Pulmonary Drug Delivery Quiz
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Questions and Answers

What is one purpose of delivering drugs to the lungs?

  • To circumvent all forms of drug delivery
  • To achieve a local effect for conditions like asthma (correct)
  • To enhance oral absorption of drugs
  • To achieve systemic metabolic effects

Which of the following drugs is specifically used for respiratory distress syndrome?

  • Pentamidine
  • Pulmonary surfactant (correct)
  • Deoxyribonuclease
  • Loxapine

Which type of drug delivery method involves instilling a liquid directly into the trachea?

  • Oral inhalation therapy
  • Intratracheal instillation (correct)
  • Subcutaneous injection
  • Aerosol inhalation

What is a characteristic of aerosol inhalation as a delivery method?

<p>Delivers a drug via oral inhalation (A)</p> Signup and view all the answers

What type of oral aerosol device uses mechanical energy to operate?

<p>Metered-dose inhalers (B)</p> Signup and view all the answers

Which condition can benefit from the use of mucolytics delivered via pulmonary methods?

<p>Cystic Fibrosis (B)</p> Signup and view all the answers

What is a limitation of using the lungs for systemic drug delivery?

<p>Hepatic first pass metabolism (C)</p> Signup and view all the answers

Which of the following is true regarding nebulizers?

<p>They include air-jet and ultrasonic types (D)</p> Signup and view all the answers

What is a significant factor that affects the efficiency of pulmonary drug delivery?

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

Which component of a pressurized metered-dose inhaler (pMDI) is responsible for delivering an accurate volume of medication?

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

What can cause an aerosol to impact in the back of the throat during drug inhalation?

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

What material is most commonly used for the container of a pMDI?

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

How does rapid aerosol release affect drug delivery in inhalers?

<p>Favors impaction in the throat (B)</p> Signup and view all the answers

Which of the following is NOT a component of a pressurized metered-dose inhaler (pMDI)?

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

What happens to the liquid in a metered-dose inhaler when it is actuated?

<p>It becomes a fine mist (D)</p> Signup and view all the answers

What is the primary purpose of the actuator in a metered-dose inhaler?

<p>To depress the metering valve (D)</p> Signup and view all the answers

What is the primary role of the propellant in metered-dose inhalers (pMDIs)?

<p>To serve as a power source for aerosolization (B)</p> Signup and view all the answers

Which propellant is considered the main alternative to CFCs used in inhalers?

<p>HFA 134 (C)</p> Signup and view all the answers

What is a significant disadvantage of using suspensions in metered-dose inhalers?

<p>Poor solubilizing capacity of propellants (B)</p> Signup and view all the answers

What happens during the aerosol release from a pMDI after the valve stem is depressed?

<p>Liquid aerosol is exposed to lower pressure (D)</p> Signup and view all the answers

What property of propellants significantly affects their function in inhalers?

<p>Their nonpolar nature (D)</p> Signup and view all the answers

What is the typical pressure maintained in a pMDI?

<p>3 atm (D)</p> Signup and view all the answers

Which of the following is a common cosolvent used in pMDI formulations?

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

What occurs when the liquid aerosol in a pMDI is exposed to atmospheric pressure?

<p>Flash vaporization occurs (A)</p> Signup and view all the answers

What mechanism generates aerosol in the Respimat device?

<p>A spring mechanism (B)</p> Signup and view all the answers

What is a characteristic of the aerosol produced by Respimat compared to pMDIs?

<p>It is softer and slower. (A)</p> Signup and view all the answers

What is the purpose of the carrier powder in Dry-Powder Inhalers (DPIs)?

<p>To improve powder flow and dispersibility. (B)</p> Signup and view all the answers

Why must the drug formulation in DPIs be micronized?

<p>To reach the proper particle size for effective delivery. (A)</p> Signup and view all the answers

What is a disadvantage of the small particle size in powdered drugs?

<p>It can result in greater cohesiveness and adhesiveness. (C)</p> Signup and view all the answers

What is the primary force that allows dry powder to flow in DPIs?

<p>Compressive force from the patient's breath. (D)</p> Signup and view all the answers

Which of the following DPIs uses capsules prefilled with drug formulation?

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

What happens to the carrier particles in a DPI, and how does this affect their respirability?

<p>They are larger and less respirable. (C)</p> Signup and view all the answers

What is one of the main effects of using spacer devices?

<p>They reduce aerosol velocity and improve lung targeting. (D)</p> Signup and view all the answers

Which component of a valved holding chamber helps to keep aerosol in the device until inhalation occurs?

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

What is a key feature of breath-actuated pMDIs?

<p>They do not require coordination of actuation and inhalation. (C)</p> Signup and view all the answers

What is a disadvantage of using spacer devices?

<p>There is significant loss of aerosol product within the device. (B)</p> Signup and view all the answers

How does the antistatic coating of a spacer device benefit its function?

<p>It reduces deposition in the spacer, increasing the available dose. (A)</p> Signup and view all the answers

Which of the following examples is a breath-actuated pMDI?

<p>QVAR Redihaler (B)</p> Signup and view all the answers

What does the flow indicator sound in a spacer device signify?

<p>The inhalation is too fast. (A)</p> Signup and view all the answers

What is the effect of reducing aerosol velocity in spacer devices?

<p>Decreases the likelihood of oropharyngeal deposition. (B)</p> Signup and view all the answers

What is the mechanism by which Afrezza delivers insulin?

<p>Insulin adsorbed onto fumaryl diketopiperazine microspheres that dissolve in the lungs (B)</p> Signup and view all the answers

Which device uses aluminum blister packs to separately store doses?

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

What type of DPI is the Pulmicort Flexhaler classified as?

<p>Multiple-dose DPI (D)</p> Signup and view all the answers

What is an important factor affecting dose delivery from DPIs?

<p>Inspiratory flow rate (D)</p> Signup and view all the answers

Which of the following is NOT a feature of the Ellipta device?

<p>Contains a reservoir for metering doses (B)</p> Signup and view all the answers

What distinguishes Diskus Powders from other inhalation devices?

<p>Contains drug plus lactose in blister strips (C)</p> Signup and view all the answers

What is the primary composition of Afrezza?

<p>Insulin regular adsorbed on FDKP microspheres (C)</p> Signup and view all the answers

Which of the following inhalers is classified as a generic of Advair Diskus?

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

Flashcards

Pulmonary drug delivery

Administering drugs to the lungs to achieve either local or systemic effects.

Local drug effects

Treatment directly targeting the lungs to address respiratory conditions.

Systemic drug effects

Using the lungs to deliver medication to other parts of the body.

Aerosol inhalation

A method of delivering drugs into the lungs using aerosolized particles or liquid medication.

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Intratracheal instillation

Injecting liquid medication directly into the trachea to reach deeper lung areas.

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Asthma treatment

Drugs like beta-2 agonists, glucocorticoids, antimuscarinics, and mast cell stabilizers are used to treat asthma.

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Respiratory infections

Drugs like pentamidine and ribavirin are used to treat respiratory infections.

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Pulmonary surfactant

A substance used to treat respiratory distress syndrome in newborns.

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Pulmonary drug delivery efficiency

Pulmonary drug delivery is often inefficient due to particles often ending up in the gastrointestinal tract.

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Suboptimal aerosol generation

Poor aerosol production in pulmonary drug delivery, often resulting in large particles that get stuck in the throat.

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Suboptimal inhalation technique

Issues with how a patient inhales the pulmonary medication leading to poor drug delivery.

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Pressurized Metered-Dose Inhaler (pMDI)

A common pulmonary drug delivery device that uses pressurized liquid to create an aerosol.

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MDI components: Container

The container holds the medication and propellants under pressure. It needs to be strong enough.

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MDI components: Metering valve

Measures and dispenses the precise amount of medication.

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MDI components: Actuator

The mouthpiece that you use to press the valve stem (which is important) and release the medication.

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MDI component: Propellant

The substance in an MDI that helps to propel the medication into the aerosol form.

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Spacer Device

A device used with a pMDI to help deliver medication more effectively to the lungs. It creates a larger, more evenly dispersed cloud of medication and makes it easier to coordinate inhalation and actuation.

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How a spacer device works

The spacer device is attached to the inhaler. When activated, the inhaler releases medication into the spacer. The patient then inhales slowly and deeply, drawing the medication into their lungs.

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Benefits of using a spacer device

Using a spacer device creates a more respirable cloud of medication, which allows for easier coordination of actuation and inhalation, reduces medication deposition in the mouth, and helps direct more medication to the lungs.

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Valved Holding Chamber

A type of spacer device with valves that control the flow of medication. The inspiratory valve keeps the medication in the chamber until the patient inhales, while the expiratory valve directs exhaled air away from the chamber.

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What does a 'flow indicator sound' mean?

A flow indicator sound on a spacer device means that the patient is inhaling too quickly. This can lead to less effective medication delivery.

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Breath-Actuated pMDI

A type of inhaler that automatically delivers medication when the patient inhales. It eliminates the need for coordination between actuation and inhalation.

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What is a Mechanical Energy-Driven Liquid Metered Dose Inhaler?

A type of inhaler that uses a mechanical system to deliver medication. It's called 'Respimat' and is produced by Boehringer Ingelheim.

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What's the most common propellant in inhalers?

HFA 134 is the most prevalent propellant in inhalers. It's an alternative to CFCs, which are harmful to the ozone layer.

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What are propellants in inhalers?

Propellants in inhalers are hydrocarbon-based compounds that are gases at room temperature but become liquids under high pressure. They act as the power source for aerosolization and transport the drug.

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What's the advantage of HFA 134 over CFCs?

HFA 134 breaks down faster in the atmosphere compared to CFCs, reducing ozone depletion. This makes it a more environmentally friendly option.

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Why are propellants nonpolar?

Propellants are nonpolar because they need to be able to disperse the drug effectively. Polar molecules would interact and potentially reduce the drug's effectiveness.

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What happens when you press an inhaler valve?

When you press the valve, the liquid aerosol inside is exposed to atmospheric pressure. It vaporizes rapidly, creating a plume of drug-containing propellant droplets.

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What are MDI solutions?

MDI solutions involve dissolving the drug directly in the propellant. Sometimes, a cosolvent like ethanol is added to enhance solubility.

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Why are MDI suspensions common?

MDI suspensions are prevalent because propellants don't dissolve many drugs effectively. Suspensions keep the drug dispersed in the propellant.

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What's the main disadvantage of MDI suspensions?

A major disadvantage of MDI suspensions is the risk of drug settling out, meaning the medication may not be evenly distributed and some might be lost.

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Respimat Device

A propellant-free inhaler that uses a spring mechanism to push liquid medication through nozzles, creating a soft and slow aerosol.

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Benzalkonium Chloride

A common preservative often found in Respimat solutions, used to prevent bacterial growth.

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Dry-Powder Inhaler (DPI)

An inhaler that dispenses dry powder medication, requiring the patient's breath to create an airflow and deliver the powder.

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Micronized Drug Particles

Very tiny drug particles that need to be the right size to be effectively inhaled, but this makes them prone to clumping.

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Carrier Powder

Larger particles that help the smaller drug particles flow and disperse properly in a DPI.

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Lactose and Glucose

Common carrier powders used in DPIs to ensure smooth delivery of drug particles.

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Unit-Dose DPI

A DPI with pre-filled capsules containing the medication, which are inserted into the device for use.

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Handihaler

A type of unit-dose DPI where the capsule is punctured on the side, releasing the powder for inhalation.

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Afrezza

Insulin delivered via inhalation, adsorbed onto tiny particles for deeper lung penetration.

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Diskhaler

A device for inhaling powdered medication, which is pre-packed in separate blister packs and pierced before inhalation.

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Diskus Powders

A device for inhaling powdered medication containing both the drug and lactose, pre-loaded in individual blisters.

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Wixela Inhub

A generic version of Advair Diskus for inhaling powdered medication.

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Ellipta

A device for inhaling powdered medication, pre-loaded with a month's supply in individual blisters.

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Pulmicort Flexhaler

A device for inhaling powdered medication, containing a reservoir of micronized budesonide and lactose.

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DPI: Inspiratory Flow Rate

The speed at which you inhale affects how much medication is delivered.

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DPI: Important Factors

Factors like inspiratory flow rate influence the effectiveness of delivering the medication.

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Study Notes

Pulmonary Drug Delivery

  • Purposes of lung drug delivery include achieving local effects (e.g., asthma treatment with beta-2 agonists, glucocorticoids, antimuscarinics, mast cell stabilizers; infections with pentamidine or ribavirin; mucolytics like n-acetylcysteine; cystic fibrosis treatment with deoxyribonuclease; respiratory distress syndrome treatment with pulmonary surfactant) and systemic effects (e.g., insulin, loxapine, levodopa)
  • Pulmonary drug delivery methods include intratracheal instillation (drug liquid into trachea) and aerosol inhalation (propellant-driven, mechanical, or dry power inhalers).

Respiratory Tract

  • Regions include upper airway (nose and nasal cavity), and the trachea-bronchial tree (segmental, nonrespiratory, respiratory bronchioles, alveolar ducts, alveoli).
  • Trachea-bronchial tree progressively decreases in caliber, primarily conducting air to the respiratory region for gas exchange.
  • Pulmonary epithelia line the upper airway and trachea-bronchial tree.
    • Ciliated epithelia in the nasal cavity, nasopharynx, larynx, trachea, and bronchi, lined with pseudostratified ciliated columnar epithelial cells, along with goblet cells.
    • Mucus in the lungs similar to nasal mucus.
      • Prevents epithelial dehydration and traps foreign particles.
      • Moved upwards by cilia in mucociliary escalator process to be swallowed.
  • Alveoli are the primary site for gas exchange within the lungs.

Aerosol Deposition in Lungs

  • Aerosol deposition occurs via inertial impaction (particles’ tendency to travel in a straight line), sedimentation (particles fall due to gravity), and diffusion (particles diffuse to deposition sites).
  • Particle size profoundly affects deposition; smaller particles reach deeper regions of the lungs.
  • Factors like breathing rate and breathing pattern also influence particle deposition rates, especially in diseased states.
  • Particles greater than 10 micrometers deposit in the oropharynx or upper airways, while particles from 5-10 micrometers deposit in the upper tracheobronchial region, particles from 1-5 in bronchioles/alveolar ducts, and those smaller than 1 micrometer deposit in the alveoli.
    • Smaller particles deposit farther down in the lung. Increased particle velocity favors deposition by impaction

Pulmonary Inhalation Devices

  • Pressurized Metered-Dose Inhalers (pMDIs) are the common type and consist of: A container, Metering Valve, Actuator/Mouthpiece, Propellant.
  • Dry Powder Inhalers (DPIs) dispense dry powder directly into the airways. The forces needed to exhale to operate these devices are important.
  • Nebulizers (SVN) produce mist of liquid.
    • Air-jet and Ultrasonic types exist.
    • Aerosol produced is nebulized in small droplets, which are then inhaled.

Drug Factors in MDIs/DPIs

  • Drug properties are important: Solvents for suspensions (drug dispersed in the solvent); micronization necessary for suspended drugs to avoid large particles impacting in the oropharynx.
  • Additives (cosolvents, surfactants).
  • Preservatives are not always needed (Single use).

Patient Factors

  • Patient conditions affect drug delivery to the lungs. Coordination/breathing patterns are important for MDIs.
  • Patients that have the ability to control or modify their breathing for inhalers would choose an MDI. For patients with problems controlling breathing or lung issues, nebulizers may work better.

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Pulmonary Drug Delivery PDF

Description

Test your knowledge on pulmonary drug delivery methods and their purposes. This quiz covers various treatments and the anatomy of the respiratory tract. Explore how different drugs are delivered to achieve local and systemic effects in patients with respiratory diseases.

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