Respiratory Medicines

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Respiratory Medicines

• Aerosol Delivery
• MDI
• DPI
• Nebulizers

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Drug delivery devices

• Large volume nebulizers
• Small volume (acorns) nebs
• Metered Dose Inhalers
• Dry Powder Inhalers
• Ultrasonic nebulizers
• SPAG Generator

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Aerosol Physics

• MMAD
• Mass Median Aerosol Diameter
• Most common method of measuring particle size
• CMD
• Count Median Diameter
• GSD
• Geometric Standard Deviation

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Aerosol Deposition

• Inertial impaction
• Gravity or sedimentation
• Kinetic Activity
• Brownian Movement
• Physical Properties of Particle
• Hygroscopic

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Particle size is important

• Large particles deposit in throat
• 10-20 microns
• Medium in airways
• 5-10 microns
• Small in alveoli
• 0.5-3 microns

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Activity of Aerosols

• Penetration
• How deep in the airway it deposits
• Deposition
• Clearance
• Retention

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Ideal Ventilatory Pattern for Optimal Deposition

• Slow deep breath
• Use of spacer
• Breath Hold

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MDI
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Advantages of MDI

• Quick easy to use
• Portability
• Needs quality instruction for proper use

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Dry Powder Inhaler

• Diskus
• Aerolizer
• Turbuhaler

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DPI

• Diskus
• Serevent
• Advair

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Inside a Discus
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Inside a turbuhaler
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Other Design types

• Advair Diskus
• Turbuhaler
• Aerolizer
• Pirbuterol

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DPI
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DPI
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Advantages of DPI

• No propellant needed
• Quick, easy to use
• Compact
• No spacer needed

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Nebulizer
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Baffle
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Advantages of Nebulizers

• Easy to learn and use
• Good for passive treatments

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Hazards of Aerosol Therapy

• Tachycardia, shakes, headaches
• Nosocomial infections
• Increased airway resistance
• Bronchospasm
• Drug reconcentration

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Nebulized Drugs

• Bronchodilators
• Beta Adrenergic
• Albuterol
• Alupent
• Terbutaline
• Salmeterol
• Xopenex
• Vaponephrine

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Nebulized drugs

• Anti-cholinergic
• Atrovent
• Robinal

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Nebulized Meds

• Mycokinetic, mucolytic
• Mycomyst
• Pulmozyme

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Aerosolized Meds

• Corticosteroids
• Azmacort
• Aeroibid
• Beclovent
• Pulmicort
• Flovent

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Aerosolized Meds

• Propyhactic Anti-asthmatics (stabilizers)
• Intal
• Tilade

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Leukotriene Modifiers

• Oral long term control medicines
• Singular
• Accolate
• Zyflo

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Aerosolized Nebs

• Gentamycin
• Tobramycin
• Pentamidine
• Ribovirin

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Pentamidine
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SPAG
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Mr. Nordin, May I be excused? My brain is full.