Exam 2 respiratory

Question 1

What is the association between nasal decongestants and epinephrine?

Answer 1

Decongestants are sympathomimetics and may enhance cardiac stimulation (tachycardia) and elevate BP

Question 2

MOA for beta adrenergic agonists

Answer 2

targets beta 2 receptors in airway - bronchodilation

Question 3

3 short acting beta adrenergic agonists

Answer 3

1. albuterol
2. levalbuterol
3. pirbuterol

Question 4

2 long acting beta adrenergic agonists

Answer 4

1. salmeterol

2. salmeterol with fluticasone (Advair) - contains a steroid

Question 5

2 diseases Advair treats

Answer 5

1. asthma

2. COPD associated with chronic bronchitis

Question 6

Name of the “reserve” drug used for patients who new better asthma medications are ineffective

Answer 6

methylxanthines - treats chronic asthma, chronic bronchitis, COPD

Question 7

MOA for methylxanthines

Answer 7

blocks phophodiesterase which increases cAMP

Question 8

main preparation of methylxanthines

Answer 8

theophylline

Question 9

4 side effects of theophylline

Answer 9

1. arrhythmias
2. tachycardia
3. seizures
4. GI effects

Question 10

Why is theophylline considered a red flag drug in dentistry?

Answer 10

Causes CNS stimulation (nausea/vomiting), adverse cardiac effects, and increasing risk for seizures when mixed with certain antibiotics and or system antifungals

Question 11

Specifically what antibiotics and antifugal cause a reaction when mixed with theophylline?

Answer 11

erythromycin
Cipro
clarithromycin
doxycycline
Antifungal = ketoconazole

Question 12

Why are glucocorticoid medications used to manage asthma?

Answer 12

Reduce inflammation and decrease frequency and severity of asthma attacks

Question 13

MOA for glucocorticoids treating asthma

Answer 13

reduce cytokine production and inhibit accumulation of basophils/eosinophils/leukocytes

Question 14

What is the name of the 1st OTC intranasal steroid?

Answer 14

Nasacort

Question 15

3 main dental considerations associated with inhalers

Answer 15

1. taste alterations
2. candidiasis
3. overuse can lead to hyper-reflexive airway

Question 16

4 main dental considerations associated with steroids

Answer 16

1. candidiasis
2. susceptibility to infection
3. delayed wound healing
4. adrenal suppression

Question 17

What chemical mediators produce a similar effect to histamine?

Answer 17

Leukotrienes (bronchoconstrictors)

Question 18

Name 3 medications primarily used for seasonal allergies and are associated with leukotrienes

Answer 18

1. Accolate - blocks leukotriene receptors
2. Singulair - blocks leukotriene receptors
3. Zyflo - Inhibits leukotriene synthesis

Question 19

MOA for anti-tussive medications

Answer 19

depresses cough center in medulla, chemical relative of morphine - lacks narcotic properties except in overdose

Question 20

generic name for anti-tussive medications

Answer 20

dextromethorphan

Question 21

generic name for expectorants?

Answer 21

guaifenesin

Question 22

MOA for expectorants?

Answer 22

irritation of stomach while stimulating respiratory fluid (lubricates) decrease mucus viscosity

Question 23

What drug may contribute to pulmonary disease is given too much?

Answer 23

Oxygen - may induce apnea/acute respiratory failure

Question 24

What disease: recurrent bronchial SM spasm, inflammation, swelling of bronchial mucosa, hypersecretion of mucous?

Answer 24

Asthma - widespread narrowing of airways, decreased ventilation with increased airway resistance, and decreased expiratory outflow

Question 25

What is the most common type of asthma and what causes it?

Answer 25

Extrinsic - inhaled seasonal allergens, seen in children and young adults, IgE mediated

Question 26

Intrinsic asthma makes up 30% of cases, what is it associated with?

Answer 26

Endogenous causes like emotional stress or GERD, normal IgE levels

Question 27

Besides extrinsic and intrinsic, what are 4 other types of asthma?

Answer 27

1. drug induced 2. food allergens 3. exercise induced 4. infectious asthma

Question 28

5 common drugs that may induce asthma

Answer 28

1. ASA 2. NSAIDS 3. cholinergics 4, beta blockers 5. ACE inhibitors

Question 29

What 3 things make up the aspirin hypersensitivity triad?

Answer 29

1. aspirin hypersensitivity 2. asthma 3. nasal polyps

Question 30

MOA for aspirin allergy

Answer 30

inhibits bronchodilating PGE2 and the formation of leukotrienes

Question 31

Name for persistent life threatening bronchospasm despite drug therapy/intervention?

Answer 31

Status Asthmaticus - attack lasts for more than 24 hours

Question 32

In Status Asthmaticus, dyspnea, cyanosis, fall in systolic pressure with inspiration all occur, what are 4 end points?

Answer 32

1. exhaustion 2. severe dehydration 3. peripheral vascular collapse 4. death without intervention

Question 33

6 symptoms of asthma

Answer 33

1. shortness of breath 2. wheezing 3. expanded chest 4. sinusitis 5. failure to grow 6. thick stringy mucous

Question 34

If you get asthma attacks about twice a week, what classification would that be?

Answer 34

Moderate (mild = only when exposed to trigger, and severe = frequent or ongoing)

Question 35

medication for mild persistent asthma

Answer 35

anti-inflammatory drug with low dose inhaled corticosteroid

Question 36

What level of asthma would get one medium dose of inhaled corticosteroid or 2 daily medications

Answer 36

Moderate persistent asthma

Question 37

What level of asthma would get daily high dose inhaled corticosteroids with long acting bronchodilator?

Answer 37

severe persistent asthma