Respiratory

Question 1

Beta-adrenergic agonists mechanism of action

Answer 1

Bronchodilator that acts on B-2 receptors on respiratory smooth muscle cells to cause relaxation and bronchodilation

Question 2

Beta adrenergic agonists- route of admin

Answer 2

• inhalation (rapid acting)

- metered-dose inhalers (MDI), dry powder inhalers, nebulizers

Question 3

Beta adrenergic agonists side effects

Answer 3

Airway irritation, nervousness, restlessness, tremor, increased HR

Question 4

Xanthine derivatives -mechanism of action

Answer 4

Bronchodilator; CNS stimulant for reversible airway obstruction (bronchitis, emphysema), works on smooth muscle to dilate but also anti-inflammatory (inhibits phosphordiesterase enzyme)

Question 5

Xanthine derivatives- admin

Answer 5

Orally

Question 6

Xanthine derivatives side effects

Answer 6

• theophylline toxicity- nausea, confusion, irritability, seizures, arrhythmia as
• serious life threatening effects
• avoid long term use
• not used frequently anymore

Question 7

Anti-cholinergics mechanism of action

Answer 7

Bronchodilator; blocks muscarinic cholinergic receptors to prevent acetylcholine-induced bronchoconstriction

Question 8

Anti-cholinergics - use/ admin

Answer 8

• drug of choice for COPD, chronic bronchitis

- inhaled for respiratory disorders

Question 9

Anti-cholinergics side effects

Answer 9

Dry mouth, constipation, urinary retention, confusion, blurred vision (less likely w/ inhaled)

Question 10

Lukotriene inhibitors use

Answer 10

Anti inflammatory; used w/ glucocorticoids for optimal COPD / asthma management

Question 11

Lukotriene Inhibitors mechanism of action

Answer 11

Inhibit lipooxygenase enzyme to dec. airway inflammation

Question 12

Leukotriene inhibitors side effects

Answer 12

Mild liver impairment

Question 13

Cromones- use/ admin

Answer 13

• used prophylactically to prevent asthma, esp in children

- nasal spray/nebulizer

Question 14

Cromones- mechanism of action

Answer 14

Anti-inflammatory; inhibit inflammatory mediators from pulmonary mast cells

Question 15

Cromones side effects

Answer 15

Free of serious effects, infrequently used

Question 16

Glucocorticoids use

Answer 16

-most effective for controlling asthma

Question 17

Glucocorticoids mechanism of action

Answer 17

Anti-inflammatory; inhibits pro inflammatory proteins and promotion of anti-inflammatory proteins, inhibit migration of neutrophils and monocytes

Question 18

Glucocorticoids side effects

Answer 18

• decreased if inhaled (ex. Thrush), avoid prolonged oral use
• thrush, catabolic effect on tissues (osteoporosis, skin/muscle wasting), aggravation of diabetes mellitus, HTN

Question 19

Antitussives use

Answer 19

Short term for suppressing coughing, used w/ acetaminophen

Questionable efficacy

Question 20

Decongestants- MOA

Answer 20

Alpha 1 adrenergic agonists that stimulate nasal vasoconstriction

Question 21

Decongestants side effects

Answer 21

CNS excitation (HA, dizziness, nervousness, HTN, palpitations)
-rebound congestion when used long term

Question 22

Acetylcysteine use

Answer 22

Expectorant/mucolyticis used with other decongestants or antihistamines A

Question 23

Acetylcysteine MOA

Answer 23

Breaks disulfide bonds of mucoproteins, less viscous

Question 24

Guaifenesin MOA

Answer 24

Expectorant; increases production of pulmonary secretions, encouraging ejection

Question 25

Guaifenesin side effect

Answer 25

GI upset

Question 26

Antihistamine MOA

Answer 26

Blocks H1 receptors to decrease nasal congestion, mucosal irritation, discharge (rhinitis, sinusitis) and conjunctivitis

Question 27

Antihistamine side effects

Answer 27

Can cross BBB- sedation

Question 28

COPD

Answer 28

Obstructive pulm disease- flow impacted, difficulty exhaling (air trapped in lungs)

Question 29

COPD management

Answer 29

Prevent airway restriction, maintain patency= anticholinergics/beta-adrenergic blockers Short term: oral glucocorticoids

Question 30

Meds for exercise induced asthma

Answer 30

- long acting beta agonist with rapid acting agonist - combined preparations (glucocorticoid + bronchodilator) - rescue inhaler as backup