CH 40: Asthma and pulmonary

Question 1

muscular, elastic structures whose diameter, or lumen, varies with the contraction or relaxation of smooth muscle.

Answer 1

bronchioles

Question 2

bronchioles are regulated by:

Answer 2

SNS and PNS

Question 3

causes bronchiolar smooth muscle to relax, the airway diameter to increase, and bronchodilation to occur

Answer 3

beta2-adrenergic receptors

Question 4

sympathetic branch activates:

Answer 4

beta2-adrenergic receptors

Question 5

parasympathetic branch causes:

Answer 5

bronchiolar smooth muscle to contract, the airway
diameter to narrow, and bronchoconstriction to occur

Question 6

some of the most frequently prescribed drugs for treating pulmonary disorders

Answer 6

bronchodilators

Question 7

chronic pulmonary disease with inflammatory and bronchospasm components.

Answer 7

asthma

Question 8

stimulates the secretion of histamine and other inflammatory mediators, which increases mucus and edema in the airways

Answer 8

acute inflammatory response

Question 9

the most common chronic illness in childhood, accounting for 13.8 million missed school days each year.

Answer 9

asthma

Question 10

goal of pharmacotherapy for asthma

Answer 10

Stop bronchospasm
Reduce the frequency of asthma attacks

Question 11

preferred drug for relief of acute symptoms

Answer 11

SABAs for bronchodilation

Question 12

alternate drugs for those who cannot tolerate SABAs

Answer 12

anticholinergics for bronchodilation

Question 13

oral drugs are used for short periods to reduce the frequency of acute exacerbations

Answer 13

corticosteroids: systemic for anti-inflammatory

Question 14

preferred drugs for long-term asthma management
oral doses may be requires for severe, persistent asthma

Answer 14

corticosteroids: inhaled

Question 15

alternative drugs to control mild, persistent asthma or exercise-induced asthma

Answer 15

mast cell stabilizers

Question 16

alternative drugs to control mild, persistent asthma or as adjunctive therapy with inhaled corticosteroids

Answer 16

leukotriene modifiers

Question 17

used in combination with inhaled corticosteroids for prophylaxis of moderate to sever persistent asthma

Answer 17

LABAs

Question 18

used in combination with inhaled corticosteroids for prophylaxis of mild to moderate persistent asthma

Answer 18

methylxanthines

Question 19

used of adjunctive therapy for patients who have allergies and severe, persistent asthma

Answer 19

immunomodulators

Question 20

albuterol (SABAs) therapeutic effects

Answer 20

Bronchodilation
Act on beta2 in the lungs
Also act on beta1 in the heart
Rescue drug for an acute attack
Facilitates drainage of mucus
Inhibits release of other inflammatory chemicals from mast
cells

Question 21

albuterol (SABAs) adverse effects

Answer 21

Headache,
dizziness,
tremor,
nervousness,
throat irritation,
drug tolerance
Tachycardia,
dysrhythmias,
hypokalemia,
hyperglycemia,
paradoxical bronchoconstriction,
increased risk for asthma-related death (LABAs)

Question 22

albuterol (SABAs) what to monitor and precautions

Answer 22

assess respiratory status before and after
advise patients not to use LABAs for rescue medication

Question 23

inhaled ipratropium (anticholinergics) therapeutic effects

Answer 23

Treatment of chronic asthma
Block the PNS and stimulates the SNS that results in
bronchodilation

Question 24

inhaled ipratropium (anticholinergics) adverse effects

Answer 24

Headache,
cough,
dry mouth,
bad taste,
paradoxical bronchospasm
Pharyngitis,
paradoxical bronchospasm,
worsening of urinary retention

Question 25

inhaled ipratropium (anticholinergics) what to monitor

Answer 25

Dry mouth, headache, cough, GI distress, and anxiety Assess respiratory status before and after

Question 26

inhaled ipratropium (anticholinergics) safety precautions

Answer 26

When administered with other inhalation medication, adminster adrenergic bronchodilators first

Question 27

Methylxanthines/ Theophylline (LABA) adverse effects

Answer 27

Nervousness, tremors, dizziness, headache, nausea, vomiting, anorexia Tachycardia, dysrhythmias, hypotension, seizures, circulatory failure, respiratory arrest

Question 28

Methylxanthines/ Theophylline (LABA) what to monitor and safety

Answer 28

Nervousness and insomnia Interactions with other drugs Have a narrow safety margin

Question 29

Most potent of anti-inflammatory substances

Answer 29

Corticosteroids (glucocorticoids)

Question 30

mediators of the immune response that are involved in allergic and asthmatic reactions.

Answer 30

leukotrienes

Question 31

Beclomethasone (Inhaled Corticosteroids) therapeutic effects

Answer 31

Prevention of asthma attacks Decrease activation of inflammatory cells Diminish mucus production and reduce airway obstruction

Question 32

Beclomethasone (Inhaled Corticosteroids) adverse effects

Answer 32

Hoarseness, dry mouth, cough, sore throat Oropharyngeal candidiasis, hypercorticism, hypersensitivity reactions

Question 33

Beclomethasone (Inhaled Corticosteroids) what to monitor and safety

Answer 33

Hoarseness and oropharyngeal candidiasis Adrenal gland atrophy, PUD Hyperglycemia Growth retardation in children cataracts Can mask the signs and symptoms of infection

Question 34

montelukast (leukotriene modifier) therapeutic effects

Answer 34

prevention of asthma attacks prevents airway edema

Question 35

montelukast (leukotriene modifier) adverse effects

Answer 35

Headache, nausea, diarrhea, throat pain, weight loss (roflumilast) Liver toxicity (zileuton), increased AST, psychiatric events including suicidality (roflumilast)

Question 36

montelukast (leukotriene modifier) what to monitor and safety

Answer 36

Respiratory status Changes in behavior Rash Oral candidiasis Suicidal ideation and depression Steven johnson syndrome NOT FOR ACUTE ATTACKS

Question 37

designed to attach to a specific receptor on a target cell or molecule. treating asthma and COPD

Answer 37

monoclonal antibodies

Question 38

treatment of COPD

Answer 38

There is no cure – treat the symptoms and slow progression of the disease encourage patient to stop smoking