Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

316 Pharmacology > Exam 3: Asthma and broncoconstriction > Flashcards

Exam 3: Asthma and broncoconstriction Flashcards

1
Q

Pathophysiology of asthma

A

Chronic respiratory inflammatory disorder of the bronchial mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Exposure to asthma stimuli/trigger results in

A

Constriction of bronchial smooth muscle (bronchospasm)
Obstruction (reversible and non-reversible)
Inflammation (mucus hyper secretion, edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Common asthma triggers

A 
Allergens
Smoke 
Chemical fumes 
Exercise 
Stress 
Viral infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

IgE mediated response

A

Allergen exposure –> IgE production -> lgE binds to mast cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Subsequent exposure to allergen ->

A

Allergen bings to IgE antibody complexes causing mast cell degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mast cell degranulation vasoactive mediators

A

Vasodilation
Increased Capillary
Edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chemotactic mediators

A
  • Cellular infiltration of neutrophils, lymphocytes, eosinophils
  • Bronchospasm, mucus secretion, impaired muccociliary function, thickening of airways, increasing bronchial smooth muscle contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Asthma attack causes

A 
Bronchospasm, dyspnea, retractions
Wheezing 
Mucus secretion 
Hypoventilation 
Puplus paradoxus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mucus secretion is

A

air-trapping (hyperinflation of alveoli)- increased expiratory time, expiratory wheezing, cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hypoventilation can cause

A

Hypoxemia, hypercapnia, respiratory acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is pulses paradoxes

A

Fall of >10mmHg SBP during inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Compensatory mechanism of asthma attack

A

Tachycardia, tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Asthma attack symptoms

A 
Expiratory wheeze
Prolonged expiration 
Chest tightness/pain 
cough 
retractions 
SOB/dyspnea 
Increased HR & RR 
DECREASE SpO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Moderate distress asthma attack

A 
Accessory muscle use 
Retractions 
Nasal Flaring 
Increased HR 
Loud respiratory wheezing 
Pulsus paradoxus 
SpO2 91-95%
Cannot lie down, may need to sit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Asthma attack for infant

A

quiet cry in infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Asthma attack severe distress symptoms

A 
Tripod position 
Talking in words vs. sentences 
RR AND HR increasing 
Loud BIPHASIC wheezing 
pulses paradoxus
SpO2 < 91%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pulsus paradoxes moderate distress

A

10-20 mmhg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pulsus paradoxes severe distress

A

20-40 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Asthma attack can lead to

A

Respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptoms of respiratory failure

A 
Silent chest 
Absent wheeze 
Bradycardia 
severe hypoxemia 
diaphoresis 
agitation 
drowsiness 
Pulpus paradoxus absent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

status asthmaticus

A

Episode that is unresponsive to beta 2 agonists/first line bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to diagnose asthma

A

Pulmonary function test
Peak flow meter
Presence of cough wheezing, dyspnea, night Time symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

FEV1

A

Forced expiratory volume in 1 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

For pulmonary function test, compare FEV1 to

A

Normal value to get percentage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Peak flow meter measures

A

Peak expiratory flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what could be signs of asthma?

A

Allergies, colds lasting longer than 10 days, nocturnal cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Goal of treatment for disorders of airway flow

A

Prevent exposure to triggers that cause symptoms, to provide quick relief, and to control the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Quick relief treatment for disorders of airflow

A

Short acting beta 2 agonists
Anticholinergics
Systemic corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Controlled treatment for disorders of airflow

A

Long acting beta 2 agonists
Inhaled corticosteroids
Leukotriene modifiers

Mast cell stabilizer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Bronchodilators drug class

A

Adrenergic: short acting beta 2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Bronchodilators are

A

rescue medication for bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Bronchodilators moA

A

Selective Beta2 adrenergic agonists, sympathomimetics- imitate the effects of NE at the receptor site
Relax smooth muscle lining airways
No anti-inflammatory effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what medication
-provides quick relief of symptoms
-Use only 1-2 times per week
May prescribe for use prior to physical activity

A

Bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Albuterol moA

A

Imitates NE on Beta 2 receptor in bronchial smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Albuterol indication

A

Acute bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Administration albuterol

A

oral inhalation, nebulized, mDI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Albuterol side effects

A 
Tachycardia
Nervouseness 
Tremors 
Dizziness
Angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Albuterol contraindication

A

Allergy to drug

– tachydysrhythmia; tachycardia dur to digitalis toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Albuterol precautions

A 
Diabetes mellitus 
Hyperthyroidism 
CV disease 
Hypertension 
Angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Albuterol interactions

A

Beta blockers reduce effectiveness of beta-2 agonists
MAOI and TCAs increase hypertension, tachycardia, and angina
Increases dosing of anti diabetic drugs due to hyperglycemia effects of beta2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Albuterol is an example of a ____ beta 2 agonist

A

Short acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Example of a long acting beta 2 agonist

A

Salmeterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Salmeterol is a

A

Long acting bronchodilator, LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What medication is used for COPD due to their increased risk of asthma related deaths

A

inhaled powder, nebulized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Combined therapy with ICS

A

Salmeterol and fluticasone (Advair)
Formoterol and budesonide (Symbicort)
Formoterol and mometasone (Dulera)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Even when taking salmeterol, always keep

A

a rescue medication on hand, like albuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Drug class alternative to SABA’s for patients using beta-blockers

A

Anticholinergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Ipratropium drug class

A

Anticholinergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Ipratropium moA

A

Block EACh at parasympathetic in bronchial smooth muscle

-Bronchodilation

50
Q

Short acting bronchodilator like ipratropium prevents

A

Mucus production

51
Q

Ipratropium side effects

A

Can’t pee, can’t see, can’t spit, can’t shit
- Increased intraocular pressure in patients with glaucoma
upper respiratory infections

52
Q

Combination drug anticholinergic + short acting beta-2 agonists

A

ipratropium + albuterol (Combivent/ DuoNeb)

53
Q

Ipratropium administration

A

inhaler, nebulizer

54
Q

ipratroprium caution in patients with

A

Glaucoma
Prostatic hypertrophy
Blasses neck obstruction

55
Q

Ipratroprium is contraindicated in individuals with

A

Allergy to soy or peanuts

56
Q

Ipratropium interactions

A

Beta-2 agonists enhance bronchodilation

57
Q

Theophylline drug class

A

Xanthines

58
Q

Methylxanthine is a

A

CNS stimulant

59
Q

Theophylline moA

A

Blocks adenosine receptors and STIMULATE CNS which cause

  • relaxation of smooth muscles of the bronchioles
  • increases contractions of diaphragmatic muscles
60
Q

Therapeutic index of theophylline

A

Narrow!

10-20 mcg

61
Q

Therapeutic index Xanthines

A

5-10 mcg

62
Q

Theophylline and caffeine interaction

A

Caffine increases side effects, cigarette smoking decreases half life by 50%!!

63
Q

Side effects of theophylline

A 
Headache 
Irritability 
Restlessness 
Insomnia 
Tremors 
Seizures 
Tachycardia 
Dysrhythmias 
Nausea 
Vomiting 
Diarrhea
64
Q

Xanthines administration

A

Oral

65
Q

Xanthines patient teaching

A

Reduce or eliminate caffeine intake
have periodic levels drawn
stop is experiencing seizure or dysrhythmias

66
Q

Xanthines caution in patient with

A 
Heart disease 
Liver or Renal dysfunction 
Acute pulmonary edema 
Hyperthyroidism 
Diabetes mellitus 
Peptic ulcer disease
67
Q

Xanthines contraindications

A

Cardiac disorder that cannot withstand myocardial stimulation

68
Q

Xanthines interactions

A

Cimetidine (Tagamet), some fluoroquinolonescaffeine increase risk of toxicity

Nicotine, phenobarbital, and phenytoin (Dilantin) decrease blood level

69
Q

Corticosteroids are an effective _______ of asthma

A

long-term control

70
Q

Administration of corticosteroid

A

Oral

Inhalation

71
Q

Oral corticosteroids are used for

A

short term management of post-exacerbation symptoms

72
Q

Inhalation corticosteroids are used for

A

long term management of chronic asthma

73
Q

Corticosteroid inhalation medication used how frequently

A

once or BID

74
Q

Inhaled corticosteroid medication may be combined with

A

SADA’s and LABA’s

75
Q

Examples of corticosteroids

A

QVAR, Beconase
Pulmicort
Flovent

76
Q

Corticosteroids precautions

A

Peptic ulcer disease; diabetes mellitus; hypertension; renal dysfunction; use of NSAIDs

77
Q

Contraindications corticosteroids

A

Recent live virus immunization (oral)
Systemic fungal infection (oral)
Oral candidiasis (inhaled)

78
Q

corticosteroids interactions

A

Potassium depleting diuretics increase risk of hypokalemia
NSAIDs increase risk of GI bleedings
Effects of insulin and oral hypoglycemics are decreased.

79
Q

Inhaled corticosteroids examples

A

beclomethasone (Beconase)

fluticasone (Flovent)

80
Q

Corticosteroid, inhaled moA

A

Anti-inflammatory

Inhibits production of inflammatory mediators

81
Q

Corticosteroid, inhaled administration

A

Inhaled BID or used in nebulizer once/day
Do not shake inhaler, do not use with spacer
RINSE mouth after use

82
Q

Corticosteroids inhaled side effects

A

Hoarseness

Thrush (oral Candida, upper respiratory infections)

83
Q

Corticosteroid oral side effects

A 
suppression of adrenal function
muscle wasting
bone demineralization (osteoporosis)
hyperglycemia
peptic ulcer disease
infection
F/E imbalances (hyponatremia, hypokalemia,
84
Q

Corticosteroids oral examples

A

prednisone,

dexamethasone

85
Q

dexamethasone is also available as an

A

Ophthalmic preparation for inflammation of the eyes/conjunctivitis and as an parenteral (IV/IM) preparation, known as DECADRON

86
Q

Corticosteroids, oral used

A

Daily QOD

87
Q

Corticosteroids, oral has what type of effect? local or systemic

A

It is a systemic steroid

88
Q

Corticosteroids, oral Side effects

A 
Increase appetite 
Weight gain 
Restlessness 
Insomnia 
Mood changes, Cushing's
89
Q

cromolyn,Mast cell stabilizers control

A

Inflammation by inhibiting mast cell degranulation

90
Q

cromolyn,mast cell stabilizer example

A

Cromolyn

91
Q

cromolyn,mast cell stabilizer moA

A

Suppresses inflammation by stabilizing the cytoplasmic membrane of mast cells
– Inhibiting the release of chemical mediators

92
Q

cromolyn,mast cell stabilizer indications

A

Prophylaxis for moderate asthma

Exercise induced asthma

93
Q

cromolyn,mast cell stabilizer route

A

Nebulizer
metered dose inhaler
PO

94
Q

is cromolyn,mast cell stabilizer a bronchodilator?

A

NO! keep rescue medication on hand

95
Q

cromolyn,Mast cell stabilizer side effects

A 
Allergic reaction 
Dry mouth 
Headache 
Bitter aftertaste
Cough
tingling 
burning
96
Q

cromolyn,Mast cell stabilizer precautions

A

Liver or kidney disease

97
Q

cromolyn,Mast cell stabilizer contraindications

A

Allergy to cromolyn
CAD
Cardia disrhythmias

98
Q

cromolyn,Mast cell stabilizer interaction

A

no known interactions

99
Q

Leukotriene Modifiers is a ______ medication

A

Long term control

100
Q

Leukotriene Modifiers are used in

A

prophylaxis in exercise induced asthma and allergic rhinitis

101
Q

Leukotriene Modifiers examples

A

montelukast (Singulair)
zariflukast (Accolate)
zileuton (Zyflo)

102
Q

Leukotriene Modifiers MoA

A

Selective leukotriene receptor antagonist
–Binds to receptors in bronchial smooth muscle and macrophages in upper airway to prevent airway edema, smooth muscle contraction and inflammation

103
Q

Leukotriene Modifiers administration

A

Oral, once/day in the evening or 2 hours prior to exercise for exercise induced asthma; can mix oral granule with applesauce, rice, or ice cream

104
Q

Leukotriene Modifiers side effects

A

Headaches
Fatigue
Dyspepsia
Liver damage (zariflukast and zileuton)

105
Q

Leukotriene Modifiers precautions

A

Severe asthma

106
Q

Leukotriene Modifiers contraindications

A

Liver dysfunction
acute asthma exacerbations
status asthmaticus

107
Q

liver dysfunction that is contraindicated in Leukotriene Modifiers

A

Zileuton

Zafirlukast

108
Q

Leukotriene Modifiers interactions

A

phenobarbital and phenytoin may necessitate higher dosages
zileuton can increase levels of warfarin, theophylline, and propranolol zafirlukast can increase levels of warfarin , tolbutamide, carbamazepine, and phenytoin.

109
Q

Monoclonal anti-IgE Antibody example

A

omalizumab

110
Q

Omalizumab, Monoclonal anti-IgE Antibody indication

A

Adjunctive therapy for preventative purposes for moderate to severe asthma

111
Q

Omalizumab, Monoclonal anti-IgE Antibody moA

A

Selectively binds to free IgE thereby inhibiting the release of allergic mediators from mass cells

112
Q

Omalizumab, Monoclonal anti-IgE Antibody administration

A

Bi-monthly or monthly subcutaneous injection in provider’s office

113
Q

Omalizumab, Monoclonal anti-IgE Antibody side effects

A

Injection site run
Viral infections
upper respiratory infections
low risk for anaphylaxis

114
Q

Omalizumab, Monoclonal anti-IgE Antibody precautions

A

Potential for producing anaphylaxis

Monitory for hypersensitivity run!!

115
Q

Why are most asthma medications inhaled

A

Locally distributed to the airways
Quicker response
Lower dose required
Systemic effects minimized

116
Q

Metered dose inhaler can be used

A

With or without spacer

117
Q

Dry powder inhaler are

A

Capsules places into inhaler

118
Q

Nebulizer is a

A

Liquid aerosolized

119
Q

When a spacer is used, more

A

medication reaches its sites of action in the lungs, and less is deposited in the mouth and throat

120
Q

Administration technique for dry powder inhaler

A

Inhaled dry, micronized powder use differently

- Close your mouth tightly around the mouthpiece of the inhaler and breath in quickly, do not breathe in through nose

121
Q

Nebulizer administration technique

A

Converts a drug solution into a mist

Requires face mask or mouthpiece

316 Pharmacology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions