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From Flashcardlet > 314-UNIT TWO EXAM > Flashcards

314-UNIT TWO EXAM Flashcards

1
Q

Explain Mucarinic Receptors.

A

Cholinergic receptors at parasympathetic end sites.

At these junctions, muscarinic receptors function either to increase or decrease the activity of the effector cells.

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2
Q

Explain Nicotinic Recptors.

A

Cholinergic receptors on postsynaptic ganglia and at the neuormuscular junction.

At these junstions, nicotinic reecptors function as excitatory receptor for the postsynaptic cell. Release of a sufficient quantity of ACh from adjoininng presynaptic cell causes an excitatory response in autonomic ganglion cells in somatic muscle fibers.

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3
Q

Describe the Somatic Nervous System.

A

It is the voluntary system that innervates skeletal muscle for motor actions (such as walking).

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4
Q

Describe the Autonomic Nervous System.

A

It is the involuntary system that is said to control vegetative or visceral functions (such as heart rate).

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5
Q

Explain and describe the Sympathetic Branch of the ANS.

A

It arises from the thoracic-lumbar portion of the spinal cord.

Ganglia are situated near the spinal cord. (Paravertebral and Collateral)

This division innervates all organs in the body.

Automatically designed to permit a generalized response to stress (divergence or secreting epinephrine)

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6
Q

Explain and describe the Parasympathetic Branch of the ANS.

A

It arises from the cranial-sacral portions of the spinal cord.

Ganglia are located in or near the organ innervated.

The cranial division innervates organs in the head, chest, and abdomen. (Third nerve-oculomotor, Seventh nerve-facial, Ninth nerve-glossopharyngeal, and Tenth nerve-vagus)

The sacral division innervates the organs of the pelvic cavity.

Effects control of day-to-day functions. (rest and disgest)

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7
Q

Catecholamines cannot be given through this drug route.

A

Cannot be given by mouth because of degradation in the stomach

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8
Q

Explain how Epinephrine and Norepinephrine is broken down

A

It has a rapid onset, but doesn’t last long because it’s metabolized by Catecholamine Methyl-Transferase and Monoamine oxidase (MAO).

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9
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

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10
Q

What is levalbuterol? Explain its differences from albuterol.

A

This drug is the single isomer of albuterol.

Appears to be a more potent bronchodilator without the associated side effects.

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11
Q

Explain the drug salmeterol and how it works.

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

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12
Q

Name the clinical iindications for Adrenergic Bronchodilators (Beta2-agonist).

A

Relaxation of smooth airway muscle to reverse or improve airflow obstruction

  • Asthma
  • Bronchitis
  • Emphysema
  • Bronchiectasis
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13
Q

Name the clinical indications for Adrenergic Bronchodilators (Long-acting).

A

Maintenance bronchodilation, control of bronchospasm, and control of nocturnal symptoms.

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14
Q

Explain and describe Continuous Nebulization.

A

Used for management of asthma, 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
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15
Q

Name the types of receptors that epinephrine stimulates.

A

Alpha 1 and 2

Beta 1 and 2

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16
Q

Describe Afferent nerve signals.

A

Nerve fiber that carry impulses from the periphery to the cord (Sensory)

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17
Q

Describe Efferent nerve signals.

A

Nerve fibers that carry impulses from the brain and spinal cord out to various neuroeffector sites (Motor)

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18
Q

Describe Adrenergic effects on bronchial smooth muscle.

A

Relaxation to reserve or improve airflow obstruction

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19
Q

What is the typical adult dosage of albuterol?

A

It is 90 mcg/puff and usually given 2 puffs q4-6h. (Proventil, ProAir, Ventolin)

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20
Q

What is the typical adult dosage of pirbuterol?

A

Its 200 mcg/puff and usually given 1-2 puffs q4-6h (Maxair)

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21
Q

What is the typical adult dosage of ipratropium bromide?

A

It is 17 mcg/puff and usually given 2 puffs qid (Atrovent)

22
Q

What is the typical adult dosage of tiotropium bromide?

A

It is 18 mcg/capsule and usually given 1 capsule once a day (Spiriva)

23
Q

When spraying an Anticholinergic, patients should avoid what?

A

The eyes

24
Q

Name the common side effects of Adrenergic drugs.

A 
Tachycardia
Headache
Nervousness
Hypertension
etc.
25
Q

Describe Combivent and its usage.

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

26
Q

Describe Atrovent and its usage.

A

Anticholinergic MDI

17mcg/puff

typical adult dosage: 2 puffs qid

used for: COPD and severa asthma

27
Q

Most common side effects of Anticholinergics.

A

dry mouth and cough

28
Q

Describe Sympathomimetic drugs.

A

A drug stimulating a receptor for Norepinephrine and is adrenergic

29
Q

Describe Sympatholytic drugs.

A

A drug blocking a receptor for Norepinephrine and is antiadrenergic

30
Q

Describe Parasympathomimetic drugs.

A

A drug causing stimulaiton of a receptor for ACH and is cholinergic

31
Q

Describe Parasympatholytic drugs.

A

A drug blocking a receptor for ACH and is anticholinergic

32
Q

Name the medication given in the lab to trigger bronchospasm that assesses degree of airway reactivity and what type of drug it is.

A

Methacholine and it is a parasympathomimetic-stimulates cholinergic receptors

33
Q

Name the type of receptor located on bronchial smooth muscle.

A

Beta 2 receptors

34
Q

Explain the parasympathetic system’s stimulation on the heart.

A

Heart rate slows down, relaxes.

35
Q

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

A

Heart rate speeds up, fight or flight

36
Q

Explain the parasympathetic system’s stimulation effects on bronchial smooth muscle.

A

Bronchi constrict

37
Q

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

A

Bronchi dilate

38
Q

Diseases that benefit from adrenergic bronchodilators.

A

Asthma
Bronchitis
Emphysema
Bronchiectasis

39
Q

Describe the main reason for giving adrenergic bronchodilators.

A

For the relaxation effects on bronchial smooth muscle

40
Q

Name examples for Sympathomimetic drugs.

A

Salmeterol, dopamine, epinephrine, albuterol, ephedrine

41
Q

Explain why inhalatioin meds are preferred for patients.

A
  • Rapid response at the site
  • Relatively painless and safe
  • Fewer side effects
  • Small amount of drug is required
  • Drugs concentrations can be modified
  • Minimal coordination required
42
Q

Name the first and second anticholinergic drugs available on the market.

A

Atrovent (ipratropium bromide); Spiriva (tiotropium bromide)

43
Q

What is the main difference between salmeterol and formeterol?

A

Formeterol has a quicker onset and peak effect than salmeterol (these are both long-acting)

44
Q

What tests are performed to check for a reversible airway obstruction?

A

Pre- and Post-pulmonary function tests

45
Q

What forms and dosages is albuterol given?

A

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

MDI: 90 mcg/puff; 2 puffs tid,qid

Tablet: 2 mg, 4 mg, and 8 mg; bid, tid, qid

Syrup:2 mg/5 ml, 1-2 tsp; tid, qid

DPI

46
Q

Describe what the keyhole theory indicates.

A

The larger the side-chain attachment to a catechol base, the greater B2 specificty

47
Q

Name the short- and long-acting adrenergic drugs.

A

Epinephrine, Racemic epinephrine, albuterol, levalbuterol, pirbuteral, metaproterenol, salmeterol, formeterol, and aformeterol

48
Q

What is the most likely mechanism involved in smooth muscle relaxation (by Beta-adrenergic drugs)

A

An increase in intracellular cAMP (Cyclic adenosine monophosphate)

49
Q

Adult dosage given for extubation stridor.

A

2.25% solution, 0.25-0.5 mL (5.63-11.25 mg) qid

50
Q

Xanthines (Theophylline and caffiene) are used to treat what conditions?

A

Asthma, COPD, Apnea of prematurity

51
Q

How is Acetylcholine broken down?

A

It is broken down by the enzyme acetlycholinesterase (AChE)–which is common in the synaptic cleft

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