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`Pharmacokinetics of Inhaled Drugs
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`RT 127
`Pharmacology
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`Pharmacokinetics of Inhaled Drugs
`
`Administration:
`
`Topical effect on upper and lower airways - respiratory drugs
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`Systemic effect via absorption and distribution in blood - insulin, antivirals, etc.
`
`A certain amount of aerosolized drug will always impact in the naso- or oropharynx and be swallowed. Efforts are made through
`improvement in delivery devices and patient breathing technique to maximize the amount of drug delivered to the lungs. It is a most
`imprecise way of delivering medication - yet due to its topical delivery it allows the administration of a much smaller dose to achieve the
`desired effect.
`
`Topical Tx: COPD, CF, Asthma
`
`Goal - To maximize lung deposition / minimize systemic exposure and unwanted side effects
`
`High lung availability/Total systemic availability
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`https://media.lanecc.edu/users/driscolln/RT127/Softchalk/Pharmcology_SFTCHLK_Lesson/Pharmacology_lesson10.html
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`IPR2021-00406
`United Therapeutics EX2058
`Page 1 of 3
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`11/9/21, 9:32 PM
`L / T Ratio
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`Pharmacokinetics of Inhaled Drugs
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`Proportion of drug available from the lung, out of the total systemically available drug
`Formula: (Lung dose)/(lung dose + GI dose)
`The higher the ratio the more efficient the aerosol drug delivery to the respiratory tract
`
`The Box 2-4 below gives techniques that can increase delivery to the lung or decrease systemic availability - the first and fourth factor
`increase delivery of drug to the lung while aiming to reduce oropharyngeal deposition and swallowing. The second factor addresses the
`amount of drug that is swallowed but metabolized quickly. The third suggestion, while not preventing oropharyngeal deposition, minimizes
`amount of drug that is swallowed by physically eliminating by rinsing and spitting. You will see staff have the patient rinse and swallow - and
`while this is a good way to prevent oral thrush as a result of inhaled steroids it does add to the systemic availability of the drug. I
`recommend doing both - first have the patient rinse and spit, then have the patient rinse and swallow as this will also clear the back of the
`throat and pharyx that is not reached when the patient only rinsing the oral cavity and spits.
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`https://media.lanecc.edu/users/driscolln/RT127/Softchalk/Pharmcology_SFTCHLK_Lesson/Pharmacology_lesson10.html
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`Pharmacokinetics of Inhaled Drugs
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`Please note the differenec in the table below between the good coordinators and the poor coordinators for the pMDI - pressurized metered
`dose inhaler - the most common method of self-medication for patients with breathing problems. Poor coordination means not coordinating
`the dispensing of the dose with a properly timed inhalation - this often is a result of improper instruction in how to take the MDI. One of the
`most important roles you will have as a RCP is that of patient education!
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`https://media.lanecc.edu/users/driscolln/RT127/Softchalk/Pharmcology_SFTCHLK_Lesson/Pharmacology_lesson10.html
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