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Pharm > Lower respiratory > Flashcards

Lower respiratory Flashcards

1
Q

What are two major categories of lower respiratory tract diseases

A

COPD and Restrictive Lung Disease

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2
Q

These FOUR pulmonary disorders are known as COPD

A

asthma,
chronic bronchitis,
bronchiectasis,
emphysema

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3
Q

This syndrome of chronic lung disease is OBSTRUCTIVE in nature

A

COPD

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4
Q

what is the most common risk factor for COPD

A

smoking

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5
Q

This obstructive, chronic lung disease is characterized by bronchospasm, wheezing, and difficulty breathing, and is TYPICALLY reversible

A

asthma

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6
Q

This chronic, PROGRESSIVE obstructive lung disease is usually caused by smoking or chronic lung infections

A

chronic bronchitis

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7
Q

This lung disease features bronchial inflammation, excessive mucous secretion, and productive coughing

A

chronic bronchitis

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8
Q

This lung disease causes damage to lungs that is frequently irreversible

A

chronic bronchitis

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9
Q

Abnormal expansion and dilation of the bronchi and bronchioles causes the breakdown of the bronchial epithelium, resulting in tissue fibrosis. It is often secondary to frequent inflammation or infection and is irreversible. This condition is called…

A

bronchiectasis

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10
Q

THIS progressive lung disease results from irreversible alveolar damage caused by smoking, atmospheric contaminants, or lack of the alpha1-antitrypsin protein.

A

emphysema

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11
Q

In emphysema, the terminal bronchioles become plugged with mucous. Fiber and elastin are lost. The alveoli are destroyed and air trapping occurs. What is the ultimate outcome?

A

inadequate gas exchange

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12
Q

in THIS TYPE of lung disease, there is a decrease in the total lung capacity from fluid accumulation or loss of elasticity of the lung

A

RESTRICTIVE lung disease

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13
Q

Pulmonary edema, fibrosis, lung tumors, thoracic deformities, and muscular disorders such as myasthenia gravis can be causes of WHAT

A

restrictive lung disease

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14
Q

THIS DRUG TYPE increases the production of cyclic adenosine monophosphate (cAMP), causing dilation of bronchioles

A

sympathomimetics (alpha and beta adrenergic agonists)

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15
Q

____ is a signaling molecule responsible for maintaining bronchodilation

A

cAMP

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16
Q

________ inhibit the action of cAMP, producing bronchoconstriction.

(type of nflammatory mediators)

A

HISTAMINES

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17
Q

_____________ block the action of histamines by increasing the production of cAMP

A

sympathomimetics

sympathomimetics increase the production of cAMP

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18
Q

What are two examples of sympathomimetic respiratory drugs?

A

albuterol,

metaproterenol

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19
Q

THIS DRUG is a SELECTIVE BETA 2 agonist used for treatment and control of asthma

A

albuterol

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20
Q

THIS DRUG is a non-selective beta-adrenergic agonist used for asthma treatment, but it primarily affects beta1 receptors.

A

metaproterenol

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21
Q

Beta 1 stimulation produces wwhat effect?

A

increases heart rate

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22
Q

Beta2 stimulation produces what effect

A

bronchodilation

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23
Q

When dose metaproterenol reach peak

A

1 hour

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24
Q

EXCESSIVE use of asthma inhalers may lead to…

A

tolerance,
paradoxic bronchoconstriction,
tremors, tachycardia, palpittatitons

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25
Q

albuterol drug type

A

beta 2 selective adrenergic agonist/ sympathomimetic

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26
Q

metaproterenol drug type

A

beta adrenergic agonist/sympathomimetic

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27
Q

THIS DRUG TYPE blocks muscarinic (cholinergic) receptors, inhibiting M3 receptors to produce bronchial smooth muscle relaxation

A

anticholinergics

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28
Q

What is one example of an anticholinergic used for COPD

A

tiotropium

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29
Q

tiotropium drug type

A

anticholinergic

30
Q

THIS COPD DRUG is administered only with the HandiHaler device

A

tiotropium

31
Q

THIS dry powder inhaled drug is used for maintenance treatment of bronchospasms associated with COPD

A

tiotropium

32
Q

lactose hypersensitivity, glaucoma, bladder obstruction, renal impairment, and cardiac dysrhythmias are CAUTIONS for WHICH DRUG?

A

tiotropium (an anticholinergic)

33
Q

hyperglycemia, GI obstruction, cataracts, and cardiac dysrhythmias are adverse reactions to WHICH DRUG (an anticholinergic asthma/COPD drug)

A

tiotropium

34
Q

What type of assessment should the nurse perform before tiotropium administration?

A

respiratory assessment

35
Q

Should tiotropium be used for ACUTE asthma attack?

A

no

36
Q

this DRUG TYPE used for COPD and asthma works by stimulating the CNS, to increase respirations, and to dilate coronary and pulmonary vessels. It also produces diuresis.

A

methylxanthine derivative bronchodilators

37
Q

aminophylline-theophylline drug type

A

xanthine derivative bronchodilator

38
Q

THIS DRUG relaxes smooth muscle of the bronchi, bronchioles, & pulmonary blood vessels, inhibits phosphodiesterase (a bronchoconstrictor), and increases cAMP to produce bronchodilation

cAMP is where it’s AT

A

aminophylline-theophylline

39
Q

The use of this drug for chronic asthma and COPD has declined sharply due to serious adverse effects including dysrhythmias, convulsions, and cardiorespiratory collapse

A

aminophylline-theophylline

40
Q

Which foods should be avoided with xanthines?

A

Other xanthines– coffee, tea, sodapop, pee/chocolate (will compound diuretic effects)

41
Q

What is the desired serum level of aminophylline-theophylline?

A

5-15mcg/mL

42
Q

At what concentration is aminophylline-theophylline toxicity likely to occur

A

greater than 20mcg/mL

43
Q

What is important to know about the therapeutic index of animophylline-theophylline?

A

it is narrow

44
Q

How would the aminophylline-theophylline dose be adjusted for a SMOKER?

A

higher dose

45
Q

montelukast drug type

A

leukotriene receptor ANTAGONIST and synthesis inhibitor

46
Q

__________ are chemical mediators that produces inflammatory changes in the lung, increasing mucous, producing edema, and causing bronchoconstriction

A

leukotrienes

47
Q

Are leukotriene modifiers used for acute asthma attack?

A

no

48
Q

Can montelukast be used for exercise induced assthma?

A

YES

49
Q

THIS DRUG TYPE reduces inflammatory symptoms of asthma or allergic rhinitis by inhibiting smooth muscle contraction.

A

leukotriene receptor antagonists

50
Q

Hepatic disease, depression, suicidal ideation, alcoholism, and advanced age are CAUTIONS for which drug?

A

montelukast

51
Q

Bleeding, seizures, suicidal ideation, and thrombocytopenia are adverse reactions to WHICH DRUG

A

montelukast

52
Q

Side Effects of THIS DRUG may include headache, drowsiness, restlessness, insomnia, confusion, depression, influenza, palpitations, and muscle cramps

A

montelukast

53
Q

aspirin and NSAIDs will BLOCK the action of this drug type

A

leukotriene antagonists/inhibitors

54
Q

Gemfibrozil, telithromycin, and clopidogrel will INCREASE the level of WHICH DRUG

A

montelukast

55
Q

Which labs may be affected by montelukast?

A

abnormal liver function tests

56
Q

What is one important assessment for the nurse to perform prior to montelukast therapy?

A

liver function

57
Q

THIS DRUG TYPE is indicated if asthma is unresponsive to bronchodilator therapy or if patient has an asthma attack while maxed on theophylline or adrenergics

A

glucocorticoids

58
Q

What are three glucocorticoids that may be used for asthma?

A

dexamethasone, prednisone, beclomethasone

dex
pred
bec

59
Q

How long does it take for inhaled glucocorticoids to reach maximum therapeutic effect?

A

1-4 weeks

60
Q

______ are MORE effective than beta 2 agonists because there is less risk of bronchial hyper-responsiveness.

A

glucocorticoids

61
Q

glucocorticoids administered by THIS METHOD will minimize the risk of adrenal suppression

A

INHALATION

62
Q

How should a glucocorticoid inhaler be discontinued?

A

by tapering

63
Q

Describe the side effects of inhaled glucocorticoids

A

SE are usually local rather than systemic, such as throat irritation, dry mouth, coughing, but side effects are usually not significant with short term use.

64
Q

HYPERGLYCEMIA is one adverse reaction to ___________, so diabetics will need to be monitored more closely

A

glucocorticoid inhalers

65
Q

Long term use of glucocorticoids can produce ______-like symptoms

A

Cushing

66
Q

_______ _______ is used for prophylactic treatment of asthma and has to be taken every day.

A

Cromolyn Sodium

67
Q

THIS DRUG acts by inhibiting histamine RELEASE and does not have any bronchodilator properties

A

cromolyn

68
Q

Is Cromolyn used for acute asthma attacks?

A

NO

69
Q

Drug therapy of choice for young children with asthma…

A

cromolyn and nedocromil to manage inflammatory effects.
Oral glucocorticoids for moderate to severe.
Beta-2 agonists for severe asthma.

70
Q

What should be considered in asthma treatment for older adults?

A

All asthma medications have many side effects, and care needs to be tailored to the individual.

71
Q

WHICH antibiotic can be used for acute exacerbations of chronic infectious bronchitis, if the infection is related to retained mucus?

A

TMP-SMZ (trimethoprim-sulfamethoxazole)

72
Q

beta-2 agonists may _____ blood sugar levels.

A

increase

Pharm (5 decks)

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