Exam 3: Respiratory Meds

Question 1

What is the action of a mucolytic?

Answer 1

breaks bonds of mucus to be less viscous and smaller

Question 2

What is the prototype drug for mucolytic class?

Answer 2

Acetylcysteine/Mucomyst

Question 3

What drug is acetylecysteine the antidote for?

Answer 3

Acetaminophen

Question 4

What pt diagnosis would mucomyst be contraindicated in?

Answer 4

Pt with asthma
explanation: Bronchospasm may occur in asthmatics; nebulized solution

Question 5

What effects could Mucomyst have on a patient?

Answer 5

N/V due to rotten egg odor
sticky coating on face after nebulization

Question 6

What is the action of an expectorant or bronchomucotropic?

Answer 6

helps to liquify (reduce viscosity)/increase volume of secretions by irritating GI system and stimulates nerve endings AKA gastropulmonary reflex

Question 7

What is the prototype drug for expectorant class?

Answer 7

guaifenesin/Robitussin/Mucinex

Question 8

What teaching should the nurse give a patient taking an expectorant?

Answer 8

increase water intake because the medication draws fluid from body

Question 9

T/F:Guaifensin causes GI ulcers.

Answer 9

False

side effects are rare and has occasional GI irritation but not enough to cause ulcers

Question 10

Which of the following is a sympathomimetic non selective bronchodilator?
A: epinephrine
B: Isoproterenol
C: Albuterol
D: Ipratropium

Answer 10

Epinephrine

non-selective does all sympathetic things

stimulates Alpha, Beta 1 and 2

Question 11

Which of the following best describes how Epinephrine is administered?

1: IM
2: breathing tube
3: SQ
4: Oral
A) 1 and 2
B) 1,2,3
C) 1
D) None of the above

Answer 11

B

Cannot be given orally because it will be destroyed by enzymes

Question 12

What effects does epinephrine have on the body?
1: vasoconstricttion to reduce edema
2: Stimulates HR and force of contraction
3: induces bronchial smooth muscle relaxation
4: none of the above

Answer 12

1, 2, 3

Alpha: vasconstriction
Beta 1: heart
Beta 2: lungs

Question 13

What are side effects the nurse may expect from their patient after using their epi pen?
A: headache
B: Tachycardia
C: tremors
D: Dyspnea
E: All of the above

Answer 13

E

Question 14

A pt with what diagnosis would epi administration be contraindicated? Select all that apply.
A: liver failure
B: Kidney problems
C: HTN
D: CAD
E: Hyperthyroidism

Answer 14

C, D, E

Question 15

What medication should be avoided when using epi?

Answer 15

MAO Inhibitors

will cause severe HTN

Question 16

Which of the following is a sympathomimetic non-selective Beta stimulator bronchodilator?
A: Epinephrine
B:Isoproterenol
C: Albuterol
D: Ipratropium

Answer 16

B

Question 17

What action does Isoproterenol have on the body?

Answer 17

stimulates Beta 1 and 2

heart and causes bronchodilation and decreases tone and motility of GI tract and uterus

Question 18

Which of the following are side effects of Isoproterenol?
A: tachycardia and palpitations
B: headache
C: Nausea
D: tremors
E: insomnia
F: All of the above

Answer 18

F

Question 19

How is isoproterenol administered?

Answer 19

IV and inhalation

Question 20

T/F: The nurse can expect her patient to be discharged with isoproterenol.

Answer 20

F

only seen in inpatient settings, commonly ICU and long term use decreases efficacy

Question 21

What is the classification of albuterol?

Answer 21

sympathomimetic selective beta 2 stimulator

beta 2 only stimulates the lungs

Question 22

What effects can the nurse observe in her patient after the administration of albuterol?

Answer 22

opens airways

relaxation of smooth muscles

Question 23

What type of inhaler is albuterol?

Answer 23

Short acting, used for acute treatment of episode

“rescue inhaler” “inhaler” lasts longer than epi but onset is slower

Question 24

Which type of inhaler should be administered first: SABA or LABA

Answer 24

SABA

give fastest acting first to open airways and LABA to prevent constriction

Question 25

What is ipratropium?

Answer 25

Anticholinergic bronchodilator, an inhlaed short acting muscarinic antagonist (SAAMA)

Question 26

Which patient would the provider prescribe ipratropium (Atrovent)? A) COPD B) Asthma C) SOB

Answer 26

COPD

Question 27

What is the action of ipratropium?

Answer 27

blocks cholinergic receptors, reducing bronchial tone ## Footnote cholinergic=constrict/ rest and digest

Question 28

What are the side effects of Atrovent?

Answer 28

dry mouth, pharyngeal irritation

Question 29

What is the prototype for methylated xanthine?

Answer 29

Aminophylline (Theophylline)

Question 30

What is the action of aminophylline?

Answer 30

directly affects smooth muscle for relaxation through inhibition of phosphodiesterase allowing increased cAMP ## Footnote phosphodiesterase is needed to make cAMP

Question 31

What is another drug in the category of methylated xanthine?

Answer 31

caffeine

Question 32

What parts of the body does the methylated xanthine class stimulate?

Answer 32

heart, CNS, renal excretion, and medullary respiratory center

Question 33

What are the ADRs of Aminophylline?

Answer 33

GI: anorexia, N/V (stimulates vomiting center), abdominal discomfort CNS: nervousness, insomnia, irritability, headache, severe convulsions, and coma CV: tachy, severe-- hypotension and arrhythmias Urinary frequency

Question 34

T/F The half life of aminophylline is shorter in non smokers than smokers.

Answer 34

F