Shared Flashcard Set

Details

Respiratory Care
Pharmacology - Chapters 1-5
48
Medical
02/12/2008

Additional Medical Flashcards

 


 

Cards

Term
Heterodisperse
Definition
In reference to the size of particles in an aerosol, meaning the particls are of different sizes
Term

Hydrofloralkane

(HFA)

Definition
A non-toxic liquefied gas propellant used to administer medication from metered dose inhalers
Term
In Vitro
Definition
Mechanically simulating the clinical setting; testing in a laboratory
Term
In Vivo
Definition

Testing done on animals or humans; clinical testing

 

Term
Monodispurse
Definition
In reference to the size of particles in an aerosol, meaning all particls are the same size
Term
Nebulizer
Definition

A device used for making a fine spray or mist, also known as an aerosol generator

Term
Penetration
Definition
Referes to the depth within the lungs reached by particles
Term
Polydisperse
Definition
in reference to the size of particls in an aerosol, meaning many different sizes
Term
Reservoir Device
Definition
Global term describing or referring to extension, auxillary, add-on devices attached to metered dose inhalers (MDI) for administration. This term could include both "spacer" and "valved holding chamber"
Term
3 main uses of aerosol therapy in respiratory care
Definition

humidification - of dry inspired gases using bland aerosols.

Imroves mobilization - and clerance of respiratory secretions, including sputum induction, using bland aerosols of water, and hypertonic or hypotonic saline

 delivery of aerosolized drugs - to the respiratory tract

Term

Mass median aerodynamic diameter

(MMAD)

Definition
a major factor in lung penetration by aerosols is particle size, which is best characterized by MMAD for inhaled drugs, because particle mass is a funtion of the third power of the particle radius. Theh particle size of interest for pulmonary applications is the range of 1-10 micrometers, and the fine particle fraction is considered to include particles <5 micrometers
Term
Count Mode
Definition
the most frequently occuring particle size in the distribution
Term

Count median diameter

(CMD)

Definition
the particle size above and below which 50% of the particles is found (ie. the size that evenly divides the number of particles in the distribution)
Term
Particles > 10 microns
Definition
Useful to treat the nasopharyngeal and oropharyngeal resions. ie. nasal spray for perennial rhinitis, such as a corticosteroid
Term
Particles 5-10 microns
Definition
may shift deposition to the more central airways, although significant oropharyngeal deposition is expected
Term
Particles 2-5 microns
Definition
As particle sizes decreas below 5 microns, deposition shifts from the oropharynx and large airways to the overall lower respiratory tract (large airways to periphery). This size range is considered useful for bronchoactive aerosols currently in use.
Term
Particles 0.8 - 3.0 microns
Definition
increased delivery of an aerosol to the lung parenchyma, including the terminal airways and alveolar region, could be achieved with particles < 3 microns
Term
3 physical mechanisms for aerosol partical deposition in the human lung
Definition

Inertial impaction - function of particle size and velocity, and increases with larger size & higher velocities.

Gravitational settling - (sedimentation) a function of particle size and time. Settleing will be greater for larger particles with slow velocities, under influence or gravity.

Diffusion (Brownian Motion) - affect particles less than one micron and is a function of time and random molecular motion

Term
Average optimal volume and flow rate for many nebulizers is a volume of ________ ml with a _______L/min flow rate.
Definition

5 ml

 

10 L/min

Term
Constant output nebulizer
Definition
Traditional net in which aerosol is produced constantly during inspiration and exhalation.
Term
Breath enhanced nebulizer
Definition
allows more aerosol release during inspiration with decreased output during exhaltion or breath holding.
Term
Dosimetric Nebulizer
Definition
Aerosol is released only during inspiration and all released aerosol is available for patient inhalation.
Term
Vibrating plate technology Nebulizer
Definition
Use a vibrating plate or mesh with multiple apertures (small holes), which allow the liquid to generate an aerosol
Term
Breath-actuated Inhalers
Definition

after an alternative for individuals who find it difficult to coordinate MDI actuation with inhalation.

Marketed for Pirbuterol

Term
The Autohaler
Definition
Pressure MDI (pMDI) cannister fitted withing the autohaler actuator. Activated when the patient inhales.
Term
Advantages of Reservoir Devices
Definition
  • Reduce oropharyngeal drug loss
  • seperation of MDI actuation & inhalation
  • allows use of MDI during acute airflow obstruction
  • available with mask for children
Term
Disadvantages of reservoir devices
Definition
  • Some brands large and cumbersome
  • additional expense compared with MDI alone
  • Some assembly required
  • Possible source of bacterial contamination with inadequate cleaning
Term
Electrostatic charge in reservoir device
Definition
By reducing this, and increase in drug delivery will occur. Can increase delivery of the aerosolized drug by up to 70%
Term
Aerosol delivery of short-acting B2 agonists in the emergency department
Definition
There is little info. to show that DPI is as effective as and MDI with a holding chamber or a Neb.
Term
Which portion of the nervous system is under voluntary control?
Definition
Skeletal muscle motor nerve portion
Term

What is the neruotransmitter at each of the following sites?

  • neuromuscular junction
  • autonomic ganglia
  • what is the most sympathetic site
Definition

Neuromuscular junction - acetylcholine

 

autonomic ganglia - acetylcholine

 

most sympathitic end sites - norepinephrine

Term
where are muscarinic receptors found
Definition

at the parasympathetic nerve terminal sites

Term
What is the effect of cholinergic stimulation of airway smooth muscle
Definition
Bronchoconstriction
Term
What is the effect of adernergic stimulation on the heart
Definition
Increased rate and force of contraction
Term
Classify the drugs pilocarpine, physostigmine, propranolol, and epinephrine
Definition

Pilocarpine - direct-acting cholinergic

physostigmine - indirect-acting cholenergic

propranolol -adernergice-blocking agent (B1 and B2)

epinephrine - adernergic agonist (stimulates a and b receptors)

Term
How do indirect-acting cholinergic agonists (parasympathomimetics) produce their action
Definition
such as neostigmine, inhibit the enzyme cholinesterase, which increases the amount of aceytylcholine available to stimulate postsynaptic sites at the nerve terminal
Term
What effect would the drug atrophine have on the eye and on airway smooth muscle
Definition
atropine iw a competitive blocking agent for muscarinic receptors. the drug would block the eye circular iris to dilate the pupil (mydriasis) paralyze the ciliary muscle to flatten the lens (cycloplegia), and antagonize cholinergically induced bronchoconstriction in the airway
Term
What is the general difference between a and b receptors in the sympathetic nervouls system
Definition
the a receptors generally cause an excitatory effect (e.g., vasoconstriction), and B receptors generally produce inhibition (e.g., airway smooth muscle relaxation)
Term
What is the primary mechanism for terminiatin the neurotransmitters aceytlcholine and norepinephrine
Definition
acetylcholine is metabolized by cholinesterase enzymes; norepinephrine is reabsorbed back into the presympathetic neuron
Term
What is the predominant sympathetic receptor type found on airway smooth muscle
Definition
The B2 receptor
Term
Identify the adernergic receptor preference for phenylephrine, norepinephrine, epinephrine, and isoproternol
Definition

phenylephrine - a receptors (a1 specifically)

norepinephrine - a>B receptors

epinephrine- a and B receptors equally

isoproternol - B (B1 and B2 receptors)

Term
What is the autoregulatory receptor on the sympathetic presynaptic neuron
Definition
a2 receptors
Term
What is the autoregulatory receptor on the parasympathetic presynaptic neuron at the terminal nerve site
Definition
the muscarinic receptor subtype M2
Term
Classify the following drugs by autonomic class and receptory preference: dopamine, ephedrine, albuterol, phentolamine, propranolol, and prazosin
Definition

dopamine - sympathomimetic (dopamine receptors, a,B)

ephedrine - sympathomimetic (a and B)

albuterol sympathomimetic (B2 preferential)

phenotolamine - a sympatholytic (a1 and a2)

propranolol - B sympatholytic (B1 an B2)

prazosin - a1 sympathlytic

Term
contrast a1 and a2 receptory effects, in general
Definition

a1 - receptor effects are generally excitetory (e.g., vasoconstriction of peripheral blood vessels).

 

a2 - receptor effects are generally inhibitory (e.g., inhibition of norepinephrine release from nerve terminals)

Term
What substance may be the neurotransmitter in the NANC (nonadrenergic, noncholinergic) inhibitory nervous system in the lung?
Definition
vasoactive intestinal peptide (VIP) or possible nitric oxide (NO)
Term
What substance is the neurotransmitter in the NANC excitatory nervous sytem in the lung
Definition
substance P.
Term
Definition