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Definition
| In reference to the size of particles in an aerosol, meaning the particls are of different sizes |
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Definition
| A non-toxic liquefied gas propellant used to administer medication from metered dose inhalers |
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Definition
| Mechanically simulating the clinical setting; testing in a laboratory |
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Definition
Testing done on animals or humans; clinical testing |
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Definition
| In reference to the size of particles in an aerosol, meaning all particls are the same size |
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Definition
A device used for making a fine spray or mist, also known as an aerosol generator |
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Definition
| Referes to the depth within the lungs reached by particles |
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Term
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Definition
| in reference to the size of particls in an aerosol, meaning many different sizes |
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Term
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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" |
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Term
| 3 main uses of aerosol therapy in respiratory care |
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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 |
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Term
Mass median aerodynamic diameter (MMAD) |
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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 |
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Term
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Definition
| the most frequently occuring particle size in the distribution |
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Term
Count median diameter (CMD) |
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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) |
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Term
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Definition
| Useful to treat the nasopharyngeal and oropharyngeal resions. ie. nasal spray for perennial rhinitis, such as a corticosteroid |
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Term
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Definition
| may shift deposition to the more central airways, although significant oropharyngeal deposition is expected |
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Term
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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. |
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Term
| Particles 0.8 - 3.0 microns |
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Definition
| increased delivery of an aerosol to the lung parenchyma, including the terminal airways and alveolar region, could be achieved with particles < 3 microns |
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Term
| 3 physical mechanisms for aerosol partical deposition in the human lung |
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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 |
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Term
| Average optimal volume and flow rate for many nebulizers is a volume of ________ ml with a _______L/min flow rate. |
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Definition
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Term
| Constant output nebulizer |
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Definition
| Traditional net in which aerosol is produced constantly during inspiration and exhalation. |
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Term
| Breath enhanced nebulizer |
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Definition
| allows more aerosol release during inspiration with decreased output during exhaltion or breath holding. |
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Term
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Definition
| Aerosol is released only during inspiration and all released aerosol is available for patient inhalation. |
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Term
| Vibrating plate technology Nebulizer |
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Definition
| Use a vibrating plate or mesh with multiple apertures (small holes), which allow the liquid to generate an aerosol |
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Term
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Definition
after an alternative for individuals who find it difficult to coordinate MDI actuation with inhalation. Marketed for Pirbuterol |
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Term
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Definition
| Pressure MDI (pMDI) cannister fitted withing the autohaler actuator. Activated when the patient inhales. |
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Term
| Advantages of Reservoir Devices |
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Definition
- Reduce oropharyngeal drug loss
- seperation of MDI actuation & inhalation
- allows use of MDI during acute airflow obstruction
- available with mask for children
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Term
| Disadvantages of reservoir devices |
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Definition
- Some brands large and cumbersome
- additional expense compared with MDI alone
- Some assembly required
- Possible source of bacterial contamination with inadequate cleaning
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Term
| Electrostatic charge in reservoir device |
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Definition
| By reducing this, and increase in drug delivery will occur. Can increase delivery of the aerosolized drug by up to 70% |
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Term
| Aerosol delivery of short-acting B2 agonists in the emergency department |
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Definition
| There is little info. to show that DPI is as effective as and MDI with a holding chamber or a Neb. |
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Term
| Which portion of the nervous system is under voluntary control? |
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Definition
| Skeletal muscle motor nerve portion |
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Term
What is the neruotransmitter at each of the following sites? - neuromuscular junction
- autonomic ganglia
- what is the most sympathetic site
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Definition
Neuromuscular junction - acetylcholine autonomic ganglia - acetylcholine most sympathitic end sites - norepinephrine |
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Term
| where are muscarinic receptors found |
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Definition
at the parasympathetic nerve terminal sites |
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Term
| What is the effect of cholinergic stimulation of airway smooth muscle |
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Definition
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Term
| What is the effect of adernergic stimulation on the heart |
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Definition
| Increased rate and force of contraction |
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Term
| Classify the drugs pilocarpine, physostigmine, propranolol, and epinephrine |
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Definition
Pilocarpine - direct-acting cholinergic physostigmine - indirect-acting cholenergic propranolol -adernergice-blocking agent (B1 and B2) epinephrine - adernergic agonist (stimulates a and b receptors) |
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Term
| How do indirect-acting cholinergic agonists (parasympathomimetics) produce their action |
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Definition
| such as neostigmine, inhibit the enzyme cholinesterase, which increases the amount of aceytylcholine available to stimulate postsynaptic sites at the nerve terminal |
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Term
| What effect would the drug atrophine have on the eye and on airway smooth muscle |
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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 |
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Term
| What is the general difference between a and b receptors in the sympathetic nervouls system |
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Definition
| the a receptors generally cause an excitatory effect (e.g., vasoconstriction), and B receptors generally produce inhibition (e.g., airway smooth muscle relaxation) |
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Term
| What is the primary mechanism for terminiatin the neurotransmitters aceytlcholine and norepinephrine |
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Definition
| acetylcholine is metabolized by cholinesterase enzymes; norepinephrine is reabsorbed back into the presympathetic neuron |
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Term
| What is the predominant sympathetic receptor type found on airway smooth muscle |
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Definition
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Term
| Identify the adernergic receptor preference for phenylephrine, norepinephrine, epinephrine, and isoproternol |
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Definition
phenylephrine - a receptors (a1 specifically) norepinephrine - a>B receptors epinephrine- a and B receptors equally isoproternol - B (B1 and B2 receptors) |
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Term
| What is the autoregulatory receptor on the sympathetic presynaptic neuron |
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Definition
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Term
| What is the autoregulatory receptor on the parasympathetic presynaptic neuron at the terminal nerve site |
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Definition
| the muscarinic receptor subtype M2 |
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Term
| Classify the following drugs by autonomic class and receptory preference: dopamine, ephedrine, albuterol, phentolamine, propranolol, and prazosin |
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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 |
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Term
| contrast a1 and a2 receptory effects, in general |
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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) |
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Term
| What substance may be the neurotransmitter in the NANC (nonadrenergic, noncholinergic) inhibitory nervous system in the lung? |
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Definition
| vasoactive intestinal peptide (VIP) or possible nitric oxide (NO) |
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Term
| What substance is the neurotransmitter in the NANC excitatory nervous sytem in the lung |
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Definition
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