mucous controling agents, surfactants Flashcards by Desmond Chan

what is mucus

secretion from goblet cells and submucosal

glands composed of 95% water and proteins

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What is sputum

expectorated secretions that contain resp.

tract, oropharyngeal and nasalpharyngeal secretions as well as bacteria and products of inflammation

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what is Mucolytic

degrade mucus polymers (s-s bonds)

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what is Mucokinetic

increases ciliary activity but anything

that increases the movement of sputum

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what is expectorant

medicine to increase hydration

volume of secretions used to treat and cause a productive cough

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what is Antitussive

cough medicine to suppress cough urge

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what is surfactant

decrease surface tension, made

up of phospholipids and proteins

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fxn of mucus

prevents infection with antimicrobial enzymes

protects against osmotic or inflammatory changes

lubrication (phospholipids)

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what is the physical propertise of mucus?

adhesion
- -> mucus to airway surface force
cohesion
- ->mucus to mucus force
viscosity
- ->resistance to flow (thickness of mucus)
elasticity
- ->returning shape

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what is the function of the mucoilary escalator

Self-cleansing (trapping and mobilizing debris)

the amount, consistency/thickness, ciliary
activity affect function

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what are the 3 layers of the escolator?

mucus (gel)
cili(sol)
epithelialhttps://www.thoughtco.com/

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what s the funciton of the gel layer

mucus moves towards larynx

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whats the function of the sol llayer

ion transport

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wht is the normal daily mucus production

100mls/day

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composition of mucus

95 % h2o

5 % glycoprotein (mucin)

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how does pharmcological treatment help with mucociliary transport?

altering consistency of gel layer
mucolytics
improving ciliary beat
sympathomimetics, cholinergics, xanthines
increasing sol layer (more watery)
hyperosmolar saline, expectorants
improving cough
bronchodilators

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the effect of beta adrenegic, xanthines and cholinergic on mucus?

all increase cilia beat and mucus production

they differ is in the transport of mucous

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what is the effect of mucus

Steroids have no effect on beat, or transport but decrease mucus production

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what s the function and MOA of mucolytics

fxn:
 Degrade complex molecular
strands to thin mucous in
airways and aid in
“expectoration

MOA:
- breaks disulfide bonds in
mucous (gel layer)
- mucolytic activity of drug
increases with 7.0 - 9.0 in
local pH

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dose/frequency of mucolytic

10%, 20% solution; 3-5 mL
via aerosol
frequency: QID, TID

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what is the adverse effect of mucolytic

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bronchospasm, cough,
Ventolin “cocktail”
Nausea
rhinorrhea
stomatitis
inactivated if mixed with
antibiotics

**patient must be able to clear secretion

what is the Non-respiratory indications for

Mucomyst®

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acetaminophen overdose

anti-oxidant
prevents hepato-renal toxicity

what is the indication and MOA of dorase alfa Pulmozyme®

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FOR CF
–>clearance of secretion

DNase (pancreatic enzyme) digests extracellular DNA material found in cellular debris of infected mucous

reproduced by recombinant DNA techniques
breaks down the DNA material in enzymatic fashion; lowers viscosity and adhesiveness

what is the dose and adminstration of Pulmozyme

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Unit Dose Vial - 2.5mg drug in 2.5mL of clear colourless solution
(refrigerated and
protected from light)

Adverse effects of Pulmozyme

dysphonia, rash, pharyngitis, chest | pain, conjunctivitis

what is an example of mucokinectic agent

beta agonist(bronchdilators) - increase cilia beat frequency - improve expiratory airflow clearance

when is mucokinectic agent not beneficial

patients with dynamic airway collapse diseases -->emphysema

what is the function of an expectorant

- pull water from airway tissues into the mucous making it more watery and easier to clear - stimulant expectorants

what is an exmaple of expectorant?

guaifenesin Benylin expectorant syrup ® or inhalational sol’n

what is the function of bland aerosols

Liquid particles suspended in a gas with or without oxygen

what is the MOA of bland aerosols?

Alters H2O content of mucous; not structure

what are 4 types of bland aersols

1. 0.9% N/S - physiologically compatible (isotonic) 2.hypotonic saline: 0.45% - for patients who cannot tolerate increase Na 3.sterile distilled water: hypotonic compared with tissue fluid 4.hypertonic saline (5% or 20% hypertonic saline) generally used for sputum induction

what is the fxn of Antitussives

decreases cough centre activity in medulla oblongata of brain

what is the indcaiton of Antitussives

Indicated for dry, unproductive (annoying) | cough only

what is some example of Antitussives

- CODEINE sulfate (narcotic) | - HYDROCODONE (narcotic)

what is fxn of surfactant

lowers surface tension increase compliance decreased WOB

what is the clincal application of surfactant

prophylaxis | rescue

wht is the composition of lipids?

1 . 90-95% lipids - -> 80-85% phospholipids * *Phosphatidylcholine (PC)* becomes DPPC when saturated, aka lecithin (surface tension lowering component) - >15- 20% phosphatidyglycerol, Sphingomyelin 2. 5-10% proteins - ->Hydrophilic - ->>Hydrophobic

how is surfactant produced?

1. Type II pneumocytes - ->lamella bodies 2. lamella bodies move to lumen of alveolus 3. LB secretes tubular myelin then unravels , which is the precusor of DPPC

when is DPPC first seen?

24 wks during gestation

wt is the metabolism/clearance of surfactant in adult

adult: 2.5mg /kg 50% is recycled back to type 2 cells half life 9 - 12 hrs

what is the metabolism/clerance of surfactantinbaby

- amount is 10x that of adult - 90% is recycled to type 2, 10% becomes marcophages - half life 6 days

what are some exogensis surfactant used

1. bLES (natural) - ->bovine or human source of aminotic fluid 2. Exosurf (synthetic)

what is the indication of exogensis surfactant

in the neonatal population to | decrease surface tension in the treatment of RDS in premature babies

how can exogensis surfactant ot be delivered

- install via ETT | - devlier via BVM

what is the side effect of exogensis surfactant

1. rapid change in compliance | 2. desaturation and bradycardia due to blocked ETT during

what is the side effect of exogensis surfactant

apnea, pulmonary hemorrhage, bronchospasm

what is some inhaled gas mixture used?

Nitric Oxide (NO): in pulmonary vascular endothelium

what is the fxn of NO

treats pulmonary hypertension including PPHN, ARDS/hypoxia, during neonatal cardiac sx, RDS, pulmonary disease - potent vasodilator

what monitor is needed for NO?

analyzer required for dose & toxic byproducts NO2 (5ppm) & methemoglobin such as co-oximeter

mucous controling agents, surfactants Flashcards

(50 cards)