Chapters 35, 36

Question 1

What are two classes of antihistamines?

Answer 1

H1 and H2

Question 2

What are the main differenes amongst local and systemic nasal congestants?

Answer 2

systemic decongestants can elicit an effect in every body system. whereas local will not

Question 3

Who should not receive dextromethorphan

Answer 3

patients who have vey thick secretions with a weak cough - this can lead the patient to developing pneumonia from retained secretions. Additionally, think of patients where coughing can have negative outcomes like recent surgery

Question 4

Is chronic bronchitis reversible

Answer 4

typically not

Question 5

Which med works by inhibiting the response of M-3 receptors?

Answer 5

tiotroprium

Question 6

Which dietary instructions will you provide to your patient taking aminophylline-theophylline

Answer 6

there is an interaction between xanthines, so you need to avoid xanthine products in addition to coffee, tea, and soda

Question 7

What occurs when H1 receptors are stimulated?

Answer 7

constriction of extravascular smooth muscle and lining of nasal cavity

Question 8

How do nasal decongestants work?

Answer 8

they stimulate the alpha-adrenergic receptors to cause vascular constriction of capillaries, and a shrinkage in mucosa

Question 9

what does the term expectorate mean?

Answer 9

to cough

Question 10

What makes restrictive lung disease different

Answer 10

decreased total lung capacity due to los of elasticity

Question 11

What class of drug is tiotropoium

Answer 11

anticholinergic

Question 12

How do leukotriene receptor antagonists work?

Answer 12

binds with leukotriene receptors to inhibit smooth muscle contraction and bronchoconstriction

Question 13

What occurs when H2 receptors are stimulated?

Answer 13

increase in gastric secretions

Question 14

What makes intranasal glucocorticoids different from nasal decongestants?

Answer 14

they also have anti-inflammatory properties

Question 15

what purpose to expectorants serve?

Answer 15

loosen bronchial secretions which are eliminated by coughing

Question 16

how do sympathomimetics work for patients with bronchoconstriction

Answer 16

increased production of cAMP, which causes bronchial dilation

Question 17

for a ptaient taking tiotropium, what effects do you need to educate them to anticipate?

Answer 17

your anticholinergic effects of: can’t see, can’t pee, can’t spit, can’t sh…defecate.

Question 18

what is the serum range for theophylline

Answer 18

5-15 mcg/ml

Question 19

what is the main difference between first and second generation antihistamines?

Answer 19

first generation can cause drowsiness, dry mouth, and anticholinergic symptoms

Question 20

pulling from the knowledge of edocrine, what can intranasal glucocorticoids also do?

Answer 20

increase your blood sugar and immunosupression

Question 21

what is the best natural expectorant?

Answer 21

fluids! recommend the patient to increase their water intake if not contraindicated

Question 22

What is different about metaproterenol than albuterol

Answer 22

metaproterenol is used for long term asthma treatment

Question 23

what is the main difference in tiotropoim than additional agents

Answer 23

this is for maintenance, and not acute attacks. imperative to educate the patietn in the difference so they don’t use the wrong drug during an acute attack

Question 24

which meds will you tell your patient to avoid while taking montelukast?

Answer 24

aspirin and NSAIDs, as they can block the action of montelukast

Question 25

what are important assessments to make for a patient receiving diphenhydramine

Answer 25

1. neuro: making sure they aren’t too lethartic
   2: respiratory: make sure patinet is not in respiratory distress
2. genitourinary: urinary retention

Question 26

whta is the goal of dextromethorphan?

Answer 26

reduce viscosity of tenacious secretions nad provides an effecting but infrequent cough

Question 27

what diseases comprise of COPD

Answer 27

asthma, bronchitis, emphysema, bronchiectasis

Question 28

if oyu need to adminster a beta agonist and an additional agent, which should be administered first

Answer 28

beta agonist always first to dilate and open the airway to improve dlivery of 2nd med

Question 29

how to methylxanthine derivatives work?

Answer 29

stimulate the CNS, resiratoins, dilate coronary and pulmonary vessels and promote diuresis

Question 30

for a patient having an acute attack, what type of medication would you want to administer first?

Answer 30

IV steroids preferred over beta-agonists as they redue bronchial hyper-responsiveness