ch 37

Question 1

Status asthmaticus

Answer 1

emergency-prolong asthma attack
several mins -hr

Question 2

intrinsic and extrinsic asthma

Answer 2

intrinsic no history of allergens
extrinsic history of asthma

Question 3

Management of asthma

Answer 3

Step1-abuterol
Step 2-low dose corticosteroid
Step3-low dose corticosteroid and long acting beta
Step4- preferred medium dose
Step5-high dose

Question 4

Short-acting beta agonist (SABA) inhalers

Answer 4

albuterol (Ventolin)
levalbuterol

Question 5

Long-acting beta agonist (LABA) inhalers

Answer 5

salmeterol (Serevent)

Question 6

Beta-Adrenergic Agonists

Answer 6

Used in treatment and prevention of acute attacks
Used in hypotension and shock
Contraindications
-Uncontrolled hypertension
Cardiac dysrhythmias
High risk of stroke (because of the vasoconstrictive drug action)

Question 7

Nonselective adrenergics

Answer 7

Stimulate alpha, beta1 (cardiac), and beta2 (respiratory) receptors
Example: epinephrine (EpiPen)

Question 8

Selective beta2 drugs

Answer 8

Stimulate only beta2 receptors
Example: albuterol (Must not be used too frequently)
and levalbuterol (Never to be used for acute treatment)

Question 9

Nonselective beta-adrenergics

Answer 9

Stimulate both beta1 and beta2 receptors
Example: metaproterenol

Question 10

MDI vs Nebulizer

Answer 10

Meter dose inhaler-inhalation
Nebulizer-A nebulizer turns liquid medicine into a mist to help treat your asthma

Question 11

Salmeterol-long acting

Answer 11

COPD and Asthma
never for acute treatment
no more than twice daily

Question 12

anticholinergics

Answer 12

Bronchchonstriction is prevented anticholinergics bind to ach receptors
-dry mouth,nasal congestion,urinary retention,headache,gi distress
-Dry mouth and irritation of pharynx-combivent & ipratropium most common adverse effect

Question 13

Xanthine Derivatives

Answer 13

caffeine and theophylline
-increased cAMP levels, smooth muscle relaxation, bronchodilation, and increased airflow
Mild to moderate cases of acute asthma

increased blood flow to the kidneys (diuretic effect)
+INTROPIC
adverse effects
Cardiac effects
Extrasystole-extra beats
increase urination

Question 14

Xanthine Derivatives: Theophylline

Answer 14

most used
Aminophylline: intravenous (IV) treatment of patients with status asthmaticus who have not responded to fast-acting beta agonists such as epinephrine
-Therapeutic range for theophylline blood level is 10 to 20 mcg/mL
Most clinicians now advise levels between 5 and 15 mcg/mL.
Interacting foods include charcoal-broiled, high-protein, and low-carbohydrate foods.

Question 15

Leukotriene Receptor Antagonists (LTRAs

Answer 15

LTRAs prevent leukotrienes from attaching to receptors on cells in the lungs and in circulation.
-By blocking leukotrienes- decreases mucus secretions
montelukast -long term prevention of asthma
see results in 1 week

Question 16

Corticosteroids

Answer 16

Used for chronic asthma
May take several weeks before full effects are seen
Inhaled are used daily to prevent attacks
budesonide
fluticasone -most used inhaler not for acute treatment
-Monitor glucose levels
adverse effects- coughing Oral fungal infections