Drops, sprays and inhalers

Question 1

3 types of drops solution

Answer 1

aqueous
organic
alcholic

Question 2

Say the medial names of the following and how many drops in each
Eyes
Nose
Ears

Answer 2

occular 1-2 drops
nasal 2-3 drops
otic/aural 3-4 drops

Question 3

How many drops in 1ml

Answer 3

20 drops

Question 4

What kind of solvent is always used for eye drops?

Answer 4

Aqueous

Question 5

How is sterility achieved with eye drops?

Answer 5

Sterile single use vials

Preservatives

Question 6

Packaging for eye drops must be..

Answer 6

protective of contamination and produce accurate dosing

must be discarded 28 days after opening

Question 7

Eye drops excipients (excluding preservatives)
Tonicity=
Viscosity= and why
pH buffers to affect what? Examples
Antioxidants

Answer 7

0.9%
hypromellose and polyvinyl alcohol to prolong contact with the eye
Buffers- stability, therapeutic activity, comfort of patient (pH 7.2-7.4)
Examples: boric acid, citric acid, sodium phosphate
Antioxidants: protect drug from oxidation e.g. sodium metabisulphate

Question 8

Eye drops preservatives - name 3

Answer 8

Benzalkonium chloride
Chlorhexidine
Chlorobtanol

Question 9

Most commonly used eye drop preservative? Why?

When isn’t it used?

Answer 9

Benzalkonium chloride
Broad spectrum of antibiotic properties
Incompatible with contact lenses

Question 10

When are preservative free eye drops used?

Packaging?

Answer 10

After surgery or in hypersensitivity reactions

sterile single use vials i.e. minims

Question 11

Name the 4 different types of packaging for eye drops. Describe them.

Answer 11

1) Sterile single use vials -injection moulded plastic with a sealed screw cap. Vials autoclaved to ensure sterility
2) Plastic bottles - sterilised before filling and filled using aseptic technique
3) Glass bottles - mostly for extemp products. 10ml ribbed amber bottles with dropper. Sterilised after filling
4) auto droppers to help patients administer the drops

Question 12

Nose and ear drops and sprays are..

Answer 12

solutions

sometimes combination products

Question 13

Nose drops and sprays pH

Answer 13

pH 5.5-6.5

Question 14

Nose drops tonicity

Answer 14

0.9%

Question 15

Nose drops local use for…

Answer 15

congestion, inflammation, infection

Question 16

Nose drops systemic use example

Answer 16

Nicorette nasal spray

Question 17

Nose drop vehicles are usually

Answer 17

aqueous

Question 18

Ear drops/sprays local effect

Answer 18

softening ear wax
infection
inflammation
can be combination products

Question 19

Vehicles for ear drops include

Answer 19

propylene glycol
oils
glycerol
water

Question 20

Nose and ear drops have similar packaging to..

Answer 20

eye drops

Question 21

Nose and ears sprays - consider 3 things

Answer 21

Age of patient
plastic vs glass
metered dose vs squeezy bottle

Question 22

What is the main issue of the packaging of ear and nose drops and sprays?

Answer 22

Contamination hence short shelf life once opened

Question 23

5 advantages of drops and sprays

Answer 23

convenient
reduced systemic side effects
fast local action
sprays used for systemic use bypass 1st pass metabolism
Drops can be administered in children

Question 24

4 disadvantages of drops and sprays

Answer 24

inaccurate dosing of drops and squeezed bottles
manual dexterity
patient preference
short shelf life once opened

Question 25

Inhalers are designed to what? Local... Systemic...

Answer 25

Deliver drug directly to lung | mostly local effect but potential for proteins and peptides to be delivered for systemic effect

Question 26

How does particle size of drug effect how a drug from an inhaler acts? Too small Too big Optimum

Answer 26

smaller the particle size, the further down the respiratory tract the drug will penetrate <1 micrometer results in particle being exhaled >10 micrometers results in drug remaining in oropharynx best size 3-5 micrometres

Question 27

Metered dose inhalers (MDIs) have what inside them?

Answer 27

Aerosol of drug and a propellant

Question 28

Propellant types?

Answer 28

HFAs vs CFCs | i.e. hydroflouroalkanes vs chloroflourocarbons

Question 29

Actuation of an MDI results in what?

Answer 29

evaporation of propellant to form droplets to be inhaled into the lung

Question 30

Technique for MDI drug delivery?

Answer 30

Coordination between actuation and inspiration Long steady inspiration One inspiration per actuation

Question 31

Why must you shake an MDI before use?

Answer 31

To disperse the propellant and the drug

Question 32

When are breath activated MDIs most commonly used?

Answer 32

for patients with coordination issues

Question 33

Name 2 brands of breath activated MDIs

Answer 33

Autohaler | Easi-breathe

Question 34

Propellant for MDIs?

Answer 34

HFA/CFC | Gases at room temperature are maintained as liquids under pressure in the aerosol cannister

Question 35

Surfactants for MDIs do what? example?

Answer 35

Aid wetting for suspension | e.g. oleic acid

Question 36

Cosolvents for MDIs do what? | Example?

Answer 36

To aid dissolution | e.g. ethanol

Question 37

Are dry powder inhalers breath actuated?

Answer 37

Yes but require stronger breath inwards

Question 38

What is the drug form like in a dry powder inhaler? (DPI) | Doses compared to MDI?

Answer 38

Drug micronised powder for inhalation | Larger doses

Question 39

Do DPIs need: coordination? propellant?

Answer 39

No and no

Question 40

Name 4 brands of DPI

Answer 40

Accuhaler Turbohaler Handi-haler Dischaler

Question 41

Accuhaler DPI has a carrier for the drug. What is it?

Answer 41

Lactose

Question 42

Why is lactose in accuhaler a problem?

Answer 42

It is the drug carrier and lactose remains in the mouth after drug is taken patients complain of powder in the mouth

Question 43

Turbohaler DPI.. the excipients? | Advantages?

Answer 43

It's pure drug | Little or no taste residue

Question 44

Packaging for MDIs | Advantageous or not?

Answer 44

``` either -tin plated steel -plastic coated glass -aluminium very stable as container protects from oxidation and microorganisms ```

Question 45

Packaging for DPIs | Advantageous or not?

Answer 45

``` Powder can be contained in -preloaded chamber -foil blister discs -hard gelatin capsules Susceptible to moisture degradation ```

Question 46

5 Advantages of inhalers

Answer 46

- Can use small does - Reduced systemic side effects - Fast onset of action - Can use with drugs of poor oral bioavailability - Cost of MDI (Cheap)

Question 47

5 Disadvantages of inhalers

Answer 47

- difficult to coordinate - Not suitable for all drugs - only 20% of drug reaches lung - Inflammation can reduce size of airways - Cost of DPI (expensive)