Asthma Flashcards by Kenneth Morgan

In the bronchioles of the lungs, what is the term for the interior space cavities that make up the Diameter of the bronchioles?

The Lumen

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Respiration is the process of what?

What 2 aspects of gas exchange does Respiration involve?
(Terms, not physiological parts of the lungs)

Respiration is moving O2 in and CO2 out of the lungs

Respiration involves Ventilation and Perfusion

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What is Ventilation?

What is Perfusion?

Ventilation is moving air in and out

Perfusion is the flow of blood through the lungs

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The sympathetic NS controls what response?

The Parasympathetic NS controls what response?

SNS controls the “fight-or-flight” response

PSNS controls the “rest-and-digest” response

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The bronchioles are lined with (____) muscles that are in control of what?

The bronchioles are lined with (smooth) muscles that are in control of how much air enters the lungs

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Activation of the Beta 2-adrenergic receptors and causing bronchiolar smooth muscle to relax is a function of which ANS?

Sympathetic NS activates Beta 2-adrenergic receptors

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The Sympathetic NS relaxes the bronchiolar smooth muscles, causing broncho (____), which (____) the diameter of the lumen.

The Sympathetic NS relaxes the bronchiolar smooth muscles, causing broncho (dilation), which (increases) the diameter of the lumen.

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The PSNS contracts bronchiolar smooth muscle, causing broncho (_____), resulting in a more (____) airway, leading to (____) airflow

The PSNS contracts bronchiolar smooth muscle, causing broncho (constriction), resulting in a more (narrow) airway, leading to (less) airflow

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Epinephrine is administered in the event of what breathing emergency?

Anaphylaxis

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Epinephrine causes vaso (____) which has the effect or raising (__) and reducing (____). Because of this, it has the risky side effects of (____) cardia and severe (____) tension

Epinephrine causes vaso (constriction) which has the effect or raising (BP) and reducing (swelling). Because of this, it has the risky side effects of (Tachy) cardia and severe (hyper) tension

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What are 3 reasons why Oral therapy is inferior to inhalation therapy for the tx of pulmonary issues?

-Oral takes longer to work
-Oral has frequent side effects
-Oral gives the patient the capacity to build up a tolerance

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Are Aerosol drugs given for a localized effect or a systemic effect?

Localized

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Aerosol therapy gives immediate relief to (_______), and loosens thick (____)

Aerosol therapy gives immediate relief to (Bronchospasms), and loosens thick (mucus)

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Which of these aerosol options vaporize a liquid drug into a mist to be inhaled?

-Nebulizer
-Meter-Dose-Inhaler
-Dry-Powder inhaler

Nebulizer

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Asthma has both (_______) and (______) components

Asthma has both (inflammatory) and (bronchospasm) components

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What is status asthmaticus?

A prolonged asthma attack that doesn’t resolve with use of meds

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Which of these 3 drug classes are short-acting “quick-relief” medications?

-Beta-2 Adrenergic Agonists
-Inhaled Corticosteroids
-Systemic Corticosteroids -
-Mast Cell Stabilizers
-Immunomodulators
-Methylxanthines
-Anticholinergics
-Leukotriene modifiers
-Long-acting Beta-2 Adrenergic Agonists

-Beta-2 Adrenergic Agonists
-Systemic corticosteroids
-Anticholinergics

These are short-acting, quick relief meds for bronchospasms

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What are the long-acting drug classes for the medication of asthma?

-Inhaled corticosteroids
-Mast cell stabilizers
-Leukotriene modifiers
-Immunomodulators
-Methylxanthines
-Long-acting Beta-2 adrenergic agonists

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Of these asthma drugs, which ones have the mechanism of bronchodilation, which have anti-inflammatory, and which are monoclonal antibodies?

-Beta-2 Adrenergic Agonists (Bronchodilator)
-Inhaled Corticosteroids
(Anti-inflammatory)
-Systemic Corticosteroids
(Anti-inflammatory)
-Mast Cell Stabilizers
(Anti-inflammatory)
-Immunomodulators
(Monoclonal Antibodies)
-Methylxanthines
(Bronchodilator)
-Anticholinergics
(Bronchodilator)
-Leukotriene modifiers
(Anti-inflammatory)
-Long-acting Beta-2 Adrenergic Agonists
(Bronchodilator)

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What is the preferred drug class for long-term asthma management?

Inhaled corticosteroids (Anti-inflammatory)

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Which two drug classes are used in combination with inhaled corticosteroids for prophylaxis of moderate to severe persistent asthma?

Long-acting Beta-2 adrenergic agonists
(Bronchodilator)

Methylxanthines
(Bronchodilator)

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Which two drug classes are used as “alternative” drugs to control mild, persistent asthma or as adjunctive therapy with inhaled corticosteroids?

Mast cell stabilizers
(Anti-inflammatory)

Leukotriene modifiers
(Anti-inflammatory)

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Which short-acting drug class is used for the tx of asthma in patients who cannot tolerate SABA’s? (Short Acting Beta-2 Adrenergic Agonists)

Anticholinergics

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What are 2 inhaled corticosteroids to know off hand?

-Beclomethasone (Qvar)
-Fluticasone

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What is a leukotriene modifier to know, and how do you spot leukotriene drugs by name?

Montelukast (SIngulair) is a drug to know Spot leukotriene modifiers by the suffix "-ast" Ex: Montelukast, Roflumilast, Zafirlukast

What is a Mast cell stabilizer to know?

Cromolyn (Intal)

The most effective drug class for relieving acute bronchospasms is what?

Short-acting Beta-2 Adrenergic Agonists (SABA)

What is the prototype drug for SABA's to know?

Albuterol

Albuterol can prevent exercise-induced bronchospasms if taken how soon before exercise?

15-30 minutes

Would a SABA like Albuterol be good for long-term prophylaxis of Asthma?

No, Albuterol is a SABA for immediate relief of asthma symptoms. You would use a LABA or Corticosteroids for long-term prophylaxis

What electrolyte imbalance can Albuterol cause if it is given prolonged use at high doses?

Hypokalemia

What patients should exercise caution when using albuterol?

-Patients with a hx of cardiac disease -HTN patients -Patients with dysrhythmias -Patients with a hx of MI

Is albuterol good for breastfeeding women to use?

Not recommended

Anticholinergics block the (____) system with broncho (____) effect

Anticholinergics block the (Parasympathetic Nervous) system with broncho (dilation) effect

Anticholinergics are often seen as a mirror to what other asthma medication? Why?

SABA's, because of their same inhaled effect Anticholinergics are the alternative to patients who can't tolerate SABA's

What is an Anticholinergic drug to know?

Atrovent

Anticholinergics achieve broncho (____) by blocking (____) receptors in the bronchial smooth muscle.

Anticholinergics achieve broncho (dilation) by blocking (cholinergic) receptors in the bronchial smooth muscle.

Anticholinergics are often occasionally prescribed for the treatment of chronic (_____) and (_____) congestion

Anticholinergics are often occasionally prescribed for the treatment of chronic (bronchitis) and (nasal) congestion

What are 4 expected side-effects of using Anticholinergics?

-Bitter taste in the mouth -Cough -Hoarseness -Dry nasal mucosa

The inhalation form of Atrovent is approved to relieve and prevent the bronchospasms that are characteristic of (____) and (____)

The inhalation form of Atrovent is approved to relieve and prevent the bronchospasms that are characteristic of (asthma) and (COPD)

What are the vital signs you should monitor after giving a patient SABA's and Anticholinergics for treatment?

-RR -Pulse ox -SpO2 -Skin pallor -Lung sounds -Respiratory effort

What drug class is the most potent and natural anti-inflammatory drug class?

Inhaled Corticosteroids (Glucocorticoids)

Inhaled Corticosteroids are the drug of choice for (____)-term (______) of asthma

Corticosteroids are the drug of choice for (long)-term (prophylaxis) of asthma

How often must corticosteroids be taken for the long-term treatment of asthma?

Every day

For the short-term therapy of severe, acute asthma, ORAL corticosteroids should be discontinued after how many days of use?

6-10 days of use

What is the Corticosteroid prototype drug to know?

Beclomethasone (Qvar)

Oropharyngeal Candias is caused by which asthma medication?

Inhaled corticosteroids (Beclomethasone)

What is the syndrome that should be assessed for before giving a patient an inhaled corticosteroid?

Cushing syndrome

Don't give corticosteroids to patients who are actively what?

Actively fighting an infection

Which of these patients would you avoid giving corticosteroids to, and which would be safe in receiving them? -Hypertension -G I disease -Congestive heart failure -Thromboembolic disease -Fungal infection -Diabetes Mellitus

All of these patients would NOT receive corticosteroids

Why would pediatric patients need to be monitored if they are routinely taking an inhaled corticosteroid?

Routine corticosteroid use in children can cause a reduction in growth

Why would corticosteroids NOT be given to a patient with a suspected active infection

Corticosteroids can hide s/s of infections in patients

Leukotriene modifiers are mediator of the (_____) response

Leukotriene modifiers are mediator of the (immune) response

Leukotriene modifiers are predominantly used for the (_____) treatment of asthma and (_____) asthma

Leukotriene modifiers are predominantly used for the (prophylactic) treatment of asthma and (chronic) asthma

Leukotriene modifiers are used in asthma reactions and (____) reactions

Leukotriene modifiers are used in asthma reactions and (allergic) reactions

Leukotriene modifiers prevent airway (____) and (______) by blocking (_____) receptors in airways

Leukotriene modifiers prevent airway (edema) and (inflammation) by blocking (leukotriene) receptors in airways

What are 3 adverse effects of leukotriene modifiers?

Headache -Nausea -Diarrhea

In addition to the usual vitals monitoring (SpO2, RR, Pulse, Pallor) what are 2 labs/tests that should be monitored closely?

A CBC test A liver function test (AST/ALT lvls)

What lab value should you closely monitor in patients taking a leukotriene modifier with Coumadin?

PT/INR, Coumadin is warfarin, a blood thinner

Methylxanthines are a (________) drug class and are closely related to (______)

Methylxanthines are a (bronchodilator) drug class and are closely related to (caffeine)

Methylxanthines can be given PO or what?

PO or IV

Methylxanthine has a very narrow margin of (_____) and interacts with many drugs. Its main side effects are (_____)/(____) and (___) stimulation

Methylxanthine has a very narrow margin of (safety) and interacts with many drugs. Its main side effects are (nausea)/(vomiting) and (CNS) stimulation

Because of its narrow margins of (____), Methylxanthine is a "(_________)" drug for the (____)-term prophylaxis of asthma in patients unresponsive to (__)'s and (______________)

Because of its narrow margins of (safety), Methylxanthine is a "(last-resort)" drug for the (long)-term prophylaxis of asthma in patients unresponsive to (BA)'s and (corticosteroids)

Mast Cell stabilizers inhibit mast cells from releasing (______).

Mast Cell stabilizers inhibit mast cells from releasing (histamines).

Mast cell stabilizers are safe for the (______) of asthma, but are not as effective as (___________) or as effective at relieving acute (_________)

Mast cell stabilizers are safe for the (prophylaxis) of asthma, but are not as effective as (corticosteroids) or as effective at relieving acute (bronchospasms)

Of the asthma drugs, which drug class is designed to attach to specific receptor on a target cell or molecule for the prophylaxis of asthma?

Immunomodulators (Monoclonal antibodies

Omalizumab is the 1st "biological" tx method for the prophylaxis of asthma, and targets which immunoglobulins?

IgE

If you are using a corticosteroid and bronchodilator together, what is the protocol of use/administration?

-Use the bronchodilator first -Wait 5–10 minutes -Use the corticosteroid to ensure that the drug reaches deeper into the bronchi

Non-phrenological care for asthma and COPD is the intake of (_____) to decrease mucus secretions

Non-phrenological care for asthma and COPD is the intake of (fluids) to decrease mucus secretions

Anticholinergics are contraindicated in patients with what type of allergy?

Soy/Peanut allergy

Albuterol effects can be inhibited by what drug class?

Beta-Blockers