Pulmonary

Question 1

What is the purpose of bronchodilators?

Answer 1

counteract bronchial hyper-responsiveness

Question 2

What is bronchial hyper-responsiveness?

Answer 2

exaggerated response of bronchial smooth muscle that creates restriction of breathing

Question 3

Triggers for bronchial hyper-responsiveness?

Answer 3

environmental factors: air quality, air temperature

exercise interactions with pulmonary disorders

Question 4

What are the two goals of treatment for pulmonary diseases?

Answer 4

target inflammatory response, mucus secretion

Question 5

Bronchodilator mechanism of action?

Answer 5

promote relaxation of smooth muscle fiber

smooth muscle contraction mediated by blocking receptors and cellular responses to irritation within ANS

Question 6

What are the 3 categories to be considered for bronchodilators?

Answer 6

sympathomimetics
methylxanthines
parasympatholytics (Anti-Cholenergic agents)

Question 7

Metered dose inhaler (MDI) administration?

Answer 7

use spacer between MDI and mouth, exhale, squeeze just after slow inspiration starts, inhale completely, hold breath 3-5 sec, repeat x 3 with 15-30sec pause between puffs

Question 8

What are 2 common sympathomimetics?

Answer 8

epinephrine HCl (adrenaline) and Albuterol

Question 9

What is epinephrine HCl (adrenaline)?

Answer 9

naturally occurring agent, useful in ED for acute disorders

Question 10

How is epinephrine HCl (adrenaline) administered?

Answer 10

sub-Q or inhalation

Question 11

What are side effects of epinephrine HCl (adrenaline)?

Answer 11

systemic:

fast pounding HR, dizziness, flushing, headaches, nervousness, inc BP

Question 12

What are adverse effects of epinephrine HCl (adrenaline)?

Answer 12

acute HTN and arrhythmia

Question 13

This selective beta agonist works on bronchiole smooth muscle in airways to produce dilation.

Answer 13

Albuterol

Question 14

This non-selective B agonist produces sympathetic “fight or flight” response.

Answer 14

epinephrine HCl (adrenaline)

Question 15

What is Albuterol used to manage?

Answer 15

manage or prevent sudden onset or bronchospasm

Question 16

side effects of Albuterol?

Answer 16

anxiety, nervousness, headache, insomnia, dizziness, temor, palpitations, irritability

Question 17

What are three well known methylzanthines?

Answer 17

caffeine
theophylline
theobromine

Question 18

All three classes of bronchodilators have influence on which system?

Answer 18

ANS

Question 19

Atrovent (ipratroprium bromide) is in which class? What is the effect?

Answer 19

anti-cholinergic: blocks Ach receptors resulting in bronchial smooth muscle relaxation

Question 20

What are the 3 umbrellas of treatment for COPD?

Answer 20

Bronchodilators
mucolytics
antiinflammatories

Question 21

What do Mucolytics do?

Answer 21

decrease viscosity of mucous and enhance its clearance from the lung

Question 22

What is the mechanism of mucolytics?

Answer 22

break disulfide bonds of glycoprotein (mucus)

Question 23

What types of patients often use mucolytics?

Answer 23

CF

COPD accompanied by thick secretions

Question 24

Mechanism of action for Beconase/Beclomethasone? (4 elements that DJ really wants us to know!)

Answer 24

dec # of inflammatory cells moving into bronchial structures, inhibits bronchoconstriction, produces smooth muscle relaxation, dec mucus secretions.
Is an anti-inflammatory medication

Question 25

Cromolyn-sodium is effective for what?

Answer 25

prophylactic management, is an anti-inflammatory medication