part 10

Question 1

• life threatening anaphylaxis can occur
• skin or blood test is required
• antagonism of IgE
• second line agent: when other meds have failed
• modest benefit with significant drawbacks
• SQ injection

Answer 1

Omalizumab - Monoclonal antibody

Question 2

• produces bronchodilation by relaxing smooth muscle of bronchi
• for asthma and COPD
• can become toxic with narrow therapeutic window
• toxicity occurs at levels above 30 mcg/mL causing severe dysrhythmias, convulsions,

Answer 2

bronchodilators: Methylaxanthines

Question 3

What is used as a rescue inhaler?

Answer 3

SABA

• albuterol
• levalbuterol

Question 4

What are the S&S of toxicity with bronchodilators: Methylaxanthines?

Answer 4

severe dysrhythmias and convulsions

cardiorespiratory collapse resulting in death

Question 5

• blocks muscarinic receptors in the bronchi reducing bronchospasm
• off labeled use in asthma, approved for COPD
• inhaled and therapeutic effects within 30 seconds
• AE: dry mouth and glaucoma

Answer 5

anticholinergic drug: Ipratropium (Atrovent)

Question 6

What are the combination drugs?

Answer 6

• glucocorticoids and LABAs: long term maintanance for adults and children (symbicort and Breo)
• beta 2 adrenergic agonist anticholinergic: for COPD and off label asthma (duoneb and combivent)

Question 7

Acute severe exacerbation:

• requires immediate attention
• What does the initial therapy consist of?

Answer 7

• oxygen to relieve hypoxemia
• systemic glucocorticoid to reduce airway inflammation
• nebulized high dose SABA to relieve airflow obstruction
• nebulized ipratropium to further reduce airflow obstruction

Question 8

• bronchospasm secondary to loss of heat and or water from the lungs
• starts wither during or immediately after exercise, peaks in 5 to 10 minutes and resolves 20 to 30 minutes later

Answer 8

EIA: exercise induced asthma

Question 9

How should a pt treat asthma?

Answer 9

• SABA: beta agonsit immediately before exercise (preferred method)
• Cromolyn 15 minutes before exercise

Question 10

What can we use to suppress cough?

Answer 10

• anti-tussive
• non-opioid anti-tussive
• expectorants and Mucolytics

Question 11

What is an adverse effect of the mucolytic acetylcysteine?

Answer 11

causes bronchospasm and smells like rotten eggs