Pharm anti-asthmatic drugs

Question 1

asthma

Answer 1

chronic inflammatory disorder of the airways

Question 2

asthma attack comprises

Answer 2

wheezing, coughing, shortness of breatj

Question 3

asthma attack symptoms:

Answer 3

bronchoconstriction, airway inflammation, edema, accumulation of mucous, smooth muscle hypertrophy

Question 4

inhalation therapy definition

Answer 4

drug delivery directly to the lungs

Question 5

advantages of inhalation therapy

Answer 5

therapeutic effects are enhanced, systemic effects are minimized, minimal enzyme degradation when compared to oral route

Question 6

devices

Answer 6

MDIs, dry powder inhalers, nebulizers

Question 7

MDI’s

Answer 7

deliver a short burst of aerosolized medicine, requires proper inhaler technique and use of a spacer

Question 8

dry powder inhalers

Answer 8

no propellant needed, easier to use, less drug deposition in the oropharynx

Question 9

drugs that are bronchodilators

Answer 9

beta agonists, anticholinergics

Question 10

anti-inflammatory agents

Answer 10

glucocorticoids, mast cell stabilizers

Question 11

Beta agonists actions

Answer 11

sympathetic nervous system= bronchodilation, agonist, beta 2 receptors are specific to the airways

Question 12

SABA= short acting beta agonist description

Answer 12

quick relief drugs (reliever/rescue inhalers, are blue)

Question 13

when are SABA’s used?

Answer 13

rapid relief during asthma attack, prevention of exercise induced bronchospasms, take only as needed, part of regimen for bronchodilation

Question 14

example of a SABA

Answer 14

albuterol (ventolin)

Question 15

SABA adr’s

Answer 15

they are rare, especially via inhaler; cardiovascular– tachycardia, hypotension; CNS– headache, nervousness, agitation

Question 16

take note of interaction between SABA’s and

Answer 16

beta blockers for HT (propanolol)

Question 17

Bronchodilators type 2: inhaled anticholinergic drugs brand types

Answer 17

ipratropium bromide (atrovent)

Question 18

ipratropium bromide action

Answer 18

parasympathetic NS stimulates bronchoconstriction, ipratropium bromide blocks this action as it is a bronchodilator and holds the airways open. It is a controller or second line medication

Question 19

glucocorticoids

Answer 19

hormones that are released from the adrenal glands (outer adrenal cortex), are steroid hormones and control glucose levels in the body. An example is cortisol

Question 20

cortisol

Answer 20

used to treat chronic stress, raises blood glucose in response to the body’s normal processes (regulating stress). Has anti-inflammatory and anti-allergy effects.

Question 21

anti-inflammatory inhaled glucocorticoids

Answer 21

agonists at glucocorticoid receptors– developed drugs to minimize glucose effects and maximize anti-inflammatory effects

Question 22

anti-inflammatory inhaled glucocorticoids work directly in…

Answer 22

respiratory tract

Question 23

anti-inflammatory inhaled glucocorticoids effects

Answer 23

suppress inflammation, block synthesis of inflammatory mediators

Question 24

example of an anti-inflammatory inhaled glucocorticoid

Answer 24

Beclomethazone (Beclovent)

Question 25

Inhaled glucocorticoids

Answer 25

used as long term control medications, prevent symptoms, prevents phophylaxis of CHRONIC ASTHMA

Question 26

color of inhaled glucocorticoid inhalers

Answer 26

brown

Question 27

inhaled glucocorticoids do not

Answer 27

resolve an acute attack

Question 28

What is the schedule to which inhaled glucocorticoids should be used?

Answer 28

use on a regular schedule, for LONG TERM CONTROL

Question 29

side effects of inhaled glucocorticoids

Answer 29

sore throat, cough, dry mouth, immunosuppressant activity= compromise normal bacterial flora, allow for opportunistic oral fungal infections (ex candidiasis)

Question 30

how to prevent candidiasis

Answer 30

use a spacer and gargle mouth with water after use

Question 31

systemic effects, rare for inhalation therapy

Answer 31

bone loss, slow growth in children

Question 32

what to tell a patient when taking glucocorticoids

Answer 32

patient should rinse mouth after use, nurse should assess sputum color and viscosity for signs of infection. If beta agonist and corticosteroid are to be used together, give beta agonist first

Question 33

status asthmaticus

Answer 33

extreme asthma exacerbation caused by hypoxemia

Question 34

how to treat status asthmaticus

Answer 34

give oxygen (decreases hypoxia), systemic glucocorticoid (decreases inflammation), nebulized SABA (bronchodilation), and nebulized ipratropium (bronchodilation)

Question 35

management of asthma

Answer 35

tests for lung function, classification of asthma severity, management of chronic asthma by avoiding asthma triggers and long term drug therapy

Question 36

education for patients with asthma

Answer 36

understanding asthma, role of medications (how they work, long term control vs quick relief, side effects), skills: inhaler use and spacer, symptom monitoring and evaluation of therapeutic effects, teach patient to have an extra supply of medication on hand and avoid triggers