Routes of Administration

Question 1

What is the therapeutic range?

Answer 1

-Range between the does causing minimum effective concentration and maximum safe concentration

Question 2

What would happen to the plasma concentration-time curve is it was for an oral liquid or IV?

Answer 2

-Initial rate will be faster and will reach site of action faster

Question 3

What does bioavailability depend on?

Answer 3

-Permeability of biological membrane, drug properties and other route -dependent factors eg stomach contents

Question 4

What is first pass of presystematic metabolism?

Answer 4

-drugs adsorbed from the stomach, small intestine and upper colon pass into the hepatic portal system straight to the liver before it goes into ‘real’ circulation

Question 5

What is phase I metabolism?

Answer 5

-Simple chemical changes eg oxidation. hydrolysis. Cytochrome P450 isoenzyme is important and products are likely to be inactive and more water soluble

Question 6

What is phase II metabolism?

Answer 6

-Involves the conjugation of groups to the drug to increase its solubility. eg glucuronates and sulphates

Question 7

What are the pharmacokinetic advantages of the inhalation route?

Answer 7

-Smaller doses can be used, reduces chance of side effects, fast onset as delivered to site of action, avoids first pass metabolism

Question 8

What are the pharmacokinetic advantages of the transdermal route?

Answer 8

-Avoids first pass metabolism, controlled rate of drug delivery, reduces dosage frequency which increases compliance

Question 9

How are drugs delivered rectally?

Answer 9

-Incorporated into a suppository which dissolves or melts within the rectum

Question 10

What are the symptoms of sinusitis?

Answer 10

-Inflammation, obstructed sinus opening, fluid build up in frontal sinus and maxillary sinus

Question 11

What are nasal sprays effective for decongestion?

Answer 11

-Local delivery, systemic absorption, easily absorbed into blood stream after by[assed mucus

Question 12

What is the main barrier to nasal sprays being effective?

Answer 12

-Mucus layer

Question 13

What is the interactive barrier?

Answer 13

-Drug molecules trapped in the mucus network

Question 14

What is the steric barrier?

Answer 14

-Drug molecule cannot infiltrate mucus network

Question 15

What are the functions of the mucus ?

Answer 15

-Clearance and air conditioning to prevent drying out

Question 16

What are the features of mucus?

Answer 16

-From serous glands and goblet cells, form viscous gels due to mucins and have ability to form disulphide bridges

Question 17

What are the types of nasal sprays?

Answer 17

-Steriod, anti-histomine, anticholinergic, saline, menthol and intranasal peptides

Question 18

Why are intranasal peptides effective ?

Answer 18

-Administered nasally to avoid proteins being broken down by enzymes in the stomach

Question 19

How do you use nasal sprays?

Answer 19

-Blow nose, shake bottle, block one nostril, insert applicator to other nostril and squeeze pump, repeat process for the other nostril

Question 20

What does benztdamine do?

Answer 20

-Exerts an anti-inflammatory and analgestic action

Question 21

What are the symptoms of oral thrush?

Answer 21

-Mouth is red with white patches, when you wipe the white patches away they leave red spots that bleed

Question 22

Treatment for oral thrush?

Answer 22

-Daktarin or nystan (POM)

Question 23

What are the symptoms of a mouth ulcer?

Answer 23

-Red/yellow sore that usually appears inside the mouth, on the cheeks or lips

Question 24

What is the treatment for mouth ulcer?

Answer 24

-Bonjela-antiseptic and pain relief

Question 25

What is otitis ?

Answer 25

-Inflammation in the ear resulting in the narrowing of the ear canal

Question 26

What are the symptoms of excessive ear wax?

Answer 26

-ear pain, ringing, hearing loss, discharge, dizziness, odour

Question 27

How can excessive ear wax be treated?

Answer 27

-Ear drops 3-4 times daily for 3-5 days

Question 28

When do you refer to ENT for excessive ear wax?

Answer 28

-If difficulty persists despite olive oil, uncertainty about condition of ear drum

Question 29

What are the types of ear drops?

Answer 29

-Alcohol/acetic acid, antibiotics, anaesthetics, corticosteroids

Question 30

How do you use ear drops?

Answer 30

-Lay on towel with affected ear up, gently pull earlobe out and up to straighten auditory tue, administer drop, gently push on ear flap to encourage liquid into ear, stay for 2 mins

Question 31

What are the types of eye drops ?

Answer 31

-Artificial tears, antibiotic, corticosteroid and glaucoma

Question 32

How do you administer eye drops?

Answer 32

-check expiry date and shake bottle if necessary, wash hands before open, lie or sit or sit downing tilt head back, make a fist and use a knuckle to pull lower lid down and look up, squeeze one drop into lower lid, close eyes and press gently on inner corner to absorb

Question 33

How do you use a pMDI inhaler?

Answer 33

-Remove cap, check dose counter, hold inhaler upright and shake, breathe out gently away from inhaler, put mouthpiece between teeth and deal lips, start to breathe in slowly and press down canister at the same time, continue to breathe in slowly and deeply, hold breath 5-10 s and remove inhaler from mouth, breathe out gently, repeat if needed and replace cap

Question 34

What are the two routes of pulmonary drug delivery ?

Answer 34

-Local or topical and systemic application via the lung

Question 35

How are drugs delivered to or via the lungs?

Answer 35

-Solid in gas, liquid in gas, gas

Question 36

What types of obstructive lung disease?

Answer 36

-Asthma, COPD, cystic fibrosis

Question 37

What are the types of restrictive lung disease?

Answer 37

-Interstitial lung disease such as pulmonary fibrosis, sarcoidosis obesity