particle size on deposition.

A
  • Larger particles (i.e.> 5 μm) mostly deposit in
    the upper airways by inertial impaction.
  • Particles 1-5 um mostly deposit in the lower
    airways by gravitational sedimentation.
  • Particles <1 μm mostly deposit in the lower
    airways by Brownian motion.
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16
Q

What is the optimum particle size range?

A

1-5 micrometres

17
Q

Describe drugs in the mucus barrier.

A
  • An aerosolised drug powder must first dissolve in the
    mucus layer before absorption.
  • Dissolution can be the rate-limiting step, especially for
    poorly soluble drugs.
  • Once in solution, the drug will diffuse through the
    mucus layer and enter the aqueous environment of the
    epithelial lining liquid.
18
Q

What is meant by mucociliary clearance.

A
  • Mucus layer constantly being propelled along the airways by rhythmic beating of cilia on epithelial cells
19
Q

When can drug absorption take place?

A
  • If dissolution is faster than clearance
20
Q

Describe the absorption of hydrophobic materials.

A
  • absorbed at a rate dependent on the oil/water partition coefficients i.e LogP
21
Q

Describe the absorption of hydrophilic compounds.

A
  • Poorly absorbed through membrane pores at rates inversely proportional to molecular size
  • Unionised form is better absorbed than ionised form
22
Q

Which form of drug is better absorbed?

A

Unionised from

23
Q

What can rate of absorption be influenced by?

A

The overall drug formulation