CH 40: Asthma and pulmonary Flashcards

1
Q

muscular, elastic structures whose diameter, or lumen, varies with the contraction or relaxation of smooth muscle.

A

bronchioles

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2
Q

bronchioles are regulated by:

A

SNS and PNS

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3
Q

causes bronchiolar smooth muscle to relax, the airway diameter to increase, and bronchodilation to occur

A

beta2-adrenergic receptors

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4
Q

sympathetic branch activates:

A

beta2-adrenergic receptors

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5
Q

parasympathetic branch causes:

A

bronchiolar smooth muscle to contract, the airway
diameter to narrow, and bronchoconstriction to occur

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6
Q

some of the most frequently prescribed drugs for treating pulmonary disorders

A

bronchodilators

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7
Q

chronic pulmonary disease with inflammatory and bronchospasm components.

A

asthma

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8
Q

stimulates the secretion of histamine and other inflammatory mediators, which increases mucus and edema in the airways

A

acute inflammatory response

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9
Q

the most common chronic illness in childhood, accounting for 13.8 million missed school days each year.

A

asthma

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10
Q

goal of pharmacotherapy for asthma

A

Stop bronchospasm
Reduce the frequency of asthma attacks

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11
Q

preferred drug for relief of acute symptoms

A

SABAs for bronchodilation

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12
Q

alternate drugs for those who cannot tolerate SABAs

A

anticholinergics for bronchodilation

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13
Q

oral drugs are used for short periods to reduce the frequency of acute exacerbations

A

corticosteroids: systemic for anti-inflammatory

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14
Q

preferred drugs for long-term asthma management
oral doses may be requires for severe, persistent asthma

A

corticosteroids: inhaled

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15
Q

alternative drugs to control mild, persistent asthma or exercise-induced asthma

A

mast cell stabilizers

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16
Q

alternative drugs to control mild, persistent asthma or as adjunctive therapy with inhaled corticosteroids

A

leukotriene modifiers

17
Q

used in combination with inhaled corticosteroids for prophylaxis of moderate to sever persistent asthma

A

LABAs

18
Q

used in combination with inhaled corticosteroids for prophylaxis of mild to moderate persistent asthma

A

methylxanthines

19
Q

used of adjunctive therapy for patients who have allergies and severe, persistent asthma

A

immunomodulators

20
Q

albuterol (SABAs) therapeutic effects

A

Bronchodilation
Act on beta2 in the lungs
Also act on beta1 in the heart
Rescue drug for an acute attack
Facilitates drainage of mucus
Inhibits release of other inflammatory chemicals from mast
cells

21
Q

albuterol (SABAs) adverse effects

A

Headache,
dizziness,
tremor,
nervousness,
throat irritation,
drug tolerance
Tachycardia,
dysrhythmias,
hypokalemia,
hyperglycemia,
paradoxical bronchoconstriction,
increased risk for asthma-related death (LABAs)

22
Q

albuterol (SABAs) what to monitor and precautions

A

assess respiratory status before and after
advise patients not to use LABAs for rescue medication

23
Q

inhaled ipratropium (anticholinergics) therapeutic effects

A

Treatment of chronic asthma
Block the PNS and stimulates the SNS that results in
bronchodilation

24
Q

inhaled ipratropium (anticholinergics) adverse effects

A

Headache,
cough,
dry mouth,
bad taste,
paradoxical bronchospasm
Pharyngitis,
paradoxical bronchospasm,
worsening of urinary retention

25
Q

inhaled ipratropium (anticholinergics) what to monitor

A

Dry mouth,
headache,
cough,
GI distress,
and anxiety
Assess respiratory status before and after

26
Q

inhaled ipratropium (anticholinergics) safety precautions

A

When administered with other inhalation medication, adminster adrenergic bronchodilators first

27
Q

Methylxanthines/ Theophylline (LABA) adverse effects

A

Nervousness,
tremors,
dizziness,
headache,
nausea,
vomiting,
anorexia
Tachycardia,
dysrhythmias,
hypotension,
seizures,
circulatory failure,
respiratory arrest

28
Q

Methylxanthines/ Theophylline (LABA) what to monitor and safety

A

Nervousness and insomnia
Interactions with other drugs
Have a narrow safety margin

29
Q

Most potent of anti-inflammatory substances

A

Corticosteroids (glucocorticoids)

30
Q

mediators of the immune response that are involved in allergic and asthmatic reactions.

A

leukotrienes

31
Q

Beclomethasone (Inhaled Corticosteroids) therapeutic effects

A

Prevention of asthma attacks
Decrease activation of inflammatory cells
Diminish mucus production and reduce airway obstruction

32
Q

Beclomethasone (Inhaled Corticosteroids) adverse effects

A

Hoarseness,
dry mouth,
cough,
sore throat
Oropharyngeal candidiasis,
hypercorticism,
hypersensitivity reactions

33
Q

Beclomethasone (Inhaled Corticosteroids) what to monitor and safety

A

Hoarseness and oropharyngeal candidiasis
Adrenal gland atrophy,
PUD
Hyperglycemia
Growth retardation in children
cataracts
Can mask the signs and symptoms of infection

34
Q

montelukast (leukotriene modifier) therapeutic effects

A

prevention of asthma attacks
prevents airway edema

35
Q

montelukast (leukotriene modifier) adverse effects

A

Headache,
nausea,
diarrhea,
throat pain,
weight loss (roflumilast)
Liver toxicity (zileuton),
increased AST,
psychiatric events including suicidality (roflumilast)

36
Q

montelukast (leukotriene modifier) what to monitor and safety

A

Respiratory status
Changes in behavior
Rash
Oral candidiasis
Suicidal ideation and depression
Steven johnson syndrome
NOT FOR ACUTE ATTACKS

37
Q

designed to attach to a specific receptor on a target cell or molecule.
treating asthma and COPD

A

monoclonal antibodies

38
Q

treatment of COPD

A

There is no cure – treat the symptoms and slow progression of the disease
encourage patient to stop smoking