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From Flashcardlet > 314 FINAL EXAM > Flashcards

314 FINAL EXAM Flashcards

1
Q

Name the surfactanct preparations

A
  • Natural/modified natural
  • Survanta, Curosurf, Infasurf
  • Bovine (cow)
  • Porcine (pig)
  • Synthetic
  • Lucinactant (experimental)
  • Synthetic natural
  • None at this time
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2
Q

Indications for Exogenous Surfactant

A

Treatment or prevention of RDS in newborns

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3
Q

Indications of Ribavirin

A

Used for the treatment of infants with lower respiratory infections caused by RSV

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4
Q

Indications for Pentamidine

A

Prevention of PCP in high risk HIV patients

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5
Q

Typical dose of Pentamidine

A

300mg in 6mL of sterile water every 4 weeks

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6
Q

Explain Delivery of Pentamidine

A

Parenterally or by aerosolized inhalation, would not be absorbed through oral administration

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7
Q

Brand Name of Pentamidine isethionate

A

NebuPent

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8
Q

Explain Delivery of Ribavirin

A

Powered/ aerosolized by a Small Particle Aerosol generator (SPAG)

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9
Q

Brand Name of Ribavirin

A

Virazole

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10
Q

What type of drug is Zafirlukast?

A

It is an Antileukoiene, non-steroidal antiasthma agent

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11
Q

Typical adult dose of Zafirlukast

A

20 mg twice daily, taken at least 1 hour before or two hours after eating

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12
Q

Common side effects of Zafirlukast.

A

Include headaches, infection, nausea, diarrhea, and generalized abdominal pain

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13
Q

Name the physical properties of mucus.

A

Viscosity, elasticity, adhesion, and cohesion

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14
Q

Brand name of Zafirlukast

A

Accolate

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15
Q

What diseases are Mucoactive therapies indicated for?

A

Diseases with hypersecretion or poor clearance of airway secretions

  • CF
  • acute and chronic bronchitis
  • pneumonia
  • diffuse panbronchiolitis
  • primary ciliary dyskinesia
  • asthma
  • bronchiectasis
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16
Q

Number of goblet cells per square millimeter in the airway.

A

6000 goblet cells/mm

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17
Q

Typical dose of Pulmozyme.

A

2.5 mg/ ampoule daily

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18
Q

Agent that increases hydration of secretions to enable them to come up easier.

A

Expectorant

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19
Q

Examples of expectorants

A

Hyperosmolar saline and dry powder mannitol

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20
Q

Generic name of Pulmozyme

A

Dornase Alfa

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21
Q

Mode of action of Pulmozyme.

A

Reduces viscosity and adhesivity of infected respiratory secretions

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22
Q

How does Pulmozyme work?

A

Reduces extracellular DNA and F-actin polymers

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23
Q

Medication combination: Long acting beta2 agonist and corticosteroid

A

Advair-Salmeterol/Fluticasone

Symbicort-Formetorol/Budesinide

Dulera-Formoterol/Mometasone

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24
Q

What effects do corticosteroids have on the airway?

A

Reduces INFLAMMATION

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25
Q

Typical SVN volume, why do we dilute?

A

3-5 mL

Dilution helps reduce any residual volume and helps the patient receive the most medications possible.

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26
Q

Name the indications for Nonsteroidal Antiasthmatic agents.

A

The main indication is preventitive management (control) of mild persistent asthma (asthma requiring step 2 care)

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27
Q

Types of Nonsteroidal Antiasthmatic agents.

A

Cromolyn-like agents (mast cell stabilizer), Antileukotrienes, and Monoclonal antibody

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28
Q

Generic name(s) of Cromolyn Sodium

A

NasalCrom, Gastrocrom

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29
Q

Typical adult dose of Cromolyn Sodium

A

SVN: 20mg/ ampoule qid
Spray: 40mg/mL (one spray q4-6h

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30
Q

Generic name for Montelukast

A

Singulair

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31
Q

Typical adult dose of Montelukast

A

1 10mg tablet daily

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32
Q

Only Antileukotriene Agent approved for infants.

A

Montelukast (Singulair)

33
Q

Brand name of Zileuton

A

Zyflo; Zyflo CR

34
Q

Typical adult dose of Zileuton

A

1 600mg tablet qid; Cr-2 tablets twice daily

35
Q

Generic name of Omalizumab

A

Xolair

36
Q

Typical adult dose of Omalizumab

A

Subcuntaneous injection every 4 weeks, dependent on weight and serum IgE level

37
Q

Side effects of Zileuton

A

Headache, general pain, abdominal pain, loss of strength, and dyspepsia

38
Q

Side effects of Montelukast

A

Diarrhea, laryngitis, pharyngitis, nausea, otitis, sinusitis, and viral infection

39
Q

Side effects of Omalizumab

A

Most severe were anaphylaxis and malignancies-very rare.

More common-injection site reactions, viral infection, upper respiratory tract infection, and pharyngitis

40
Q

Name antiviral agents

A

Amantadine (Symmetrel)
Rimantadine (Flumadine)
Oseltamivir (Tamiflu)
Zanamivir (Relenza)

41
Q

Indications for Corticosteroids

A

Maintenance, control therapy of chronic asthma and recommended for patients with COPD

42
Q

Name some common Corticosteroids.

A

Beclomethasone (QVAR), Flunisolide(AeroBid), Fluticasone (Flovent), Budesonide (Pulmicort), Mometasone (Asmanex twisthaler), Ciclesonide (Alvesco), Fluticasone/Salmeterol (Advair), Budesonide/formoterol (Symbicort), Mometasone/formoterol (Dulera)

43
Q

Typical doses for Corticosteroids

A

MDI: 2 puffs bid
DPI: 1 inh bid

44
Q

Hazards/Side effects of Corticosteroids

A

Local: Oropharyngeal fungal infections, dysphonia, cough or bronchoconstriction, and inadequate dose due to incorrect use of MDI

Systemic: Adrenal insufficiency, extrapulmonary allergy, acute asthma, HPA suppresion (minimal, dose-dependent), growth restriction (dose-dependent)

45
Q

A patient has chest tightness and wheezing 4-6x/week. What would you recommed to help treat this patient?

A

Controlling asthmatic agents:

  • Non-steroidal antiasthmatics
  • Long-acting B2 agonists
  • Corticosteroids
46
Q

Long-acting Beta2 Agonists

A

Indicated for maintenance therapy that is not controlled by regular low-dose inhaled corticosteroids and for COPD needing daily inhaled bronchodilator therapy for reversible airway obstruction

47
Q

Short-acting Beta2 Agonists

A

Prescribed as rescue inhalers for breakthrough symptoms if needed between scheduled doses of long-acting B2 agonist

48
Q

Combivent (Ipratropium bromide and albuterol)

A

Anticholinergic and B2 agonist combination MDI

18mcg ipratropium bromide/90mcg albuterol per puff

typical adult dosage: 2 puffs qid

used for: COPD and severe asthma

49
Q

Salmeterol (Serevent Diskus)

A

It is a long-acting Beta 2-agonist.

Indicated for long-term maintenance therapy of asthma, which is not controlled by occasional use of short-acting B2-agonist.

It inhibits histamine for up to 20 hours, and has been shown to exert stronger anti-inflammatory effects in addition to its smooth muscle relaxing properties

Dosage-50mcg/inh; 1 inh bid

50
Q

Levalbuterol

A

-Pure (R)-isomer of racemic albuterol
-Less side effects than albuterol
-Brand name (Xopnenex)
>45mcg/puff
>2 puffs qid

B2-Agonist

51
Q

Typical Dose of Albuterol

A

MDI: 90mcg/puff and 2 puffs q4-6h

SVN: 0.5% solution, 0.5 ml (2.5mg), 0.63 mg, 1.25 mg, and 2.5 ml unit dose–tid,qid

B2-Agonist

52
Q

Name the receptors stimulated by Beta2 adrenergic drugs

A

Beta-2 Receptors

53
Q

Ipratropium Bromide

A

Brand name (Atrovent)
MDI:17mcg/ puff; 2 inh qid
Solution: 0.02%-500mcg q3-4d

Anticholinergic

54
Q

Pirbuterol acetate

A 
Brand name (Maxair Autohaler)
MDI: 200mcg/puff; 1-2 puffs q4-6h

B2-Agonist

55
Q

Describe how Nitrates work.

A

They reduce myocardial oxygen demand by causing venodilation of coronary arteries and collaterals, resulting in decreased end-diastolic pressures.

56
Q

Indications for Nitrates

A
  • Acute treatment and prophylaxis of angina
  • Acute MI
  • Acute heart failure
  • Low-output syndromes
  • Hypertension (intravenous)
57
Q

Name an Example of a Nitrate

A

Nitrostat

58
Q

Describe Managment with Nitrates

A

Patients are typically managed on combination therapy–one or more long-acting preparations combined with a quick acting agent

59
Q

Indications for Beta Blocking Agents

A

Treat hypertension

60
Q

Examples of Beta Blocking Agents

A

Lopressor-cardioselective, has more effect on Beta 1 receptors than Beta 2

Inderal (propranolol)-nonselective, block both Beta 1 and Beta 2 receptors and can cause bronchospasm. Contraindicateed for asthma

61
Q

First Line Agents for Hypertension

A

Thiazide Diuretics, Beta Blockers, ACE inhibitors, Angiotensin II receptor blockers, Alpha, Beta Blockers, and Calcium antagonists

62
Q

Indications for Barbiturates

A

Short term use for sedation or hypnotic effects (Pentobarbital), anesthesia (Brevital, Pentothal), anticonvulsant effects (Phenobarbital)

63
Q

Mechanism of Action for Barbiturates

A

Nonspecific CNS depressants acting at the level of the thalamus that depress the sensory cortex, decrease motor activity, alter cerebral function, and produce drowsiness, sedation, and hypnosis

64
Q

Contraindications for Barbiturates

A

Pregnancy; cautious use with depressed or suicidal patients, history of drug abuse or hepatic disease

65
Q

Side effects of Barbiturates

A

CNS depression resulting in drowsiness, lethargy, headache, depression, and vertigo

Can cause serious respiratory depression, serious cardiovascular effects such as
hyoptension and bradycardia

Can cause withdrawal symptoms if stopped after long use.

66
Q

Name, indications, and side effects for Nonbarbiturates

A

Brand name-Ambien/Generic-zolpidem

Indications-Used for short term treatment of insomnia, but lose effectiveness after two weeks

Side effects-G.I. distress and hangover effects

67
Q

Explain and describe Continuous Nebulization.

A

Used for management of status asthmaticus, reduces need for frequent therapist attendance.

Generally given 10 to 15 mg/hour (adult dose)

Can be deliverd by:

  • Refilling SVN
  • Volumetric infusion pump
  • Large-volume nebulizer
68
Q

What is Racemic Epinephrine? What concentrations does it come in?

A

It is a synthetic form of epinephrine.

Used to treat conditions in which upper airway swelling may occur. (Examples-Croup, extubation stridor)

Concentrations: 2.25% solution

69
Q

Describe Sympathomimetic drugs.

A

A drug stimulating a receptor for Norepinephrine and is adrenergic

70
Q

Explain the sympathetic system’s stimulation effects on the heart.

A

Heart rate speeds up, fight or flight

71
Q

Explain the sympathetic system’s stimualtion effects on bronchial smooth muscle.

A

Bronchi dilate

72
Q

What particle size is best for therapeutic and diagnositc purposes to deposit in the lower airway?

A

1-5 micrometers, 10-30% actually deposits in the lung

73
Q

Respigam

A

Agent indicated for the prevention of serious lower respiratory tract infections with RSV in children under 24 months of age with bronchopulmonary dsyplasia, congenital heart disease, or history of premature birth

74
Q

Types of diseases treated with Beta 2 bronchodilators.

A

Asthma, Bronchitis, Emphysema, and Bronchiectasis

75
Q

Metaproterenol (Alupent)

A
  • Short acting B2 agonist
  • Better for maintenance therapy

0.3 mL of 5% solution tid, qid

76
Q

Benzodiazepines

A

Used as sedativess, hypnotics, anxiolytics, anticonvulsants and muscle relaxants.

Examples: alprazolam (Xanax), lorazepam (Ativan), oxazepam (Serax), clonazepam (Klonopin)

77
Q

Opioids

A

Decrease sensation of dyspnea in patients with advanced respiratory failure

78
Q

Going from % to mg/mL

A

Move decimal place to right

79
Q

Going from mg/mL to %

A

Move decimal place to left

From Flashcardlet (17 decks)

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