Ch. 40 - Asthma & Other Pulmonary Disorders

Question 1

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

Answer 1

Bronchioles

Question 2

Diameter of airways controlled by what?

Answer 2

Two branches of the autonomic nervous system & controls the amount of air entering the lungs.

Question 3

The two branches of the autonomic system that controls airways

Answer 3

Sympathetic branch
Parasympathetic branch

Question 4

Activates beta2-adrenergic receptors and causes bronchiolar smooth muscle to relax.
The airway diameter increases (bronchodilation), increasing O2 to tissues.

Answer 4

sympathetic branch of the autonomic system

Question 5

Causes bronchiolar smooth muscle to contract
The airway diameter is narrowed:
Bronchoconstriction occurs
Results in less airflow

Answer 5

Parasympathetic branch of the autonomic nervous system

Question 6

Common route of administration for pulmonary drugs

Answer 6

Inhalation/Aerosol Therapy

Question 7

The respiratory system offers what for delivering drugs?

Answer 7

A rapid and efficient mechanism

Question 8

The rich blood supply of the pulmonary system allows for what?

Answer 8

Quick absorption and onset of action
Delivers the drug directly to the sites of action

Question 9

Aerosol therapy onset of action

Answer 9

almost immediate

Question 10

Aerosol drugs administered for local effects do what?

Answer 10

Offer immediate relief of bronchospasm
Loosen thick mucus

Question 11

Side effects are reduced, but systemic effects can still occur

Answer 11

r/t aerosol therapy

Question 12

Disadvantage of aerosol therapy

Answer 12

Difficult to measure a precise dose
Side effects occur if the patient swallows the drug or does not rinse their mouth after inhalation

Question 13

A chronic disease that has both inflammatory and bronchospasm compoenets

Answer 13

Asthma

Question 14

Asthma symptoms occur when?

Answer 14

From exposure to triggers
Upon exertion (exercise-induced)

Question 15

Common triggers of asthma

Answer 15

Air pollutants
allergens
Checmicals and food
Respiratory infections
Stress

Question 16

Severe, prolonged form of asthma unresponsive to drug treatment that may lead to respiratory failure

Answer 16

Status asthmaticue

Question 17

Components of Asthma

Answer 17

Bronchospasm
Mucus Production
Inflammation

Question 18

Asthma has what two components?

Answer 18

Bronchoconstriction
Inflammation

Question 19

Goals of drug therapy for asthma

Answer 19

To terminate acute bronchospasms in progress (quick-relief medications)
To reduce the frequency of asthma attacks (long-acting medications)

Question 20

beta2-adrenergic agonists, anticholinergics, systemic corticosteroids

Answer 20

Quick-relief medications for asthma

Question 21

inhaled corticosteroids, mast cell stabilizers, leukotriene modifiers, long-acting beta2-adrenergic agonists, methylxanthines and immunomodulators

Answer 21

long-acting medications for asthma

Question 22

Most effective drugs for relieving acute bronchospasm

Answer 22

beta adrenergic agonist

Question 23

beta-adrenergic agonist prototype

Answer 23

albuterol

Question 24

beta-adrenergic agonist/albuterol MOA

Answer 24

Activate beta2 receptors in bronchial smooth muscle to cause bronchodilation

Question 25

Beta-adrenergic side effects

Answer 25

Fewer cardiac side effects than older nonselective beta-adrenergics

Question 26

Beta-adrenergic agonist duration range

Answer 26

ultrashort-long-acting

Question 27

Alternative bronchodilators occasionally used alternatively to beta-agonists in asthma therapy

Answer 27

anticholinergic drugs

Question 28

Anticholinergic/ipratropium (Atrovent) MOA

Answer 28

Block parasympathetic nervous system with bronchodilator effect

Question 29

Anticholinergic administration form for asthma

Answer 29

Inhaled

Question 30

Group of bronchodilators related to caffeine

Answer 30

Methylxanthines

Question 31

Once mainstay of chronic asthma pharmacotherapy

Answer 31

Methylxanthines

Question 32

theophylline

Answer 32

Example of a Methylxanthine

Question 33

Infrequently prescribed b/c of the narrow margin of safety, especially with prolonged use Interact with numerous drugs

Answer 33

Methylxanthines

Question 34

Potent anti-inflammatory drugs

Answer 34

Corticosteroids

Question 35

Corticosteroid prototype

Answer 35

beclomethasone

Question 36

drugs of choice for long-term prophylaxis of asthma

Answer 36

Inhaled corticosteroids

Question 37

Must be taken daily Systemic side effects rarely observed

Answer 37

Inhaled corticosteroids

Question 38

used for short-term therapy of severe, acute asthma

Answer 38

Oral corticosteroids

Question 39

Oral corticosteroids limit to therapy

Answer 39

under 10 days

Question 40

Designed to attach to specific receptor on a target cell or molecule

Answer 40

Monoclonal Antibodies

Question 41

Used for asthma prophylaxis

Answer 41

monoclonal antibodies

Question 42

Omalizumab (Xolair) approved 2003

Answer 42

monoclonal antibody example

Question 43

Omalizumab (Xolair) MOA

Answer 43

Attached to receptor on immunoglobulin E (igE)

Question 44

mediators of immune response

Answer 44

Leukotrienes

Question 45

Involved in allergic and asthmatic reactions

Answer 45

Leukotrienes

Question 46

Leukotrienes prototype

Answer 46

montelukast (Singulair)

Question 47

Primarily used for asthma prophylaxis

Answer 47

montelukast (Singulair)/leukotriene modifier

Question 48

Reduce inflammatory component of asthma

Answer 48

montelukast (Singulair)/leukotriene modifier

Question 49

used when persistent asthma not controlled with other drugs

Answer 49

oral leukotriene modifiers

Question 50

Inhibit mast cells from releasing histamine and other chemical mediators

Answer 50

mast cell stabilizers

Question 51

safe for prophylaxis of asthma

Answer 51

mast cell stabilizers

Question 52

Less effective than inhaled corticosteroids

Answer 52

mast cell stabilizers

Question 53

Ineffective at relieving acute bronchospasm

Answer 53

mast cell stabilizers

Question 54

Obstructed airflow commonly caused by: bronchitis emphysema asthma

Answer 54

COPD

Question 54

Pharmacotherapy goals of COPD

Answer 54

Relieve symptoms Avoid complications

Question 55

Bronchodilators Mucolytics and expectorants Oxygen therapy Antibiotics Roflumilast (Daliresp)

Answer 55

Drug Classes for COPD

Question 56

Used to reduce the viscosity of the bronchial mucus and to aid in its removal

Answer 56

Mucolytics and expectorants

Question 57

Assists breathing and has been shown to reduce mortality in patients

Answer 57

O2 therapy

Question 58

May be prescribed for patients with multiple bouts of pulmonary infections

Answer 58

Antibiotics

Question 59

Anti-inflammatory effects on the airways by inhibiting the enzyme phosphodiesterase-4. Oral tablet that is administered once daily

Answer 59

roflumilast (Daliresp)