Exam 4- Gas Exchange

Question 1

albuterol (Proventil)

Class and MOA

Answer 1

Class: Beta-2 Adrenergic Agonists- SABA
MOA: selectively binds to and stimulates beta 2-adrenergic receptors in bronchial smooth muscle causing bronchodilation

Question 2

Albuterol (Proventil)

AE 4, contraindications 1

Answer 2

AE
* Sympathomimetic effects
* hypokalemia
* arrhythmia/tachycardia
* paradoxical bronchospasm
Contra: Cardiac issues

Question 3

ipratropium (Atrovent)

Class and MOA

Answer 3

Class: Anticholinergic Drugs- SAMA
MOA: Block the parasympathetic nervous system, which results in actions similar to those of stimulating the sympathetic nervous system… cause bronchodilation

Question 4

ipratropium (Atrovent)

ADE 3, monitor 1

Answer 4

ADE: cough, xerostomia (dry mouth), nervousness/dizziness
Monitor: pulmonary function before and after administration

Question 5

theophylline (Theo-Dur)

Class and MOA

Answer 5

Class: Methylxanthine
MOA: bronchodilation and decreased airway sensitivity to histamine, adenosine, and allergens by increasing cAMP

Question 6

theophylline (Theo-Dur)

ADE 3, cautions 1, and interactions 3, monitor 1

Answer 6

ADE: dysrhythmias, seizures, circulatory failure (shock)
Cautions: cardiac problems
Interactions: caffeine, tobacco, marijuana
monitor: serum drug levels

Question 7

fluticasone (Flovent)

class, MOA, therapeutic affects 2

Answer 7

Class: inhaled corticosteroids
MOA: inhibits multiple inflammatory cytokines
Ther: decrease airway inflammation, diminished mucus production and edema

Question 8

fluticasone (Flovent)

ADE 4, monitor 1

Answer 8

ADE: rhinitis, cough, sore throat, oral/esophageal fungal infections
Monitor: growth effects in pediatric patients

Question 9

montelukast (Singulair)

Class, MOA

Answer 9

Class: Anti-inflammatory Controllers: LTRA
MOA: selectively binds to leukotriene receptors

Question 10

montelukast (Singulair)

ADE, reports, age

Answer 10

ADE: neuropsychiatric disorders/suicidality; Pulmonary/hepatic eosinophilic infiltration
Reports: neuropsychiatric disorders( suicidality, aggressive behavior, hallucinations, depression, and others)
Age: 2+

Question 11

diphenhydramine (Benadryl):

Class, MOA

Answer 11

Class: H1 Antagonists
MOA: Blocks central/ peripheral H1 receptors

Question 12

diphenhydramine (Benadryl):

AE 2, key point 1

Answer 12

AE: drowsiness, dizziness
Key point: on BEERS

Question 13

fluticasone (Flonase)

Claass, MOA

Answer 13

Class: IntraNasal Glucocorticoids
MOA: decrease the secretion of inflammatory mediators, reduce tissue edema, cause mild vasoconstriction

Question 14

fluticasone (Flonase)

AE 2, teach 2

Answer 14

AE: epistaxis (nosebleed), nasal septal perforation
Teach: Must use daily! Symptom relief takes at least 1 to 3 weeks

Question 15

pseudoephedrine (Sudafed)

Class, MOA

Answer 15

Class: AR Relievers: phenethylamine and amphetamine
MOA: activates adrenergic receptors causing nasal mucosa vasoconstriction

Question 16

pseudoephedrine (Sudafed)

AE 2, contra 2, caution 1, key point 1

Answer 16

AE: arrhythmia, HTN
Contra: Severe HTN/CAD
Caution: kidney/liver impairment
Key: potential for misuse

Question 17

dextromethorphan (Delsym, Robitussin DM)

Class, MOA

Answer 17

Class: Antitussives (Cough Suppressants)
MOA: Suppresses the medullary cough center

Question 18

dextromethorphan (Delsym, Robitussin DM)

AE 2, Interactions 5, key points , teach 1

Answer 18

AE: Serotonin syndrome, abuse potential
Interactions: grapefruit juice, ETOH, antihistamines, antidepressants, and opioids (nearly doubles opioid analgesic effect)
Key: abuse risk
teach: increase fluids

Question 19

guaifenesin (Mucinex)

Class, MOA

Answer 19

Class: Expectorants and Mucolytics
MOA: increases volume and decreases viscosity of respiratory tract secretions

Question 20

guaifenesin (Mucinex)

AE 1, key point 1

Answer 20

AE: nephrolithiasis
Key: most effective in dry nonproductive cough

Question 21

MDI

1 teaching

Answer 21

Metered Dose Inhaler
* Hand held pressurized device, requires hand/lung coordination. Wait 1 min between puffs

Question 22

DPI

Answer 22

Dry Powder Inhaler
* timing of drug delivery and inhalation do not have to be coordinated, more medication is delivered to the lung

Question 23

budesonide (pulmicort)

class

Answer 23

Class: inhaled corticosteroid

Question 24

budesonide (Rhinocort) is the same as what?

Answer 24

Flonase