Chapter 9 - Mucus Drugs

Question 1

What are the surface epithelial cells of the mucociliary system?

Answer 1

Pseudo stratified columnar Ciliated
Goblet cells
Clara cells

Question 2

What are the cells in the submucosal layer?

Answer 2

Serous

Mucous

Question 3

What sputum composed of?

Answer 3

Mixed inflammatory cells
Cellular debris
Bacteria

Question 4

What drugs are called mucoregulatory medications?

Answer 4

• corticosteroids
• indomethacin
• macrolide antibiotics
• anti-cholinergic agents

Question 5

What are mucoregulatory drugs useful in?

Answer 5

Broncorrhea associated with airway inflammation.

-decreased hypersecretion

Question 6

What are some therapeutic options for hypersecretion?

Answer 6

Remove causative factors
Optimize clearance(bronchodilators/coughing)
Use mucoactive agents when indicated

Question 7

What is mucomyst used for?

2 things

Answer 7

• Mucolytic

- acetaminophen OD

Question 8

What is the mode of action for mucomyst?

Answer 8

Disrupts Di-sulfide bonds

Question 9

What’s a hazard of mucomyst?

Answer 9

Bronchodpasms

Question 10

What are some secondary complications of mucomyst?

Answer 10

NSR
Nausea
Rhinorrhea
Stomatitis

Question 11

What are you not allowed to mix with NAC?

Answer 11

Antifungals

Antibiotics

Question 12

What is dornase Alfa used for?

Answer 12

• Mucoactive agent for CF pts and to preserve or improve their LUNG FUNCTION
• to reduce respiratory infections that require paraenteral antibiotics

Question 13

What does dornase Alfa do to non-CF airways diseases?

Answer 13

No efficacy

Question 14

What is the mode of action of Dornase alfa?

Answer 14

Decreases viscocity and adhesivity

-decreases DNA of sputum

Question 15

What are the storage requirements of dornase Alfa?

Answer 15

Refrigerate and protect for light

Question 16

What are the common side effects are of dornase Alfa?

Answer 16

Voice alternations
Inflammation of larynx and pharynx
Rash
Chest pain

Question 17

What are some expectorants?

Answer 17

MSGS
SSKI(iodine containing)
Sodium bi-carb
Guaifenesin
Mannitol(oligosaccaride)

Question 18

What is something you give a patient before using broncotol?

Answer 18

SABA

Question 19

What do beta agonists do to cilia?

Answer 19

-Increase beat frequency, but doesn’t really effect mucous clearance

Question 20

What’s an issue with using a bronchodilator for airway clearance?

Answer 20

It opens up the airway, but by relaxing the airway, it can cause collapse in floppy airways.
This can cause plugging

Question 21

What are some mucokenetic agents?

Answer 21

Bronchodilators

Surface phospholipids

Question 22

What is the % concentration of hypertonic saline?

Answer 22

7%

Question 23

Which patients are too risky to give gravity postural drainage therapies to?

Answer 23

GERD

Muscle weakness

Question 24

What is insufflation/exsufflation exercise?

Answer 24

Using machines to give positive pressure to inflate then negative pressure to stimulate coughing

Question 25

Who would benefit from insufflation/exsufflation exercises?

Answer 25

- COPD | - neurological muscle weakness patients who can't cough

Question 26

What are the steps of the active cycle breathing (ACB)?

Answer 26

-take breath at mid-volume inhale -squeeze are out air from chest and abdomen (It shouldn't be a violent huff)

Question 27

What is a mucolytic agent?

Answer 27

An agent that breaks down mucus

Question 28

What is a cause for decreased secretions in CF patients?

Answer 28

Defective ion transports for sodium and chloride

Question 29

What 2 destructive forces do bronchial secretions stop?

Answer 29

- alpha 1 protease enzymes | - leukoproteases

Question 30

What are some diseases involved in hypersecretion is mucus?

Answer 30

- chronic bronchitis - asthma - bronchorrhhea

Question 31

What do diseased CF lung airways consist of?

Answer 31

DNA-rich pus

Question 32

How do you describe the mucus airways of CB patients?

Answer 32

Excessive number of goblet and submucosal glands | Which causes hypersecretion

Question 33

What is an issue with asthmatic patients who have been under constant beta agonist usage when diagnosed for hypersecretion?

Answer 33

Beta agonists may induce secretion of viscous mucus. | Aggressive usage may contribute to airway obstruction

Question 34

What is a mucokenetic agent?

Answer 34

Increase cough clearance by increasing expository flow or by reducing sputum adhesivity and tenacity

Question 35

What's the mode of action for anticholenergic agents with regards to mucoregulatory treatment?

Answer 35

They stop production of mucous by inhibiting M3 cholinergic mechanisms. They don't dry secretions

Question 36

What is hyperosmolar saline used for?

Answer 36

To induce sputum for testing

Question 37

What is autogenic drainage?

Answer 37

Incorporating staged breathing techniques to collect sputum in central airways. Then suppress coughs but keep building volume of breaths over time until you get to a moment where you can cough out a lot

Question 38

What is a draw back to autogenic drainage?

Answer 38

It requires lots of coordination. | Patients over 8 years old

Question 39

What is a form of PAP that people can do themselves?

Answer 39

Pursed lip breathing used by COPD patients