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Patho-Pharm > Patho-Pharm Exam 1 - Respiratory > Flashcards

Patho-Pharm Exam 1 - Respiratory Flashcards

1
Q

90% of respiratory illnesses are caused by what?

A

Smoking

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2
Q

What is a hyperresponsiveness of airways that is usually reversible and considered a disease of inflammation other than obstruction?

A

Asthma

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3
Q

Is asthma a disease of inflammation or obstruction?

A

Inflammation

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4
Q

Asthma is a constriction of what?

A

Bronchial smooth muscle

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5
Q

Hypersecretion of what occurs in asthma?

A

Mucous

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6
Q

Is asthma considered reversible or irreversible?

A

Reversible

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7
Q

An allergic response is an immune response T/F?

A

True

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8
Q

What immunoglobulin in involved in an asthma response?

A

IgE

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9
Q

What does IgE do to cause an immune response?

A

Binds to mast cells and drills holes in them to release histamine and leukotrienes.

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10
Q

Where are mast cells located?

A

In tissues all over the body.

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11
Q

Histamine and leukotrienes are released from what cells?

A

Mast cells

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12
Q

Edema and inflammation cause the smooth muscle of the bronchioles to do what?

A

Constrict

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13
Q

What are the usual causes of chronic bronchitis?

A

Smoking or inhaling irritants

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14
Q

Is the airway inflammation in chronic bronchitis reversible or irreversible?

A

Irreversible

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15
Q

For people with chronic bronchitis, what takes a lot of energy?

A

Breathing

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16
Q

Alveolar destruction is responsible for what condition?

A

Emphysema

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17
Q

In what condition are the “springs” broken”?

A

Emphysema

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18
Q

Is emphysema reversible or irreversible?

A

Irreversible

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19
Q

Identify the following conditions as irreversible or reversible:

Asthma
Chronic bronchitis
Emphysema

A

Asthma - reversible
Chronic bronchitis - irreversible
Emphysema - irreversible

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20
Q

What is the major cause of COPD?

A

Smoking

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21
Q

What is one bronchodilator?

A

Beta-adrenergic agonists

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22
Q

How do bronchodilators work?

A

Reduce airway constriction

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23
Q

Agonists stimulate the adrenergic receptors in what part of the autonomic nervous system?

A

Sympathetic NS

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24
Q

In what phase of asthma attack are bronchodilators used?

A

Acute

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25
Q

Which receptors in the lungs are affected by beta-adrenergic agonists?

A

B2

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26
Q

Which receptors in the heart are affected by beta-adrenergic agonists?

A

B1

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27
Q

Common side effects of beta-adrenergic agonists?

A

Palpitaions, tachycardia, tremors

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28
Q

What is the device that is used with an inhaler to deliver the appropriate amount of medication?

A

A spacer

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29
Q

Corticosteroids are used for what type of asthma?

A

Chronic

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30
Q

Do corticosteroids relieve acute asthmatic attacks?

A

No

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31
Q

Inhaled or oral forms of corticosteroids reduce systemic effects?

A

Inhaled

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32
Q

How long does it take to see effects with a corticosteroid used for asthma?

A

Several weeks

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33
Q

Corticosteroids stabilize membranes of cells to prevent the release of what stubstances?

A

Inflammatory substances

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34
Q

Corticosteroids increase the responsiveness of bronchial smooth muscle to what other bronchodilator and are commonly used in conjunction with it?

A

Beta-adrenergic agonists

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35
Q

What is the suffix for corticosteroids?

A

-sone or -olone

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36
Q

What form is usually used for a combo corticosteroid/beta-adrenergic agonist treatment?

A

Powder inhaler

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37
Q

Adverse affects of corticosteroids?

A

Pharyngeal irritation
Coughing
Dry mouth
Oral fungal infections
Decreased immune response

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38
Q

What is one thing to teach patients after the administration of inhaled steroids?

A

Rinse and spit after use

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39
Q

What is a spirometer used for?

A

Encourage deep breathing in patients after surgery or laying in bed

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40
Q

What technique of breathing is used as retraining?

A

Purse-lip breathing

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41
Q

In COPD, what happens to flatten the diaphragm to make it immobile?

A

Air gets trapped in the lungs.

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42
Q

CO2 and H2O combine to form what in the lungs and what does it cause?

A

CO2 and H2O form carbonic acid which increases systemic acidity.

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43
Q

Why is it important to push the stale air out of the lungs in emphysema?

A

To avoid respiratory acidosis

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44
Q

What breathing exercise contracts the abdominal muscles and forces the diaphragm up and aids in expelling air?

A

Pursed lip breathing

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45
Q

Weight loss and malnutrition are common with what disease condition?

A

Emphysema

46
Q

Patients on long-term oxygen therapy most commonly use what device to deliver oxygen?

A

A nasal canula

47
Q

What is the FIO2 of room air?

A

21%

48
Q

What is the increase in FIO2 for each L of O2?

A

3%

49
Q

What drug has anti-inflammatory properties, is used for chronic asthma, does not relieve acute asthma symptoms and make take several weeks for effects to be seen?

A

Corticosteroids

50
Q

What dosage forms are corticosteroids available in?

A

Oral or inhaled

51
Q

What is the MOA of corticosteroids?

A

Turn off inflammation process (immune system)

52
Q

Are corticosteroids good for long or short term control of asthma?

A

Long term

53
Q

What is the inhaled corticosteroid to know for this test?

A

Fluticasone (Flonase)

54
Q

What is fluticasone commonly combined with in powdered inhalers to treat persistent asthma?

A

Beta-adrenergic agonist (fast acting)

55
Q

Pharyngeal irritation, coughing, dry mouth and what other side effect are the result of inhaled corticosteroids?

A

Oral fungal infections

56
Q

Why are oral fungal infections caused by inhaled corticosteroids?

A

Because they depress the immune system

57
Q

How many meters of O2 can be administered through a nasal canula?

A

4 L

58
Q

When a pt needs more than 4L of oxygen, what device is needed to administer it?

A

A venturi mask

59
Q

A pt is prescribed 2 different types of inhaled medication for COPD. How long should the nurse wait to administer the 2nd medication?

A

Five minutes

60
Q

The nurse has a prescription to give a client a long-acting beta 2 agonist, two puffs, and a steroid, two puffs by metered-dose inhaler. Which medication should be administered first?

A

The bronchodilator (beta 2 agonist) should be administered first to open the bronchioles to allow the steroid to get where it needs to go.

61
Q

In an acute asthma attack, which medication should be given first?

A

Albuterol (beta adrenergic agonist)

62
Q

If a pt is being treated with a short-acting inhaled beta 2 agonist, what step in asthma treatment is this?

A

First step

63
Q

What is the typical cause of the common cold?

A

Viruses

64
Q

Why is excess mucous produced in response to a viral invasion that causes a cold?

A

From the inflammatory response in the mucosa of the upper respiratory tract to the invasion.

65
Q

Nasal mucosal irritation causes the release of what substances?

A

Inflammatory and vasoactive substances

66
Q

What is the effect of inflammatory and vasoactive substances in the nasal mucosa?

A

Dilation of the small blood vessels, causing congestion

67
Q

Treatment of the common cold is what type of therapy?

A

Empiric - because don’t know the cause, just treating symptoms

68
Q

What is an antihistamine used to treat symptoms of the common cold?

A

Diphenhydramine (Benadryl)

69
Q

In what cells are histamines stored?

A

Mast cells

70
Q

Where are mast cells located?

A

Everywhere - skin, lungs, GI tract

71
Q

Where are a low level of mast cells located?

A

Blood plasma

72
Q

T/F - An allergic release of histamine requires prior exposure to the allergen?

A

True

73
Q

Which immunoglobulin is associated with allergic reactions?

A

IgE

74
Q

What does IgE do to cause the release of histamine?

A

Drills hole in mast cell which releases histamine which binds to histamine receptors stimulating further release of histamine.

75
Q

What substance is responsible for the sneezing, coughing, wheezy, itchy, runny nose of a cold?

A

Histamine

76
Q

Vasodilation, increased capillary permeability, bronchoconstriction are the result of the release of what?

A

Histamine

77
Q

Vasodilation is associated with bronchoconstriction - T/F?

A

True

78
Q

Vasodilation is associated with decreased capillary permeability?

A

False. Vasodilation is associated with increased capillary permeability.

79
Q

Histamine acts through what receptor?

A

H1

80
Q

What is the MOA of antihistamines?

A

Block action of histamine at H1 receptor sites

81
Q

T/R - Diphenhydramine is best used palliative?

A

False. It is best used prophylactically.

82
Q

Diphenhydramine is what generation of H1 antagonists?

A

First generation

83
Q

Is diphenhydramine water or lipid soluable?

A

Lipid soluable

84
Q

What can diphenhydramine do because it’s lipid soluable?

A

Cross the blood/brain barrier

85
Q

What are the three properties of antihistamines?

A
  • Antihistaminic
  • Anticholinergic (Depressed acetyl choline, a neurotransmitter)
  • Sedative
86
Q

Second generation antihistamines differ from first generation how?

A
  • Much less sedation
  • Cross blood-brain barrier poorly
87
Q

Stimulate saliva, gastric, lacrimal and bronchial secretions are the effects of what substance?

A

Histamines

88
Q

Reduced salivation, gastric secretion, lacrimal and bronchial secretions are the effects of what substance?

A

Antihistamines

89
Q

What is an anticholinergic effect?

A

Drying effect that reduces nasal, salivary, lacrimal and nasal secretions

90
Q

What drug is an anticholinergic?

A

Diphenhydramine (Benadryl)

91
Q

Anticholinergic drugs repress what neurotransmitter?

A

Acetyl choline

92
Q

What are the effects of anticholinergics?

A

Mad as a hatter
Red as a beet
Can’t see
Can’t pee
Can’t spit
Can’t shit

93
Q

What part of the autonomic NS do anticholinergic drugs mimic?

A

Sympathetic

94
Q

GI upset can be reduced with anticholinergics by doing what?

A

Taking it with meals

95
Q

2 types of coughs?

A

Production/non-productive

96
Q

What are the 2 types of antitussives?

A

Opioid and non-opioid

97
Q

Which type of cough are antitussives used for?

A

Non-productive coughs only

98
Q

Where is the cough center of the brain that is affected by opioids?

A

Medulla

99
Q

What is a big side effect of the opioid-based antitussive codeine?

A

Constipation

100
Q

Is codeine a good pain reliever?

A

No

101
Q

What is a non-opioid antitussive medication?

A

Dextromethorphan

102
Q

What is the MOA of dextromethorphan?

A

Suppress the cough center of the brain in the medulla, just like opioid-based antitussive codeine, only is non-opioid.

103
Q

Dizziness, nausea and drowsiness are adverse effects of what antitussive?

A

Dextromethorphan

104
Q

Sedation, nausea, vomiting, lightheadedness and constipation are adverse effects of what antitussive?

A

Codeine

105
Q

What is the MOA of expectorants?

A

Thin mucus

106
Q

What should patients taking guaifenesin do?

A

Drink plenty of water

107
Q

What drug reduces the viscosity of secretions?

A

Guaifenesin

108
Q

What type of laxative is polyethylene glycol?

A

Hyperosmotic

109
Q

What is the MOA of hyperosmotic laxatives?

A

Draws water into bowel from surrounding tissue

110
Q

What is the brand name of hyperosmotic laxative that is used for bowel cleansing for procedures?

A

Miralax

111
Q

How fast does Miralax, a hyperosmotic laxative, work?

A

30-60 minutes

112
Q

What is a mild hyperosmotic laxative that is used in children?

A

Glycerin

Patho-Pharm (8 decks)

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