Respiratory

Question 1

Class of meds that terminate asthma attack

order is important

Answer 1

Beta2-adrenergic agonists
Methylxanthines
Inhaled anticholinergics

Question 2

Beta2-adrenergic agonists

Answer 2

most common for tx for bronchoconstriction

Short-acting, intermediate-acting, long-acting

Question 3

Methylxanthines

Answer 3

long-term management of asthma with the beta agonists and anticholinergics don’t work

Question 4

Methylxanthines therapeutic index

Answer 4

narrow

Question 5

What should be avoided when on methylxanthines

Answer 5

caffeine (CNS stimulant)

Question 6

Inhaled anticholinergics

Answer 6

promote bronchodilation by blocking muscarinic ACH receptors

alternative to short-acting beta2 agonists (can also be combined with these)

Question 7

Focus for preventing asthma episodes

Answer 7

reducing inflammation

Question 8

Classes of meds that prevent asthmatic episodes

Answer 8

Corticosteroids
Mast cell stabilizers
Leukotriene Modifiers
Monoclonal Antibodies

Question 9

Corticosteroids

Answer 9

suppress the immune system

most effective

Question 10

Mast cell stabilizers

Answer 10

prevent histamine release

VIA MDI or nebulizer

Question 11

Mast cell function

Answer 11

respond to environmental triggers by releasing histamine which causes inflammation of the bronchi

Question 12

Leukotriene modifiers

Answer 12

reduce inflammation by

• blocking enzyme that controls leukotriene synthesis
• blocking leukotriene receptors

Question 13

Leukotriene function

Answer 13

promote inflammation and recruit WBCs to site of injury

Question 14

Monoclonal Antibodies

Answer 14

prevent release of histamine by mast cells differently than mast cell stabilizers

reduced frequency of asthma episodes

Question 15

Asthma

Answer 15

Characterized by bronchoconstriction and inflammation in response to environmental triggers

Question 16

Bronchocontriction

Answer 16

sudden contraction of smooth muscle causing dyspnea

with inflammatory process (thick secretions are produced) - narrows lumen

Further edema

Question 17

Chronic inflammation results in…

Answer 17

increase in airway edema
increase in mucous secretions
smooth muscle constriction in bronchioles

Question 18

Adverse effects pf beta-adrenergic

Answer 18

throat irritation
headache
anxiousness
dry mouth

tachycardia, chest pain
paradoxical bronchospasm
Allergic rxn

Question 19

Why are the order of meds taken to terminate an asthma attack important?

Answer 19

short acting bronchodilator should be given first for fast effects

Question 20

Why is a spacer used

Answer 20

If the patient has difficulty coordinating breathing with inhaler activation

increase delivery of drugs to the lungs and decrease deposition of drug on the oropharyngeal mucosa

Question 21

How long to wait between puffs of a MDI

Answer 21

1 minute

Question 22

Metered-dose inhaler (MDI)

Answer 22

pressurized devices that deliver a measured dose of drug with each activation

Hand-mouth coordination is required

Question 23

Dry-powder inhalers (DPI)

Answer 23

easier to use
drugs are in the form of dry, micronized powder
no propellant employed

Question 23

Antitussives side effects

Answer 23

Dizziness, sedation

Depression
ataxia
stupor
seizure
coma

Question 23

Antitussives

Answer 23

Manage non-productive coughs

Raise the cough thershold in the CNS

Opioids
Non-opioids

Question 24

Expectorant

Answer 24

reduce thickness or viscosity of bronchial secretions

to encourage coughing

Question 25

Mucolytics

Answer 25

Breaks down thick mucous

Question 26

When to use expectorants

Answer 26

used with caution in elderly, asthma or respiratory insuffiency

they should receive more fluids

COPD

Question 27

Nutritional therapy for COPD

Answer 27

Eat 5 to 6 small meals
Rest 30 min. before eating
Use a bronchodilator before meals
Foods that are easy to prep
Fluid 2-3L per day between meals unless they have heart failure.
Fluids should be taken between meals 
Avoid foods that cause gas
Late stage - increased calories. High calorie, high protein

Question 28

Mucolytics should be used…

Answer 28

COPD