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Questions and Answers
Why is inhalation the preferred route for delivering drugs in asthma and COPD treatment?
Why is inhalation the preferred route for delivering drugs in asthma and COPD treatment?
What percentage of the drug typically reaches the lower airways when using a metered-dose inhaler?
What percentage of the drug typically reaches the lower airways when using a metered-dose inhaler?
What happens to the majority of the drug that does not reach the lungs when using an inhaler?
What happens to the majority of the drug that does not reach the lungs when using an inhaler?
Why is proper inhaler technique important for patients?
Why is proper inhaler technique important for patients?
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Which outcome may occur for a drug once it reaches the lungs?
Which outcome may occur for a drug once it reaches the lungs?
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What is one significant benefit of proper inhaler use?
What is one significant benefit of proper inhaler use?
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Which statement about metered-dose inhalers (MDIs) is accurate?
Which statement about metered-dose inhalers (MDIs) is accurate?
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What may happen to larger drug molecules when using an inhaler?
What may happen to larger drug molecules when using an inhaler?
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What is the main advantage of using a spacer with a metered-dose inhaler (MDI)?
What is the main advantage of using a spacer with a metered-dose inhaler (MDI)?
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Why are Dry Powder Inhalers (DPI) not recommended for children under 7 years of age?
Why are Dry Powder Inhalers (DPI) not recommended for children under 7 years of age?
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What is a primary use of nebulisers in asthma treatment?
What is a primary use of nebulisers in asthma treatment?
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How does using a spacer help reduce systemic side effects of medications?
How does using a spacer help reduce systemic side effects of medications?
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What distinguishes a metered-dose inhaler (MDI) from a dry powder inhaler (DPI)?
What distinguishes a metered-dose inhaler (MDI) from a dry powder inhaler (DPI)?
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In what situation is the oral route of medication typically utilized?
In what situation is the oral route of medication typically utilized?
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What is a disadvantage of using a dry powder inhaler (DPI)?
What is a disadvantage of using a dry powder inhaler (DPI)?
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What is the purpose of administering medication via the parenteral route?
What is the purpose of administering medication via the parenteral route?
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What primarily contributes to the slow onset of action of lipophilic drugs like salmeterol?
What primarily contributes to the slow onset of action of lipophilic drugs like salmeterol?
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How does a drug's hydrophilicity affect its therapeutic effect?
How does a drug's hydrophilicity affect its therapeutic effect?
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What is a common adverse effect caused by excessive stimulation of β₂-receptors in skeletal muscle?
What is a common adverse effect caused by excessive stimulation of β₂-receptors in skeletal muscle?
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What can excessive stimulation of β₂-receptors lead to in diabetic patients?
What can excessive stimulation of β₂-receptors lead to in diabetic patients?
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Why is inhalation therapy preferred for administering β₂-agonists?
Why is inhalation therapy preferred for administering β₂-agonists?
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What causes hypokalaemia associated with β₂-agonists?
What causes hypokalaemia associated with β₂-agonists?
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What consequence may arise from stimulating β₂-receptors in cardiac tissue?
What consequence may arise from stimulating β₂-receptors in cardiac tissue?
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What is a notable effect of β₂-agonists on glucose metabolism?
What is a notable effect of β₂-agonists on glucose metabolism?
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What component in cigarette smoke affects the metabolism of theophylline?
What component in cigarette smoke affects the metabolism of theophylline?
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Why is dose adjustment of theophylline necessary in patients with pneumonia?
Why is dose adjustment of theophylline necessary in patients with pneumonia?
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What is the mechanism by which theophylline causes nausea?
What is the mechanism by which theophylline causes nausea?
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What is a common side effect of theophylline related to cardiac function?
What is a common side effect of theophylline related to cardiac function?
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How does theophylline contribute to diuresis?
How does theophylline contribute to diuresis?
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What effect does theophylline have on cerebral blood vessels, leading to headaches?
What effect does theophylline have on cerebral blood vessels, leading to headaches?
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Which side effect of theophylline is associated with elevated cAMP levels in the brain?
Which side effect of theophylline is associated with elevated cAMP levels in the brain?
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Which side effect of theophylline's mechanism is still unclear and may involve cAMP?
Which side effect of theophylline's mechanism is still unclear and may involve cAMP?
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What factor contributes to theophylline's continued use in developing countries?
What factor contributes to theophylline's continued use in developing countries?
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How does theophylline's mechanism as a phosphodiesterase inhibitor lead to potential adverse effects?
How does theophylline's mechanism as a phosphodiesterase inhibitor lead to potential adverse effects?
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What adverse implication may arise from theophylline's action of antagonizing adenosine in patients with cardiovascular conditions?
What adverse implication may arise from theophylline's action of antagonizing adenosine in patients with cardiovascular conditions?
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Why is theophylline's ability to prevent the translocation of NF-κB significant in asthma treatment?
Why is theophylline's ability to prevent the translocation of NF-κB significant in asthma treatment?
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Which of the following is a potential side effect of elevated cAMP levels due to theophylline's action?
Which of the following is a potential side effect of elevated cAMP levels due to theophylline's action?
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Which of the following factors may limit the use of more expensive alternatives to theophylline in developing countries?
Which of the following factors may limit the use of more expensive alternatives to theophylline in developing countries?
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In what way does theophylline provide therapeutic benefits in conditions like asthma?
In what way does theophylline provide therapeutic benefits in conditions like asthma?
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What is the role of adenosine in the respiratory system that theophylline antagonizes?
What is the role of adenosine in the respiratory system that theophylline antagonizes?
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Study Notes
Inhaler Techniques
- Proper inhaler technique maximizes drug delivery
- Around 10-20% of the drug from a metered-dose inhaler (MDI) reaches the lungs
- The rest of the drug is swallowed and absorbed through the gastrointestinal tract, undergoes metabolism before reaching the systemic circulation
- Proper inhaler technique improves effectiveness and reduces systemic side effects
Inhalation Route Advantages
- Inhalation is preferred for delivering drugs in asthma and COPD
- Delivers drug directly to the lungs, reducing risk of systemic side effects compared to oral or injectable routes
Drug Action in the Lungs
- The drug may act directly on target cells
- The drug may distribute to more peripheral airways
- The drug may undergo metabolism in the lungs, possibly becoming more active
- Larger molecules may get retained in the airways
Delivery Devices
Metered-Dose Inhaler (MDI)
- Uses a propellant to deliver medication
- May be difficult to use, especially for patients who struggle with coordinating inhalation and device activation.
- Spacers can help
Dry Powder Inhaler (DPI)
- Doesn't contain a propellant; medication drawn in by patient's inspiratory effort
- Easier to use than an MDI
- Powder may irritate the airways
- Not suitable for children under 7 years of age
Spacer
- Reduces need for coordination between inhalation and pressing MDI button
- Slows down medication particles, reducing upper airway deposition (oropharynx)
- Increases the proportion reaching the lower airways
- Improves efficacy and minimizes side effects
Nebulizers
- Typically used during acute exacerbations of asthma and COPD
- Deliver the drug in a mist form, making it easier to inhale
Oral Route
- Reserved for patients unable to use inhalers
- Example: patients with arthritis or very elderly patients who may have trouble remembering how to use an inhaler.
Parenteral Route
- Used for severely ill patients who require urgent and high doses of medication
- Medication administered through injections or intravenous administration
Theophylline
Mechanism of Action
- Theophylline is a phosphodiesterase inhibitor
- It inhibits phosphodiesterase, leading to increased levels of cAMP
- Increased cAMP leads to bronchodilation
Therapeutic Effects
- Theophylline antagonizes adenosine
- Prevents airway constriction, leading to improved airflow
- Prevents the translocation of NF-κB into the nucleus
- Reduces expression of inflammatory genes, helping to manage asthma symptoms
Adverse Effects
- Increased cardiac contractility and heart rate
- Headache
- Gastric Discomfort
- Diuresis
- Epileptic seizures
- Behavioural disturbances
Monitoring Strategies
- Monitor for side effects, especially in high-risk patients
- Dosage adjustment may be necessary
- Patients with pneumonia
- Patients on enzyme inhibitors
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Description
This quiz covers the essential techniques for effective inhaler use, particularly for metered-dose inhalers (MDIs). Learn about drug delivery advantages through inhalation, action in the lungs, and the functionality of different delivery devices. Enhance your understanding of respiratory medication delivery for conditions like asthma and COPD.
