Obstructive Plum pharm - Exam 1B

Question 1

albuterol & levalbuterol are what class of drugs

Answer 1

short acting Beta-Adrenergic Agonists
(bronchodilators)

Question 2

short acting Beta-Adrenergic Agonists
(bronchodilators) MOA

Answer 2

(Mimics action of SNS) relax and dilates the airways by stimulating the B2 adrenergic receptors throughout the lungs

Question 3

albuterol & levalbuterol indications

Answer 3

Prevention (exercise induce asthma) or relief of bronchospasm related COPD disorders
rescue drugs esp for asthma

Question 4

albuterol & levalbuterol SE

Answer 4

Hypertension
Hypotension
Insomnia
Restlessness
Anorexia
Cardiac stimulation
Hyperglycemia
Tremor
Vascular headache

Question 5

albuterol & levalbuterol nursing considerations

Answer 5

Short acting duration = 4-6hr (rescue drugs)

Contraindications: uncontrolled HTN, cardiac dysrhythmias, high risk of stroke (can be given w/ beta blockers but may need increased BB dose)

Avoid use with MAOis & sympathomimetics (ephedrine/Sudafed) d/t HTN risk

Raises BG

antidote: beta blockers but watch for bronchospasm

Question 6

what class are salmetrol and formoterol

Answer 6

long acting Beta-Adrenergic Agonists
(bronchodilators)

Question 7

long acting Beta-Adrenergic Agonists
(bronchodilators) MOA

Answer 7

(Mimics action of SNS) relax and dilates the airways by stimulating the B2 adrenergic receptors throughout the lungs

Question 8

salmetrol and formoterol indications

Answer 8

worsening COPD, moderate to severe asthma

Question 9

salmetrol and formoterol SE

Answer 9

Hypertension
Hypotension
Insomnia
Restlessness
Anorexia
Cardiac stimulation
Hyperglycemia
Tremor
Vascular headache

Question 10

salmetrol and formoterol nursing considerations

Answer 10

Long acting duration = 12-24 hr (prevention)

Always give long acting with a corticosteroid

Salmeterol has been associated w/ increased asthma related death

Contraindications: uncontrolled HTN, cardiac dysrhythmias, high risk of stroke (can be given w/ beta blockers but may need increased BB dose)

Avoid use with MAOis & sympathomimetics (ephedrine/Sudafed) d/t HTN risk

Raises BG

Antidote: beta blocker (but watch for bronchospasm)

Question 11

what class is Ipratropium

Answer 11

Anticholinergics
(bronchodilators)

Question 12

anticholingeric MOA

Answer 12

Blocks action of acetylcholine which turns off PNS and turns on SNS, causing bronchodilation and decreased mucus production

Question 13

Ipratropium indication

Answer 13

Used for prophylaxis and maintenance asthma therapy

Question 14

Ipratropium SE

Answer 14

Urinary retention, sedation, dizziness, confusion, hallucinations, blurred vision, dry eyes, tachycardia, feeling hot, decreased sweating, dry mouth & throat, constipation
anticholinergic affects

Question 15

Ipratropium nursing consideration

Answer 15

Often given in combination with albuterol

Not a rescue drug

Question 16

what class are Theophylline and Aminophylline

Answer 16

Xanthine Derivatives
(bronchodilators)

Question 17

Xanthine derivatives MOA

Answer 17

Increasing levels of the cAMP enzyme by inhibiting phosphodiesterase (stimulates CNS & CVD, and causes bronchodilation by relaxing the smooth muscle)

Question 18

Theophylline and Aminophylline indications

Answer 18

Preventative treatment of asthma attacks and COPD exacerbation

Question 19

Theophylline and Aminophylline SE

Answer 19

Caffeine effect,
N/V/D, insomnia, tachycardia, dysrhythmias, seizures

Question 20

Theophylline and Aminophylline nursing considerations

Answer 20

2nd line med d/t high toxicity risk and lots of drug-drug interactions

Interactions:
Caffeine (inc SE)
Smoking (dec absorb)

Question 21

Theophylline and Aminophylline antidote

Answer 21

activated charcoal

Question 22

Theophylline and Aminophylline contraindications

Answer 22

Uncontrolled cardiac dysrhythmias, seizure disorders, hyperthyroidism, peptic ulcer

Question 23

what class are Montelukast and Zafirlukast

Answer 23

Leukotriene receptor antagonist
(anti inflammatory)

Question 24

Leukotriene receptor antagonist MOA

Answer 24

LTRAs prevent leukotrienes from attaching to receptors located on immune cells and within the lungs to prevent inflammation

Question 25

Montelukast and Zafirlukast indication

Answer 25

Prophylaxis and chronic treatment of asthma Can be used for allergies

Question 26

Montelukast and Zafirlukast SE

Answer 26

Headache, nausea, dizziness, insomnia, diarrhea

Question 27

Montelukast and Zafirlukast nursing considerations

Answer 27

Montelukast can be given to kids <12mo, zafirlukast is for +5 yrs Not a rescue drug

Question 28

what class are Beclomethasone diproprionate, Budesonide and Fluticasone

Answer 28

inhaled corticosteroids (anti inflammatory)

Question 29

inhaled corticosteroids MOA

Answer 29

Reduce inflammation and enhance activity of beta agonists

Question 30

Beclomethasone diproprionate, Budesonide and Fluticasone indications

Answer 30

Prevention of persistent asthma attacks and long-term maintenance of severe COPD

Question 31

Beclomethasone diproprionate, Budesonide and Fluticasone SE

Answer 31

Pharyngeal irritation, coughing, dry mouth and oral fungal infections

Question 32

Beclomethasone diproprionate, Budesonide and Fluticasone nursing considerations

Answer 32

Takes several weeks for full effect to be reached Not a rescue drug **Usually take w/ bronchodilator, give bronchodilator first** **Be sure to take on regular schedule, not PRN** **Rinse out mouth after use**

Question 33

what class are Budesonide + Formoterol and Fluticasone + Salmeterol

Answer 33

Combination inhaled glucocorticoid & bronchodilator (anti inflammatory)

Question 34

Combination inhaled glucocorticoid & bronchodilator MOA

Answer 34

Reduce inflammation and causes bronchodilation

Question 35

Budesonide + Formoterol and Fluticasone + Salmeterol indication

Answer 35

Prevention of persistent asthma attacks and long-term maintenance of severe COPD

Question 36

Budesonide + Formoterol and Fluticasone + Salmeterol SE

Answer 36

Pharyngeal irritation, coughing, dry mouth and oral fungal infections

Question 37

Budesonide + Formoterol and Fluticasone + Salmeterol nursing consideration

Answer 37

Not a rescue drug

Question 38

what class is cromolyn

Answer 38

Mast cell stabilizer (anti inflammatory)

Question 39

Mast cell stabilizer MOA

Answer 39

Stabilizes membranes of mast cells & prevent release of broncho-constrictive inflammatory substances

Question 40

cromolyn indications

Answer 40

Used for prevention of acute asthma attacks

Question 41

cromolyn nursing considerations

Answer 41

Take 15-20 mins before encountering known trigger Not a rescue drug

Question 42

what class is Omalizumab

Answer 42

Monoclonal antibody anti asthmatic

Question 43

Monoclonal antibody anti asthmatic MOA

Answer 43

Monoclonal antibody which selectively binds to immunoglobulin IgE which **limits the release of mediator of the allergic response**

Question 44

Omalizumab indications

Answer 44

Add on therapy for asthma

Question 45

Omalizumab SE

Answer 45

anaphylaxis

Question 46

Omalizumab nursing considerations

Answer 46

Monitor closely for hypersensitivity reactions (anaphylaxis is big risk)

Question 47

what class is Roflumilast

Answer 47

Selective PDE-4 inhibitor

Question 48

Selective PDE-4 inhibitor MOA

Answer 48

Selectively inhibits PDE4 enzymes in the lung cells

Question 49

Roflumilast indication

Answer 49

Prevention of COPD exacerbations

Question 50

Roflumilast SE

Answer 50

N/V/D, headache, muscle spasms, decreased appetite, uncontrolled tremors

Question 51

Roflumilast nursing consideration

Answer 51

Not a rescue drug