Inhaler Techniques and Drug Delivery
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Questions and Answers

Why is inhalation the preferred route for delivering drugs in asthma and COPD treatment?

  • It delivers the drug directly to the lungs, minimizing systemic side effects. (correct)
  • It allows higher doses of medication to be used.
  • It is the fastest route for drug absorption.
  • It reduces the need for frequent dosing.

What percentage of the drug typically reaches the lower airways when using a metered-dose inhaler?

  • 30-40%
  • 10-20% (correct)
  • 70-80%
  • 50-60%

What happens to the majority of the drug that does not reach the lungs when using an inhaler?

  • It is wasted and has no effect.
  • It is swallowed and metabolized before reaching systemic circulation. (correct)
  • It is converted into an inactive form in the lungs.
  • It is absorbed into the bloodstream without any changes.

Why is proper inhaler technique important for patients?

<p>It ensures maximum drug delivery to the lungs. (B)</p> Signup and view all the answers

Which outcome may occur for a drug once it reaches the lungs?

<p>It can act directly on target cells. (C)</p> Signup and view all the answers

What is one significant benefit of proper inhaler use?

<p>It leads to better drug delivery and minimizes side effects. (C)</p> Signup and view all the answers

Which statement about metered-dose inhalers (MDIs) is accurate?

<p>MDIs may be difficult for patients to coordinate inhalation and device activation. (A)</p> Signup and view all the answers

What may happen to larger drug molecules when using an inhaler?

<p>They may get retained in the airways. (C)</p> Signup and view all the answers

What is the main advantage of using a spacer with a metered-dose inhaler (MDI)?

<p>It reduces the need for coordination between inhalation and pressing the MDI button. (A)</p> Signup and view all the answers

Why are Dry Powder Inhalers (DPI) not recommended for children under 7 years of age?

<p>Children under 7 cannot generate enough inspiratory flow. (B)</p> Signup and view all the answers

What is a primary use of nebulisers in asthma treatment?

<p>To deliver medication in mist form for easy inhalation during acute exacerbations. (C)</p> Signup and view all the answers

How does using a spacer help reduce systemic side effects of medications?

<p>By decreasing medication deposition in the oropharynx. (D)</p> Signup and view all the answers

What distinguishes a metered-dose inhaler (MDI) from a dry powder inhaler (DPI)?

<p>MDIs use a propellant, while DPIs rely on the patient's inhalation effort. (A)</p> Signup and view all the answers

In what situation is the oral route of medication typically utilized?

<p>For patients unable to use inhalers due to physical limitations. (A)</p> Signup and view all the answers

What is a disadvantage of using a dry powder inhaler (DPI)?

<p>It may irritate the airways during use. (B)</p> Signup and view all the answers

What is the purpose of administering medication via the parenteral route?

<p>To allow for immediate and high doses of medication. (B)</p> Signup and view all the answers

What primarily contributes to the slow onset of action of lipophilic drugs like salmeterol?

<p>Incorporation into lipid bilayer (D)</p> Signup and view all the answers

How does a drug's hydrophilicity affect its therapeutic effect?

<p>It influences receptor availability and onset time (A)</p> Signup and view all the answers

What is a common adverse effect caused by excessive stimulation of β₂-receptors in skeletal muscle?

<p>Tremor (C)</p> Signup and view all the answers

What can excessive stimulation of β₂-receptors lead to in diabetic patients?

<p>Increased plasma glucose levels (D)</p> Signup and view all the answers

Why is inhalation therapy preferred for administering β₂-agonists?

<p>It minimizes adverse effects compared to systemic routes (A)</p> Signup and view all the answers

What causes hypokalaemia associated with β₂-agonists?

<p>Promotion of K+ entry into skeletal muscle (B)</p> Signup and view all the answers

What consequence may arise from stimulating β₂-receptors in cardiac tissue?

<p>Increased risk of arrhythmias (A)</p> Signup and view all the answers

What is a notable effect of β₂-agonists on glucose metabolism?

<p>They increase plasma glucose levels (C)</p> Signup and view all the answers

What component in cigarette smoke affects the metabolism of theophylline?

<p>Polycyclic aromatic hydrocarbons (B)</p> Signup and view all the answers

Why is dose adjustment of theophylline necessary in patients with pneumonia?

<p>Decreased clearance leading to higher drug levels (D)</p> Signup and view all the answers

What is the mechanism by which theophylline causes nausea?

<p>Inhibition of phosphodiesterase 4 leading to increased cAMP levels (A)</p> Signup and view all the answers

What is a common side effect of theophylline related to cardiac function?

<p>Cardiac Arrhythmias (C)</p> Signup and view all the answers

How does theophylline contribute to diuresis?

<p>Blocks proximal tubular reabsorption of sodium and fluid (B)</p> Signup and view all the answers

What effect does theophylline have on cerebral blood vessels, leading to headaches?

<p>Dilation of cerebral blood vessels (B)</p> Signup and view all the answers

Which side effect of theophylline is associated with elevated cAMP levels in the brain?

<p>Seizures (D)</p> Signup and view all the answers

Which side effect of theophylline's mechanism is still unclear and may involve cAMP?

<p>Behavioral disturbances (C)</p> Signup and view all the answers

What factor contributes to theophylline's continued use in developing countries?

<p>Cost-effectiveness compared to alternatives (C)</p> Signup and view all the answers

How does theophylline's mechanism as a phosphodiesterase inhibitor lead to potential adverse effects?

<p>By promoting increased levels of cAMP (A)</p> Signup and view all the answers

What adverse implication may arise from theophylline's action of antagonizing adenosine in patients with cardiovascular conditions?

<p>Exacerbation of arrhythmias (A)</p> Signup and view all the answers

Why is theophylline's ability to prevent the translocation of NF-κB significant in asthma treatment?

<p>It reduces the expression of inflammatory mediators (D)</p> Signup and view all the answers

Which of the following is a potential side effect of elevated cAMP levels due to theophylline's action?

<p>Tachycardia (C)</p> Signup and view all the answers

Which of the following factors may limit the use of more expensive alternatives to theophylline in developing countries?

<p>Economic constraints (D)</p> Signup and view all the answers

In what way does theophylline provide therapeutic benefits in conditions like asthma?

<p>By inhibiting phosphodiesterase activity (C)</p> Signup and view all the answers

What is the role of adenosine in the respiratory system that theophylline antagonizes?

<p>Increases airway constriction (A)</p> Signup and view all the answers

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.

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