Ch. 14 Respiratory Meds Flashcards
With which of the following lung disorders would acetylcysteine (Mucomyst) be indicated?
- Emphysema
- Bronchiectasis
- Cystic fibrosis
- Pulmonary edema
A. 1 and 2 only
B. 2 and 3 only
C. 3 and 4 only
D. 1, 2, and 3 only
- Bronchiectasis
- Cystic fibrosis
Acetylcysteine (Mucomyst) is a mucolytic drug that chemically reduces the viscosity of secretions, which makes them easier to expel from the airway. Its use is indicated for lung conditions that are characterized by thick, tenacious sputum, such as bronchiectasis and cystic fibrosis. Pancreatic dornase (Pulmozyme) is an- other commonly used mucolytic that is more effective. The NBRC exams may still ask about Mucomyst.
A patient with glottic edema after extubation is in mild respiratory distress. Which of the following medications would be of benefit in this situation?
A. Cromolyn sodium (Intal)
B. Succinylcholine (Anectine)
C. Racemic epinephrine (Vaponefrin)
D. Pentamidine (NebuPent)
Racemic epinephrine (Vaponefrin)
Racemic epinephrine stimulates alpha-receptors, which results in constriction of blood vessels, reducing the swelling observed with glottic edema.
You are having difficulty intubating a combative patient in the emergency department. The respiratory therapist should recommend the delivery of which drug to facilitate intubation?
A. Succinylcholine
B. Cromolyn sodium
C. Atropine sulfate
D. Epinephrine
Succinylcholine
Succinylcholine is a fast-acting, short-lasting paralytic agent often used to paralyze combative patients who are difficult to intubate. The patient should be administered a sedative before being given any paralytic drug.
Which of the following airway disorders may be successfully treated with dexamethasone (Decadron)?
1. Asthma
2. Glottic edema
3. Pulmonary edema
A. 1 only
B. 2 only
C. 1 and 2 only
D. 2 and 3 only
- Asthma
- Glottic edema
Decadron is a steroid that exhibits antiinflammatory properties. It is useful in the treatment of asthma and glottic edema.
The physician wants to paralyze an agitated, combative asthmatic patient who is being mechanically ventilated. Which of the following would be the most appropriate drug to utilize at this time?
A. Vecuronium (Norcuron)
B. Succinylcholine
C. D-tubocurarine (Curare)
D. Midazolam (Versed)
Vecuronium (Norcuron)
Vecuronium is used for prolonged neuromuscular blockade for ventilator patients. Succinylcholine is also a neuromuscular blocker but is used for short-term (5 minutes) paralysis to facilitate tracheal intubation in a combative patient. D-tubocurarine is a neuromuscular blocker that is no longer used. Midazolam is a sedative that should be administered prior to a neuromuscular blocker.
A patient with status asthmaticus is being mechanically ventilated. Over the past 2 hours, the patient’s dynamic compliance has dramatically decreased. Which of the following drugs should be recommended to help improve this situation the fastest?
A. Beclomethasone (Beclovent, Vanceril)
B. Albuterol (Proventil)
C. Racemic epinephrine
D. Cromolyn sodium
Albuterol (Proventil)
Dynamic compliance decreases as a result of increased airway resistance, in this case, bronchospasm. A fast-acting rescue adrenergic bronchodilator such as albuterol is the most appropriate treatment. While be- clomethasone, a steroid, reduces airway inflammation, it takes longer to produce effects than a bronchodilator. Racemic epinephrine has bronchodilating properties, but is not as strong or long-lasting as albuterol. The alpha-constricting properties of racemic epinephrine make it a commonly used medication to treat glottis edema. Cromolyn sodium is an asthma-preventive drug that stabilizes the mast cells, preventing the release of substances that cause bronchospasm. It should not be used during an attack.
Oral candidiasis is a potential side effect of which of the following medications?
- Ipratropium bromide (Atrovent)
- Flunisolide (Aerobid)
- Beclomethasone
A. 2 only
B. 1 and 2 only
C. 2 and 3 only
D. 1,2,and3
- Flunisolide (Aerobid)
- Beclomethasone
Oral candidiasis or thrush is a side effect of long- term use of inhaled corticosteroids such as flunisolide and beclomethasone.
Atrovent is characterized as which type of respiratory medication?
A. Beta-adrenergic bronchodilator
B. Anticholinergic bronchodilator
C. Steroid
D. Mucolytic
Anticholinergic bronchodilator
Atrovent reduces the anticholinergic constricting reflexes in the airway, which results in bronchodilation. Beta-adrenergic bronchodilators such as albuterol or Xopenex (levalbuterol) are beta-2 stimulators that increase the dilating effects in the airway.
The physician is preparing to perform a bronchoscopy on a patient with suspected lung cancer. The physician wants to accomplish conscious sedation for the procedure. The respiratory therapist should recommend which of the following medications?
A. Midazolam
B. Vecuronium
C. Succinylcholine
D. Morphine sulfate
Midazolam
Versed (midazolam) provides conscious sedation as is indicated during invasive procedures such as a bronchoscopy. It is also administered to anxious or agitated ventilator patients. Vecuronium and succinylcho- line are neuromuscular blockers. Morphine has seda- tive effects but is generally used for pain management.
A 15-year-old asthmatic patient is being released from the hospital following a 3-day stay to treat her condition. Upon discharge, the respiratory therapist should recommend which type of medication to help prevent further attacks?
A. Beta-adrenergic bronchodilator
B. Leukotriene modifier
C. Mucolytic
D. Anticholinergic bronchodilator
Leukotriene modifier
Leukotrienes are mediators of bronchoconstriction and inflammation resulting in asthma attacks. By inhibiting their release, the attack is prevented. Singulair and Accolate are examples of leukotriene modifiers (asthma preventives).
Neuromuscular Blocking Agents (Paralytics)
- Succinylcholine
- Pancuronium bromide (Pavulon)
- Vecuronium
- Rocuronium (Zemuron)
Which medication is used for a patient who is fighting mechanical ventilation?
Pancuronium bromide (Pavulon)
120 to 180 mins duration
Longer duration paralytics
- Pancuronium bromide (Pavulon)
- Vecuronium
- Rocuronium (Zemuron)
The paralyzing effects of the nondepolarizing agents (pancuronium, vecuronium, and rocuronium) may be reversed with the administration of
edrophonium (Tensilon) or neostigmine (Prostigmin).
Commonly used inhaled steroids
a. Dexamethasone
b. Beclomethasone
c. Budesonide (Pulmicort)
d. Flunisolide
e. Triamcinolone acetonide (Azmacort)
f. Fluticasone propionate (Flovent)
