CH6 Respiratory Pharmacology Flashcards
Asthma is characterized by _____ airway obstruction and is associated with reduction in _____ airflow.
A) reversible; inspiratory
B) reversible; expiratory
C) irreversible; inspiratory
D) irreversible; expiratory
B) reversible; expiratory
Asthmatics trap air due to constriction of bronchiolar smooth muscle. A few hours later, inflammation occurs, resulting in an increase in secretions in the lungs and swelling in the bronchioles. Asthma is characterized by reversible airway obstruction and is associated with a reduction in expiratory airflow. The reversible airway obstruction is in contrast to chronic obstructive pulmonary disease (COPD), which is characterized by irreversible airway obstruction, which occurs with either chronic bronchitis or emphysema.
Asthma may be precipitated by (1) allergens, (2) exercise, (3) stress.
A) 1, 2, 3
B) 1, 2
C) 1, 3
D) 2, 3
A) 1, 2, 3
The dental health care worker should treat dental patients with asthma so that minimal stress is induced. Asthma may be precipitated by allergens, pollution, exercise, stress, or upper respiratory tract infection.
_____ is a concern when administering local anesthetics with sulfiting agents as a preservative for the vasoconstrictor.
A) Tardive dyskinesia
B) Bronchoconstriction
C) Tachycardia
D) Emesis
B) Bronchoconstriction
Sulfites are used in local anesthetic solutions to prevent oxidation of the vasoconstrictor. The group of people most susceptible to allergic reactions caused by sulfites includes the 9 to 11 million persons in the United States in whom asthma has been diagnosed. Sulfiting agents in local anesthetic agents with vasoconstrictor can lead to bronchoconstriction.
Patients with asthma should bring their fast-acting _____ inhaler to be used prophylactically or in the management of an acute asthmatic attack in the dental office.
A) π’-agonist
B) π΅1-agonist
C) π΅1-antagonist
D) π΅2-agonist
E) π΅2-antagonist
D) π΅2-agonist
The stimulation of ο’2-receptors results in smooth-muscle relaxation. Because the blood vessels of the skeletal muscle are innervated with ο’2-receptors, stimulation causes vasodilation. Relaxation of the smooth muscles of the bronchioles, also containing ο’2-receptors, results in bronchodilation. A fast-acting ο’2-agonist should be available to manage an acute asthmatic attack in the dental office. Signs of asthma include shortness of breath and wheezing.
Which of the following respiratory diseases is associated with irreversible airway obstruction?
A) Asthma
B) Chronic bronchitis
C) Emphysema
D) Both A and B
E) Both B and C
E) Both B and C
Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airway obstruction, which occurs with either chronic bronchitis or emphysema. Asthma is characterized by reversible airway obstruction and is associated with reduction in expiratory airflow.
Which of the following groups of medications are considered first-line treatment for chronic obstructive pulmonary disease (COPD)?
A) π΅-adrenergic agonists
B) Methylxanthines
C) Anticholinergics
D) Leukotriene (LT) antagonists
C) Anticholinergics
Inhaled anticholinergic drugs appear to inhibit vagally mediated reflexes by antagonizing the action of acetylcholine. This then causes bronchodilation. Ipratropium bromide (Atrovent) is a short-acting anticholinergic agent available for oral inhalation for people with COPD. Anticholinergics are considered first-line treatment for chronic bronchitis and emphysema, but ο’-adrenergic agonists and methylxanthines are also used to produce bronchodilation in these patients. In many instances, patients receive a combination metered-dose inhaler (MDI) with an anticholinergic drug and a ο’2-adrenergic agonist.
The drive for ventilation is stimulated by a(n) _____ in the partial pressure of _____ in the normal person.
A) depression; carbon dioxide (PaCO2)
B) elevation; carbon dioxide (PaCO2)
C) depression; oxygen (PaO2)
D) elevation; oxygen (PaO2)
B) elevation; carbon dioxide (PaCO2)
The drive for ventilation is stimulated by a rise in carbon dioxide. Swimmers are told not to hyperventilate before swimming under water for this reason. In the normal person, the drive for ventilation is stimulated by an elevation in PaCO2. The PaO2 can vary widely without stimulating ventilation in the normal patient.
Which of the following respiratory diseases is associated with irreversible airway obstruction?
A) Asthma
B) Chronic bronchitis
C) Emphysema
D) Both A and B
E) Both B and C
E) Both B and C
Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airway obstruction, which occurs with either chronic bronchitis or emphysema. Asthma is characterized by reversible airway obstruction and is associated with reduction in expiratory airflow.
Asthma is characterized by __________ airway obstruction, and chronic bronchitis by __________ airway obstruction.
A) reversible; reversible
B) reversible; irreversible
C) irreversible; reversible
D) irreversible; irreversible
B) reversible; irreversible
Asthma is characterized by reversible airway obstruction and chronic bronchitis is characterized by irreversible airway obstruction. Asthma is characterized by reversible airway obstruction. There have been many famous Olympic champions who were asthmatic. Chronic bronchitis and emphysema are forms of chronic obstructive pulmonary disease that are characterized by irreversible airway obstruction.
Which respiratory disease is characterized by destruction of lung alveoli?
A) Asthma
B) Upper respiratory tract infection
C) Chronic bronchitis
D) Emphysema
D) Emphysema
Emphysema is characterized by alveolar destruction with air space enlargement and airway collapse. Asthma is characterized by inflammation and swelling in the bronchioles. Patients with upper respiratory tract infections have inflammation and swelling as well. Chronic bronchitis is a result of chronic inflammation of the airways and excessive sputum production.
Adrenergic agonists produce bronchodilation by stimulating which type of receptors?
A) Alpha
B) Beta-1
C) Beta-2
D) Neuromuscular junction
C) Beta-2
With the development of selective π2-agonists, bronchodilation with fewer cardiac side effects can be achieved. Stimulation of alpha receptors causes peripheral vasoconstriction. Stimulation of π1-receptors causes an increase in cardiac output. Stimulation of neuromuscular junction receptors causes muscle movement.
Which of the following statements represents the primary advantage of the use of metered-dose inhalers (MDIs)?
A) The inhaled dose can be accurately measured.
B) They are difficult to use properly, and they can be abused.
C) The onset of action is unpredictable.
D) The bronchodilator effect is less than that of a comparable oral dose.
A) The inhaled dose can be accurately measured.
The inhaled dose can be accurately measured. MDIs are difficult to use properly (particularly for children) and they can be abused, with a resultant decrease in response. The onset of action is rapid and predictable (versus unpredictable response with orally administered agents). The bronchodilator effect is greater than a comparable oral dose.
A spacer is often placed between the metered-dose inhaler and the mouth to decrease the amount of drug delivered to the lungs.
True
False
False
The spacer increases the amount of drug delivered to the lungs.
Albuterol is a bronchodilator that can be administered via a metered-dose inhaler (MDI). It is recommended in prophylactically treating (preventing) chronic asthma.
A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second statement is false.
D) The first statement is false; the second statement is true.
C) The first statement is true; the second statement is false.
Albuterol (ProAir HFA, Proventil HFA, Ventolin HFA), metaproterenol (generic), levalbuterol (Xopenex HFA), and pirbuterol (Maxair Autohaler) are short-acting π2-agonists. Inhaled corticosteroids are the most effective long-term treatment for control of symptoms in all patients with mild, moderate, or severe persistent asthma. Albuterol is a bronchodilator administered via inhaler. However, it is recommended to treat acute asthma attacks, not in the prevention of asthma. One major mistake that many asthmatics make is to rely on the albuterol inhaler and omit using the steroid inhaler.
Which of the following drugs used to treat respiratory diseases carries a black box warning about a higher risk of asthma-related deaths as a result of a high number of asthma-related deaths reported with salmeterol therapy during a clinical trial?
A) Mast cell degranulation inhibitors
B) Anti-immunoglobulin E (IgE) antibodies
C) Short-acting π΅2-agonist
D) Long-acting π΅2βagonist
D) Long-acting π΅2βagonist
Long-acting π΅2-agonists are best administered in a fixed-dose combination in the same inhaler with an inhaled corticosteroid. Long-acting π΅2-agonists are combined with corticosteroid inhalers so that two different drugs, at lower doses, can be used to treat persistent asthma. Long-acting π΅2-agonists carry a black box warning.
