Pulmonary Drug Delivery Overview
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Questions and Answers

What is a significant advantage of delivering drugs through the lungs compared to other routes?

  • Lower cost of production
  • Increased duration of action
  • Higher bioavailability due to bypassing hepatic first-pass metabolism (correct)
  • Easier administration for patients

Which medication is used specifically to treat neonatal respiratory distress syndrome?

  • Exogenous pulmonary surfactant (correct)
  • N-acetylcysteine
  • Pentamidine
  • Levodopa

What is the primary method of drug delivery in aerosol inhalation?

  • Intravenous injection
  • Subcutaneous injection
  • Inhalation of aerosolized drug particles (correct)
  • Direct tracheal instillation

Which of the following is NOT classified as an asthma medication mentioned in the content?

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

What type of aerosol inhaler relies on a pressurized propellant for drug delivery?

<p>Propellant-driven inhaler (D)</p> Signup and view all the answers

Which systemic medication is delivered via inhalation for diabetes treatment?

<p>Recombinant human insulin (C)</p> Signup and view all the answers

In which method of drug delivery is specific patient positioning particularly crucial?

<p>Intratracheal instillation (A)</p> Signup and view all the answers

Which drug is used to help reduce mucus viscosity in patients with cystic fibrosis?

<p>N-acetylcysteine (D)</p> Signup and view all the answers

Which mechanism is primarily responsible for larger aerosol particles colliding with airway walls?

<p>Inertial Impaction (B)</p> Signup and view all the answers

What is the fate of drug deposited in the oropharynx?

<p>It can be absorbed locally or swallowed. (C)</p> Signup and view all the answers

What factor significantly influences the deposition of aerosol particles in the lungs?

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

Which size range of aerosol particles is most suitable for reaching the alveoli?

<p>Particles 1-5 microns (B)</p> Signup and view all the answers

Gamma scintigraphy is used for which purpose in aerosol studies?

<p>To visualize aerosol deposition (C)</p> Signup and view all the answers

What occurs to drugs that reach the alveoli?

<p>They can be absorbed or engulfed by macrophages. (C)</p> Signup and view all the answers

What causes sedimentation of aerosol particles in the lungs?

<p>Gravity acting on slower airflow (D)</p> Signup and view all the answers

Which factor is least likely to influence where aerosol particles deposit in the lungs?

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

What is the primary mechanism by which dry powder inhalers (DPIs) deliver medication to the lungs?

<p>By requiring sufficient inhalation force (B)</p> Signup and view all the answers

What role do ciliated cells play in the respiratory tract?

<p>They assist in propelling mucus upwards through the mucociliary escalator (D)</p> Signup and view all the answers

Which component of the respiratory system is primarily responsible for systemic drug absorption?

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

What process allows alveolar macrophages to remove foreign particles from the lungs?

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

What is a key advantage of the mucus layer in the lungs?

<p>It keeps the lung lining moist and traps foreign particles (B)</p> Signup and view all the answers

What is the function of the mucociliary escalator in the respiratory system?

<p>To move trapped particles towards the pharynx (B)</p> Signup and view all the answers

What was a significant reason for the rise in popularity of dry powder inhalers over metered dose inhalers?

<p>They utilize propellants that are more environmentally friendly (B)</p> Signup and view all the answers

What is the primary role of alveolar macrophages in the respiratory system?

<p>To engulf and remove foreign particles in the alveoli (C)</p> Signup and view all the answers

What effect does a rapid, shallow breathing pattern have on particle deposition in the lungs?

<p>Favors deposition in the upper tracheobronchial tree. (B)</p> Signup and view all the answers

Which physiological factor can significantly enhance particle deposition from inhaled aerosols?

<p>Breath-holding after inhalation. (A)</p> Signup and view all the answers

How does the efficiency of pulmonary drug delivery typically compare to other routes of administration?

<p>Generally lower due to high losses to the GI tract. (C)</p> Signup and view all the answers

What is a primary characteristic of Metered Dose Inhalers (MDIs) regarding their dosing mechanism?

<p>They use a metering valve for precise dosing. (D)</p> Signup and view all the answers

Which factor contributes to the low efficiency of pulmonary drug delivery?

<p>Suboptimal inhalation technique. (C)</p> Signup and view all the answers

What role do propellants play in Metered Dose Inhalers?

<p>They serve as the power source for aerosol generation. (C)</p> Signup and view all the answers

What impact does the disease state, such as COPD or asthma, have on particle deposition?

<p>It can lead to narrower airways that increase turbulence. (D)</p> Signup and view all the answers

Which of the following properties is crucial for the performance of aerosol devices?

<p>The boiling point and vapor pressure of the propellant. (A)</p> Signup and view all the answers

Which of the following medications is specifically mentioned as a bronchodilator for asthma treatment?

<p>Beta-agonists (B)</p> Signup and view all the answers

What is the significance of avoiding hepatic first-pass metabolism in pulmonary drug delivery?

<p>It leads to higher bioavailability. (C)</p> Signup and view all the answers

In which pulmonary drug delivery method is direct administration into the trachea performed?

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

What is a primary characteristic of propellant-driven aerosol inhalers?

<p>They deliver the drug through a fine mist. (D)</p> Signup and view all the answers

Which condition is specifically treated with exogenous pulmonary surfactant?

<p>Neonatal Respiratory Distress Syndrome (D)</p> Signup and view all the answers

Which medication is delivered systemically via the lungs for Parkinson's disease?

<p>Levodopa (A)</p> Signup and view all the answers

What is the primary focus of aerosol inhalation methods?

<p>To deliver drugs for deep lung penetration (D)</p> Signup and view all the answers

Which medication is administered via aerosol for the treatment of Pneumocystis jirovecii pneumonia?

<p>Pentamidine (A)</p> Signup and view all the answers

Which breathing pattern primarily supports particle deposition in the upper tracheobronchial tree?

<p>Rapid, shallow breathing (D)</p> Signup and view all the answers

What is the main reason that a significant portion of inhaled drug dosage ends up in the gastrointestinal tract?

<p>Suboptimal aerosol generation (D)</p> Signup and view all the answers

Which component of Metered Dose Inhalers (MDIs) ensures the delivery of a precise dose upon actuation?

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

How does breath-holding after inhalation affect particle deposition?

<p>It enhances sedimentation and diffusion (B)</p> Signup and view all the answers

What impact does altered lung architecture, such as in emphysema, have on particle deposition?

<p>Reduces deposition in alveoli (B)</p> Signup and view all the answers

Which of the following factors negatively influences the efficiency of aerosol delivery?

<p>Rapid inhalation (B)</p> Signup and view all the answers

What is the role of propellants in Metered Dose Inhalers (MDIs)?

<p>To generate high pressure for aerosolization (B)</p> Signup and view all the answers

What is a primary function of the pulmonary epithelium in the respiratory tract?

<p>To trap particles and debris (C)</p> Signup and view all the answers

What effect does a disease state like asthma have on airway conditions relevant to particle deposition?

<p>It causes narrowed airways and increased turbulence (C)</p> Signup and view all the answers

How do nebulizers primarily create the aerosol that is inhaled?

<p>By generating vibration through ultrasonic waves (A)</p> Signup and view all the answers

What happens to drug particles larger than 10 microns upon inhalation?

<p>They deposit in the oropharynx. (B)</p> Signup and view all the answers

Which part of the respiratory system does NOT play a role in the mucociliary escalator?

<p>Alveoli (A)</p> Signup and view all the answers

Which mechanism primarily influences the deposition of finer aerosol particles (< 1 micron)?

<p>Diffusion. (A)</p> Signup and view all the answers

What challenge is posed by dry powder inhalers (DPIs) regarding patient use?

<p>The requirement for forceful inhalation (D)</p> Signup and view all the answers

What is the primary consequence of aerosol particles depositing in the gastrointestinal tract?

<p>Reduced effectiveness due to first-pass metabolism. (A)</p> Signup and view all the answers

What role do alveolar macrophages play in the lungs?

<p>They serve as immune defenders by engulfing particles (C)</p> Signup and view all the answers

Which of the following inhaled aerosol particles is most likely to reach the deep lung structures?

<p>Particles 1-5 microns. (B)</p> Signup and view all the answers

What is the significance of the large surface area of the alveoli?

<p>It allows for faster drug absorption (A)</p> Signup and view all the answers

What primarily causes inertial impaction of aerosol particles?

<p>Inability of larger or fast-moving particles to navigate airway curves. (C)</p> Signup and view all the answers

What is a major reason for the shift towards using dry powder inhalers (DPIs)?

<p>They do not require CFC propellants (A)</p> Signup and view all the answers

How does the mucociliary escalator affect drug deposited in the tracheobronchial region?

<p>It clears drug particles out of the respiratory system. (B)</p> Signup and view all the answers

What aspect of mucus in the lungs primarily aids in protecting the lung tissue?

<p>It traps foreign particles like dust and bacteria (A)</p> Signup and view all the answers

What is a critical factor influencing the depth of aerosol particle deposition in the lungs?

<p>The velocity of inhalation by the patient. (A)</p> Signup and view all the answers

Which characteristic of gamma scintigraphy makes it valuable in aerosol studies?

<p>It illustrates how aerosol particles distribute in the lungs. (A)</p> Signup and view all the answers

Flashcards

Pulmonary drug delivery

Administering drugs to the lungs for localized or systemic effects.

Local effect in lungs

Treating lung conditions directly, like asthma and COPD.

Systemic effect via lungs

Drugs absorbed in the lungs, bypass the liver for higher bioavailability.

Intratracheal instillation

Direct drug administration to the trachea, often for pulmonary surfactant.

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Aerosol inhalation

Most common method; aerosolized drug inhaled into the lungs.

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Propellant-driven inhalers

Classic aerosol inhalers using pressurized propellants for drug delivery.

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Asthma medication examples

Beta-agonists, corticosteroids, anti-muscarinics, and mast cell stabilizers.

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COPD medication examples

Mucolytics like N-acetylcysteine and deoxyribonuclease.

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Aerosol cloud

A mist of tiny particles containing medication released by inhalers, designed to reach the lungs.

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Deposition sites

The specific locations in the lungs where the aerosol particles land, depending on their size and the patient's breathing.

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Gamma Scintigraphy

A technique using radioactive tracers to visualize where inhaled particles deposit in the lungs, showing the distribution of medication.

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Oropharynx

The back of the mouth and throat, where some inhaled medicine can be absorbed or swallowed.

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Tracheobronchial region

The windpipe and airway branches, where medicine can be cleared by mucus, absorbed into the bloodstream, or captured by immune cells.

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Alveoli

Tiny air sacs in the lungs where gas exchange occurs, and where some medicine can be absorbed or cleared by immune cells.

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Inertial impaction

Large or fast-moving particles hitting the walls of the airways, especially in the mouth and upper airways.

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Sedimentation

Smaller particles settling down due to gravity as airflow slows down in the deeper parts of the lungs.

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Mechanical Energy Inhaler

A newer type of inhaler that uses mechanical energy to convert liquid medication into an aerosol, which is then inhaled by the patient. This method does not rely on pressurized propellants like older inhalers.

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Dry Powder Inhaler (DPI)

A type of inhaler that delivers medication in a dry powder form. The patient inhales through the device, creating airflow that disperses the powder into the lungs.

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Nebulizer

A device that transforms liquid medication into a fine mist of tiny droplets using air or ultrasonic waves. This mist is then inhaled by the patient.

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Tracheobronchial Tree

The branching network of airways in the lungs, starting with the trachea and progressively getting smaller, like a tree with many branches, ending in the alveoli.

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Pulmonary Epithelium

The cells lining the airways of the lungs. In the upper airways and tracheobronchial tree, they have cilia, tiny hair-like structures that move mucus upwards.

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Mucociliary Escalator

The process of moving mucus upwards in the airways by the coordinated action of cilia. This helps remove debris and foreign substances from the lungs.

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Alveolar Macrophages

Specialized immune cells in the alveoli that engulf and destroy foreign particles like bacteria, dust, and undissolved drug crystals.

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Particle Velocity & Deposition

Higher particle velocity increases the likelihood of particles getting stuck in the upper airways due to inertia. This is called inertial impaction.

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Rapid Breathing & Deposition

Rapid, shallow breaths favor deposition of particles in the upper airway, like the trachea and bronchi. This is because there is less time for particles to reach the deeper parts of the lungs.

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Slow Deep Breathing & Deposition

Slow and deep breaths allow particles to travel deeper into the lungs, reaching the alveoli for potential absorption.

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Breath-Holding & Deposition

Holding your breath after inhaling allows particles to settle down in the lungs for absorption and minimizes exhalation.

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Lung Disease Impact on Deposition

Lung diseases like asthma or emphysema can change the size and shape of airways and impact particle deposition, potentially leading to increased impaction.

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Pulmonary Drug Delivery Efficiency

The efficiency of delivering drugs to the lungs is generally low, with a large portion reaching the GI tract instead.

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Factors Affecting Low Efficiency

Factors contributing to low efficiency include: - Suboptimal aerosol generation - Fast release velocity - Suboptimal inhalation technique

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Metered Dose Inhalers (MDIs)

MDIs use pressurized canisters containing a measured dose of medication, a propellant, and minimal excipients. The metering valve delivers a precise dose when activated.

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Why deliver drugs to lungs?

Pulmonary drug delivery aims to target the lungs directly for local effects (treating lung conditions) or to reach the bloodstream for systemic effects (treating conditions beyond the lungs).

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What are the key benefits of pulmonary drug delivery?

Pulmonary drug delivery offers several advantages, including achieving localized effect in the lungs, avoiding the liver's breakdown (higher drug bioavailability), and convenient administration.

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Particle Size & Deposition

The size of aerosol particles greatly influences where they deposit in the lungs. Smaller particles reach deeper, while larger ones settle higher.

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Diffusion

The smallest particles move randomly and deposit on airway surfaces due to diffusion.

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First-Pass Metabolism

Drug absorbed in the mouth or GI tract is processed by the liver, potentially reducing its effectiveness.

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Deep Lung Penetration

Smaller particles (1-5 microns) are ideal for reaching deep into the lungs, where they can be absorbed systemically.

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Lung Disease & Deposition

Lung diseases (like asthma or emphysema) can alter airway size and shape, impacting particle deposition. This can lead to increased impaction in the upper airways.

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Study Notes

Pulmonary Drug Delivery

  • Local Effect: Drugs are delivered to lungs to target specific airways, like in asthma and COPD, for immediate action.
    • Examples: asthma medications (beta-agonists, glucocorticoids, antimuscrinics, mast cell stabilizers) and COPD medications (mucolytics).
    • Also for neonatal respiratory distress syndrome (exogenous pulmonary surfactant) and infections (pentamidine, ribavirin).
  • Systemic Effect: Lungs provide a systemic route for drug delivery, avoiding liver first-pass metabolism.
    • Higher bioavailability compared to other routes like oral.
    • Examples: Afrezza (dry powder inhaler for diabetes), Adesu (dry powder for schizophrenia), and INBRIJA (dry powder for Parkinson's disease).

Pulmonary Drug Delivery Methods

  • Intratracheal Instillation: Direct administration of drug solution to the trachea, primarily for neonatal respiratory distress syndrome.
  • Aerosol Inhalation: Common method where aerosolized drug particles are inhaled into lungs.
    • Delivery through the mouth or tracheostomy.
    • Critical method discussed here.

Types of Oral Aerosols

  • Propellant-driven: Classic aerosol inhalers, utilizing pressurized propellant to deliver medicine as fine mist.
  • Mechanical Energy-driven: Newer inhaler type using mechanical energy to produce aerosol.

Anatomy and Physiology of Respiratory Tract

  • Tracheobronchial Tree: Lung airways branching from trachea to bronchi, bronchioles and alveoli.
  • Alveoli: Tiny air sacs for gas exchange, large surface area key for drug absorption.
  • Pulmonary Epithelium: Cells lining airways, with cilia in upper airways for mucociliary escalator (mucus movement).
  • Role of Mucus: Protects lungs by trapping particles and germs via the mucociliary escalator. Hydrates lung tissue.
  • Alveolar Macrophages: Specialized immune cells that remove foreign particles in alveoli.

Aerosol Deposition in the Lungs

  • Deposition Sites: Affected by particle size, velocity and breathing patterns.
  • Gamma Scintigraphy: Imaging technique visualizing aerosol deposition patterns.
  • Fate of Deposited Drug: Possible destinations are oropharynx (swallowing), tracheobronchial region (systemic absorption, mucociliary clearance), or alveoli (systemic absorption, macrophages).

Mechanisms of Aerosol Deposition

  • Inertial Impaction: Large, fast particles impact airway walls.
  • Sedimentation: Particles settle due to gravity in lower airways.
  • Diffusion: Smallest particles diffuse and settle on surfaces.
  • Particle Size: Small particles penetrate deeper into lungs.
  • Particle Velocity: High velocity increases inertial impaction.
  • Other (patient-related factors): Fast/slow, deep/shallow breathing, disease-related effects (narrowed airways).

Efficiency of Pulmonary Drug Delivery

  • Low efficiency: Substantial portion of inhaled dose ends up in GI tract.
  • Factors affecting low efficiency: suboptimal aerosol generation, fast release, and poor inhalation technique.
  • Types of Pulmonary Delivery Devices: Metered Dose Inhalers (MDIs), Dry Powder Inhalers (DPIs) and nebulizers.

Metered Dose Inhaler (MDI)

  • Pressurized canisters.
  • Metering valve, actuator, and propellants (hydrocarbon-based).

Dry Powder Inhalers (DPI)

  • Alternative to MDIs due to CFC propellants phasing out.
  • Produce drug particles using air jet or ultrasonic waves.

Other Excipients

  • Surfactants: Used as dispersions and prevent particle sticking.

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Pulmonary Drug Delivery Methods PDF

Description

This quiz explores the concepts of pulmonary drug delivery, focusing on both local and systemic effects. It highlights various medications used for conditions like asthma, COPD, and neonatal respiratory distress syndrome. Understand the delivery methods such as intratracheal instillation and aerosol inhalation in drug administration.

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