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Pharmacology > Mucolytics Chap 9 > Flashcards

Mucolytics Chap 9 Flashcards

1
Q

Will mucolytics work on infected mucus?

A

no

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2
Q

What diseases increase the volume (or thickness) of mucus?

A

chronic bronchitis, asthma, cystic fibrosis, acute bronchitis, pneumonia, bronchiectasis,

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3
Q

When would you consider the use of mucolytics?

A

After patient has been adequately hydrated and has received therapy to decrease infection/ inflammation, and mucus causing irritants have been removed (like tobacco smoke)

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4
Q

Most mucolytic medications work by doing what?

A

irritating the airway and making the patient’s cough

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5
Q

Are goblet cells innervated?

A

no

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6
Q

What provides mucin along the airway surface?

A

submucosal glands

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7
Q

There are approximately _____ goblet cells in every square millimeter of normal airway

A

6000

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8
Q

T/F The sympathetic system controls submucosal glands

A

false

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9
Q

What is the physical composition of mucus?

A

95% water, 3% protein and carbohydrates, 1% lipids

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10
Q

Mucus forms______________ chains

A

polypeptide chains

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11
Q

What type of cells form mucosa?

A

pseudostratified columnar ciliated epithelial cells, goblet cells, serous cells and clara cells

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12
Q

The mucocilliary blanket lines the airways from the ____ to the _______.

A

nose to the terminal bronchi

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13
Q

What function do the cilla perform?

A

move mucus up the airway, protect lungs from inhaled debris

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14
Q

There are approximately ____ cilia per cell and they beat ____ times per minute.

A

up to 200 that beat 1000 x/min

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15
Q

T/F The mucosa is innervated.

A

false

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16
Q

T/F the submucosa is innervated

A

true

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17
Q

Which layer contains bronchial glands that produce the most mucus, and what is the daily production?

A

the submucosa; 100 mL/day

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18
Q

What are the two layers that make up the mucociliary blanket?

A

Gel, sol

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19
Q

What is the thickness of the gel layer?

A

0.5 to 20 microns

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20
Q

What is the thickness of the sol layer?

A

7 microns

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21
Q

Which layer is the top layer?

A

Gel- works like flypaper to trap debris

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22
Q

Which layer has the cilia?

A

sol layer

23
Q

Mucus is held together by ____________ bonds.

A

disulfide.

24
Q

What are factors that impair mucociliary transport?

A

diseases, infections, airway drying (moving ISB),extereme temp changes, narcotics, dehydration, ET suctioning, cig smoke, airway trauma, hyperoxia and hypoxia

25
Q

What factor does mucus have that you want to keep when considering mucus clearing?

A

stretchability- the goal should be to decrease the viscosity of the mucus without decreasing what actually keeps it together- the stretchibility

26
Q

Viscosity gives what property to mucus?

A

resistance to flow

27
Q

Elasticity gives what property to mucus?

A

property of deforming under force and then resuming shape

28
Q

What are the three approaches to secretion management?

A

1- increase the depth of sol layer (water, saline or expectorants)
2. alter the consistency of the gel layer (mucolytics)
3 Those that improve ciliary activity (brochodilators and corticosteroids

29
Q

T/F Bland aerosols affect the mucus directly

A

false- they just dilute its water content and irritate the airway

30
Q

What delivery methods are used with bland aerosol therapy?

A

SVN, LVN, USN, and direct instillation (lavage)

31
Q

Name a hypotonic solution

A

sterile water, hypotonic saline

32
Q

Name an isotonic solution

A

normal saline (0.9% sodium chloride)

33
Q

Which is more likely to cause bronchospasm, hypertonic, isotonic or hypotonic solutions?

A

In order from least to most likely- isotonic, hypotonic, hypertonic

34
Q

What is the difference between distilled water and sterile water?

A

distilled water contains no additives or minerals and is more irritating to the airways than sterile water

35
Q

Name two mucolytics

A

mucomyst, pulmozyme

36
Q

What is the mode of action for mucomyst?

A

disulfide bond breaker

37
Q

Can mucomyst be used on thick/infected secretions?

A

NO. Can’t be used on infected secretions

38
Q

What mucolytic is used to treat acetaminophen OD?

A

mucomyst

39
Q

For what disease states is mucomyst used?

A

cystic fibrosis, chronic bronchitis, tuberculosis and acute tracheobronchitis

40
Q

What is the dose for mucomyst?

A

10% sol- 3 to 5 ml TID/QID

20% sik- 3 to 5 ml TID/QID

41
Q

What are the adverse reactions to mucomyst

A

bronchospasm (more likely at 20%)

nausea, runny nose, excess watery secretions in the airway, inflammation of the mucus lining in the mouth

42
Q

T/F Mucomyst is a potent antidote that can be given via nasogastric tube

A

true

43
Q

T/F Dornase alpha is considered a maintenance drug

A

True

44
Q

T/F Dornase alpha only works on infected mucus

A

True

45
Q

T/F Dornase alpha is used to manage viscous pulmonary secretions.

A

true

46
Q

T/F Dornase alpha can be given alone or with a bronchodilator

A

false- should always be given in conjunction with bronchodilator

47
Q

T/F Dornas alpha can be mixed with albuterol

A

False. Pulmozyme must have its own nebulizer. It can’t be mixed with other drugs. Must give the bronchodilator first then the pulmozyme

48
Q

What are adverse reactions to pulmozyme?

A

voice alteration, pharyngitis, laryngitis, rash, chest pain, conjuctivitis

49
Q

How do expectorants work?

A

increase the production and expectoration of mucus by increasing the amount of fluid in the respiratory tract and stimulating cough

50
Q

Hypertonic saline, guaifenesin, terpin hydrate, ammonium chloride and potassium iodide are all examples of

A

expectorants

51
Q

What is the mode of action for antitussives?

A

depress the cough center (located in the medulla)

52
Q

What is the most common cough suppresent?

A

codeine is the most common narcotic

dextromethorphan is most common non narcotic

53
Q

What purpose does ethanol (ethyl alcohol) have on mucokinetics?

A

it denatures bubbles that occur as in pulmonary edema. the bubbles occupy less space and increase area for diffusion

54
Q

What is the mode of action for dornase alfa (pulmozyme)

A

it is a proteolytic enzyme that breaks down DNA material and decreases the viscosity of mucus

Pharmacology (14 decks)

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