Respiratory study guide

Question 1

Pathophysiology of asthma

Answer 1

• Chronic inflammation, resulting in an increase in airway edema and mucous secretions
• Bronchospasm; hyper responsiveness to stimuli

Question 2

Pathophysiology of COPD

Answer 2

-Consists of either chronic bronchitis and/or emphysema

Question 3

Chronic bronchitis

Answer 3

Excess mucus production in the lower respiratory tract

Question 4

Emphysema

Answer 4

Loss of bronchiolar elasticity and destruction of alveoli

Question 5

Common causes of COPD

Answer 5

Smoking and air pollutants

Question 6

Definition of respiration

Answer 6

Process by which oxygen brought into body, carbon dioxide is removed

Question 7

Definition of perfusion

Answer 7

Blood flow through the lung

Question 8

Ventilation

Answer 8

Process of moving air in/out of lungs

Question 9

Step 1 treatment approach

Answer 9

Preferred: SABA PRN

Question 10

Step 2 treatment approach

Answer 10

Preferred: Low dose ICS
Alternative: Cromolyn, LTRA, nedocromil, or theophylline

Question 11

Step 3 treatment approach

Answer 11

Preferred: Low dose ICS + LABA or Medium dose ICS
Alternative: Low dose ICS + either LTRA, theophylline, or zileuton

Question 12

Step 4 treatment approach

Answer 12

Preferred: Medium dose ICS + LABA
Alternative: Medium dose ICS + either LTRA, theophylline, or zileuton

Question 13

Step 5 treatment approach

Answer 13

Preferred: High dose ICS + LABA and consider omalizumab for patients who have allergies

Question 14

Step 6 treatment approach

Answer 14

Preferred: High dose ICS + LABA + oral corticosteroids AND consider omalizumab for patients who have allergies

Question 15

What are the differences between treatment of acute symptoms vs prevention?

Answer 15

Acute symptoms: SABA

Prevention: Corticosteroids, Inhaled anticholinergic, leukotriene modifiers

Question 16

Mechanism of Albuterol

Answer 16

• Beta 2 agonist (SABA)
• Selectively binds to beta 2 adrenergic receptors in bronchial smooth muscle to cause bronchidilation
• fast onset

Question 17

Mechanism of Salmeterol

Answer 17

• Beta 2 agonist (LABA)
• Selectively binds to beta 2 adrenergic receptors in bronchial smooth muscle to cause bronchodilation
• Slow onset

Question 18

Mechanism of Ipratropium

Answer 18

• Inhaled anticholinergic

- Blocks cholinergic receptors in bronchial smooth muscle

Question 19

Mechanism of Beclomethasone

Answer 19

• Inhaled corticosteroid

- Reduces inflammation and immune response, thus decreasing frequency of asthma attacks

Question 20

Mechanism of Cromolyn

Answer 20

• Mast cell stabilizer
• Stabilizes mast cells, thus preventing inflammatory response
• Prevents release of histamine and other inflammatory mediators in airways

Question 21

Mechanism of Theophylline

Answer 21

• Methylxantine
• Relaxes bronchial smooth muscle
• Suppresses airway responsiveness to stimuli that promote bronchospasm
• Modest bronchodilator

Question 22

Mechanism of Omalizumab

Answer 22

• Monoclonal antibodies

- Prevents inflammation and dampens response to allergens

Question 23

SE of albuterol and salmeterol:

Answer 23

• Headache
• Throat irritation, dry mouth
• Restlessness, insomnia
• Nervousness, tremor
• Cardiac tachycardia, chest pain
• Paradoxical bronchospasm
• Allergic reaction

Question 24

Precautions of slameterol and albuterol:

Answer 24

• History of tachycardia
• Prolonged QT interval
• Coronary artery disease
• Hypertension

Question 25

SE of Ipratropium:

Answer 25

- Dry mouth, bitter taste - Nausea, GI distress - Upper respiratory tract irritation - Paradoxical brochospasm

Question 26

Precautions of Ipratropium:

Answer 26

- Closed angle glaucoma | - Urinary tract obstruction

Question 27

SE of Beclomethasone

Answer 27

- Hoarseness, dry mouth, disgusia - Development of cataracts (long term therapy) - Corticosteroid toxicity - Growth Inhibition in children - Oral thrush

Question 28

SE of Cromolyn

Answer 28

- Cough - Pharyngeal irritation - Local burning and stinging * Discontinue if eosinophilia develops*

Question 29

Contraindications of Theophylline:

Answer 29

- Seizure disorders - Heart failure, dysrhythmias - Active peptic ulcer - Liver disease

Question 30

SE of Theophylline:

Answer 30

- Nausea/vomiting - Headache, irritability, insomnia - Dysrhythmias - Seizures

Question 31

SE of Omalizumab:

Answer 31

- Anaphylaxis - Bleeding - Severe dysmenorrhea