Preservative/antioxidant – not necessary in single-dose vials and only water-soluble antioxidants are used in nebulizers Sulfites may cause bronchospasm o Osmolarity – iso-osmolarity to prevent bronchoconstriction (not as critical as in injectable or ophthalmic but still need it within a vertain range) o Flavoring – approves the taste since it’s going into the mouth Some sweetening can be used Are they pyrogen free? o All aqueous-based drug products can be manufactured sterile o Terminal sterilization is not required but test of sterility and microbial load should be conducted o Spacers are usually contamination and need to be cleaned more frequently 5. Select suitable delivery devices to optimize therapeutic outcomes MDI: o High oral deposition (goes to systemic absorption) o Low dose sizes can be administered o Cannot use proteins DPI: o Breath-actuated; dose delivery depends on inspiratory flow rate o Can trigger cough reflex o Susceptive to effect of humidity on the drug Nebulizer: o Aqueous drug solutions o Allow for large doses to be delivery o Proteins may lose activity 6. Advise patients on how to use the devices MDI: o Remove the cap and hold inhaler upright o Shake the inhaler o Tilt your head back slightly and breathe out slowly o Position the inhaled in the spacer o Press down on the inhaler to release the medication ass you start to breathe in slowly o Breathe in slowly (3-5 seconds) o Hold your breath for 10 seconds to allow the medication to reach the lungs o Repeat puff as directed DPI: o Stand up and open the device o Activate the inhaler o Hold the inhaler level (parallel to the floor) o Exhale to the end of the normal breath o Inhale slowly and deeply o Hold breath for 10 seconds o Close the diskus o Rinse out your mouth and spit out the water Nebulizer: o Remove the top part of the nebulizer cup and place the medicine in the bottom half, then place back together
o Connect the tubing and connect mouthpiece or facemask to the cup o Connect the tubing and turn on the compressor o Inhale slowly and deeply for 5-10 minutes or until the medicine is gone, then turn compressor off
Ophthalmic, Nasal, & Otic Drug Delivery Objectives: 1. Understand & explain physiological and anatomical aspects of the delivery of eye, ear, and nose products Eye: o Precorneal barriers Tear turnover, nasolachrymal drainage (part of drug getting administered to eye gets collected in duct and drains into the mouth), metabolism by esterases and proteases, protein binding o Conjunctival barriers Junctions of conjunctival of epithelium, drug efflux pumps, lymphatic drain the drug into the blood Can’t get into sclera or choroid Can’t get into posterior segment of the eye o Cornea barriers Cornea is a huge protecting organ over the eye that’s like a rock and doesn’t let anything go through Contains tight junctions of epithelium, hydrophobic nature of corneal epithelium limits penetration of hydrophilic drugs, drug efflux pumps, etc.
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