Mucus-Controlling Drug Therapy Flashcards Preview

RT104A-Pharmacology > Mucus-Controlling Drug Therapy > Flashcards

Flashcards in Mucus-Controlling Drug Therapy Deck (36):
1

KT: abhesive

substance that redcues adhesion

2

KT: expectorant

medication meant to increase the volume or hydration o airway secretion

3

KT: mucin

the principal constituent of mucus and a high-molecular-weight glycoprotein, it gives mucus its physical/chemical properties such as viscoelasticity

4

KT: mucoactive agent

term connoting any medication or drug that has an effect on mucus secretion: may include mucolytic, expectorant, mucospissic, mucoregulatory, or mucokinetic agents

5

KT: mucokinetic agent

medication that increases cough or ciliary clearance of respiratory secretions

6

KT: mucolytic agent

medication that degrades polymers in secretions

7

KT: mucoregulatory agent

drug that reduces the volume of airway mucus secretion

8

KT: mucospissic agent

medication that increases viscocity of secretions and may be effective in the therapy of bronchorrhea

9

N-Acetylcysteine (NAC)

-Mucolytic, Mucoactive
-MucoMyst (10%, 20%)
-Breaks disulfide bonds
-Used for viscous secretions (plugs) or acetaminophen overdose

10

Dornase alfa

-Mucolytic, Mucoactive
-Pulmozyme
-Used to treat CF patients
-Breaks apart DNA and F-actin

11

Properties of mucus (4)

-Protective
-Lubricative
-Waterproofing
-Entraps microorganisms

12

General Indication for Mucoactive Therapy

reduce the accumulation of airway secretions, improve pulmonary function/gas exchange, reduce infection/damage

13

Disease/States for Mucoactive Indication

-CF
-CB (COBP)
-Pneumonia (viral/bacteria)
-Diffuse panbronchiolitis (DPB-emphysema)
-Primary cilia dyskinesia
-Asthma
-Bronchiectasis (over-production)
-Dehydration

14

Optimal mucus would be...

thin enough to be able to cough out mucus, and thick enough to not slide deeper into alveoli.

15

Physiology: two layers

-Gel - stickier/drier
-Periciliary layer - wet
-functional surfactant layer sepeartes periciliary fluid from mucus gel

16

Physiology: surface epithelial cells

-pseudostratified, columnar, ciliated epithelial cells
-surface goblet cells (no direct innervation, 600 goblet cells/mm2 of a normal airway)
-clara cells

17

Physiology: submucosal glands

-innervated by the parasympathetic system
-provides airway surface mucin, the chemical that makes up sputum
-serous and mucous cells pump out more fluids

18

4 things to look for when diagnosing sputum

-size
-color
-tenaciousness
-smell

19

Physiology: ciliary system

-200 cilia per cell
-effective power stroke
-recovery stroke

20

4 factors affecting mucociliary system

-COPD
-airway drying
-narcotics
-endotracheal suctioning

21

Healthy mucus is:

clear, viscoelastic, sticky

22

A healthy person secretes...

100 mL/day, most of which s reabsorbed in the bronchial mucosa or swallowed w/ saliva

23

Two major classes or mucin are...

secreted and membrane-tethered mucins (mucus plugs)

24

5 mucoactive CF drugs

-Dornase alfa (MucoMyst)
-Kalydeco (Ivacaftor)
-Bronchitol (d-mannitol)
-Gelsolin
-Thymosin B4

25

Therapeutic options for controlling hypersecretion (3)

- Remove causative factors
-Optimize threacheobronchial clearance
-Use mucoactive agents when indicated

26

Hazards/Precautions of NAC

-bronchospasm (less common in 10%)
-mechanical obstruction of airway
-sticky film on patients face/mask
-incompatible w/ certain antibiotics

27

Dose and administration of Dornase Alfa

-A single use ampoule (2.5 mg in 2.5 mL)
-Refrigerated and protected from light
-Delivered by the Hudson RCI, Acorn II, and PARI LC PLus

28

Adverse Effects of Dornase Alfa

Common: voice alteration, pharyngitis, laryngitis, rash, chest pain, and conjunctivitis

29

Kalydeco

Ivacaftor
facilitates chloride transfer channels (lack of sodium channels in CF, only used w/ certain genetic markers)

30

Bronchitol

D-mannitol
Increases mucociliary clearance, reduces sputum viscosity, increases hydration of fluid layer, enhances airway clearance
avg. FEV1, improvement of 7%, DPI
cannot be used w/ asthmatics

31

Gelsolin and Thymosin B4

Used for CF and reduces viscosity of sputum.
Gelsolin is dose-dependent
Thymosin B4 is dose and time dependent

32

3 Expectorants

-Iodide-containing agent
-Sodium bicarbonate
-Guaifenesin (Mucinex)

33

Iodide-containing agents

Thought to stimulate the secretion of airway fluid

34

Sodium-bicarbonate

Increases the local bronchiol pH, and weakens the bond.
Does not liquefy the sputum, so easier to clear mucus out

35

Guaifenesin-may stimulate the cholinergic pathway and induce increased secretion from submucosal glads

-may stimulate the cholinergic pathway and induce increased secretion from submucosal glands

36

General Contraindications of Mucoactive Therapy

-FEV1