Test # 4 Obstructive lung disease

Question 1

Explain how a Metered dose inhaler differs from a dry powder inhaler

Which one is not good for patients that are short of breath

and you must rinse mouth out or will get thrush

Answer 1

MDI - press down and the right size particles goes into lungs - Inhale DEEPLY and SLOWLY

Powder - breath activated - only on inspiration - NOT GOOD FOR pt that are SOB - INHALE DEEPLY and QUICKLY

Question 2

What are the three goals to treat asthma

Answer 2

1. relax airways
2. reduce inflammation
3. reduce mucus secretions

Question 3

What is the difference between controller medicine and rescue medicines when treating asthma

Answer 3

Controller - use to PREVENT symptoms BEFORE they start

Rescue - Used to TREAT symptoms AFTER they have started

Question 4

What is the MOA for beta agonist?

Answer 4

they increase cAMP which causes smooth muscle relaxtion

Question 5

Name two short acting beta agonist used to treat asthma

Answer 5

Albuterol

Lecalbuterol

Question 6

Name two long acting beta agonist used to treat asthma

You should not use these by themselves to treat asthma! increased risk of death if used without a corticodteroid

Answer 6

Salmeterol

Formoterol

Question 7

Name two SHORT acting anticholinergics to treat asthma and COPD - these are also rescue drugs

Answer 7

Ipratropium bromide and Atrovent

Question 8

Name two LONG acting anticholinergics to treat just COPD

Answer 8

tiotropium and aclidinium

Question 9

what is the MOA of anticholinergics that are used to treat asthma and COPD?

Don’t use in pt with glacoma, enlarged prostate,, and Myasthenia gravis

Answer 9

the block the M3 receptor on sm muscle - which inhibit brochoconstriction

Question 10

What are two side effects of using corticosteroids for treat asthma or COPD?

Answer 10

Pneumonia and thrush (voice changing - Dysphonia)

Question 11

Name 4 corticosteroids that alter gene transcription causing less inflammation.

Answer 11

Fluticasone
Budesonide
Mometasone
Beclomethasone

Question 12

Name two leukotriene inhibitors

1. block LTE receptors
2. inhibit syntheses of leukotrienes

Answer 12

Block - Montelukast

Inhibit - Zileuton

Question 13

name one drug that is a methylxanthine. It inhibits PDE (metabolism of cAMP) and inhibits adenosine (causes broncholconstriction)

*** must follow blood levels!!

S.E. - tachy, N/V, seizures

Answer 13

Theophylline

Question 14

What ANti-IgE med is used to treat mod-severe asthma?
It binds to the receptor so the allergen can’t bind
SQ 1-2x/month 0 very expensive

Answer 14

Omalizumab

Question 15

What type of asthma drug was the cornerstone of therapy for asthma?

Answer 15

Corticosteroids

Question 16

What are the two types of drugs that are used as first line agents for COPD control

Answer 16

LABA or anticholinergics

Question 17

What PDE4 inhibitor increases cAMP which decreases inflammation

SE: gi upset, diarrhea

Answer 17

Roflumilast

Question 18

What antibiotic is commonly used for COPD exacerbations that are related to bacterial infections? It also has anti-inflammatory effects

Answer 18

Azithromycin

Question 19

What chronic nebulized antibiotic is only indicated in patients colonized with Pseudomonas?

Answer 19

Tobramycin