Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Exam 1 > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Which two volatile anesthetics do NOT reduce bronchomotor tone?

A

desflurane and nitrous oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

which three volatile anesthetics have a favorable effect on bronchomotor tone?

A

isoflurane
sevoflurane
halothane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which three IV anesthetics have a favorable influence on bronchomotor tone?

A

propofol
ketamine
midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what makes up the conduction zone?

A

upper airways: mouth, nose, pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the respiratory zone?

A

lower airways: bronchioles, alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What nervous system controls the respiratory system?

A

Vagus/PNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What occurs when M3 receptors are activated?

A

bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are substance P and neurokinin A?

A

substances that cause neurogenic inflammation and broncoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How long do short acting beta 2 agonists last? (according to stoelting)

A

4-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F long acting beta agonists should be prescribed if short acting beta agonists are used greater than twice a week

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does a beta agonist work?

A

causes stimulators G protein to activate adenylate cyclades converting adenosine triphophate into cyclic adenosine mono phosphate (cAMP) which decreased calcium and leads to smooth muscle relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do long acting beta agonists last longer than short acting?

A

lipophilic side chain allows a slow, steady release of medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the most common side effects of a beta 2 agonist?

A

tremors, tachycardia, hyperglycemia, hypokalemia, and hypomagnesmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes beta 2 agonist tolerance?

A

down regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is ipratropium?

A

short acting anti cholinergic, anti muscarinic commonly used as maintenance therapy for COPD (blocks muscarinic receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is tiotropium?

A

the ONLY long acting anti cholinergic available for COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are common side effects of anti cholinergics?

A

dry mouth, urinary retention, constipation, pupillary dilation, and blurred vision
can’t see, can’t pee, can’t spit, can’t shit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is fluticasone?

A

inhaled corticosteroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is montlukast?

A

leukotriene modifiers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is cromolyn?

A

mast cell stabilizer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is theophylline?

A

methylxanthine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are side effects of theophylline?

A

common: headache, nausea, vomiting, restlessness, abdominal discomfort, GERD, Diuesis
severe: seizures, cardiac dysrhythmias, and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is an undesired side effect of ketamine?

A

increase in salivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is an additional measure that can be taken, last resort to cause broncodialation?

A

Magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does nitric oxide work?

A

non cholinergic PNS nerves release onto airway smooth muscle which causes relaxation; thus, broncodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What nerve innervates control of the airway smooth muscle?

A

vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What cholinergic receptor interested the respiratory system?

A

M3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

substances that could lead to bronchoconstriction:

A

histamine
prostaglandins
leukotrienes
platelet activating factor
bradykinin
substance P
neurokinin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

T/F COPD is reversible

A

FALSE

30
Q

What is the primary cause of COPD?

A

Smoking

31
Q

how long does a productive cough have to be present to be characterized as chronic bronchitis?

A

3 months in each of 2 successive years

32
Q

What is emphysema?

A

permanent enlargement of the airspaces distal to the terminal bronchioles

33
Q

copd treatment:

A

education/smoking cessation
short acting bronchodialators
long acting bronchodialators
rehab
inhaled steroids
oxygen
surgery

34
Q

what is asthma?

A

allergen triggers/histamine inflammatory mediators that cause episodic attacks of bronchospasm, inflammation, edema, and mucus production

35
Q

clinical manifestations of asthma:

A

expiratory wheezing, dyspnea, non productive cough, prolonged expiration, tachycardia, tachypnea

36
Q

An asthma attack can lead to:

A

status asthmaticus which is a bronchospasm not reversed by usual measures

37
Q

T/F neromuscular blockades are a first line treatment of status asthmaticus

A

FALSE

38
Q

What are the 4 histamine releasing medications that should be avoided in patients with bronchoconstricting diseases?

A

atracurium, succs, morphine, merderidine

39
Q

What is the beta blocker of CHOICE for individuals with lung disease?

A

Esmolol (beta1 selective)

40
Q

asthma management:

A

SABA
ICS
LABA
Theophylline
daily systemic steroid

41
Q

Where are the M3 receptors located?

A

lower airways (12-16 generation of bronchiole tree)

42
Q

How do inhaled steroids work?

A

stabilize mast cells by preventing degranulation + production of cytokines

43
Q

How do Leukotriene modifiers work?

A

inhibits histamines which prevents airway inflammation pathways

44
Q

Where do anticholinergics work?

A

M3 receptor

45
Q

When should inhalers be d/c’ed and continued after surgery?

A

they should be continued the morning of and be restarted immediately

46
Q

Albuteral dose:

A

nebulized 2.5mg OR 90mcg/puff 2-3 puff

47
Q

whats the difference between albuterol and levoalburerol?

A

levoalbuterol is a clockwise enatomer that causes less tachycardia

48
Q

Salmeterol dosage:

A
49
Q

What is the LABA black box warning?

A

can cause fatal or near fatal asthma attacks when NOT used in conjunction with a SABA

50
Q

What is a side effect of inhaled anesthetics?

A

prolonged QT: increased risk for cardiac arrhythmias

51
Q

Theophylline MOA:

A

inhibits phosphodiasterase -> increases cAMP -> decreases calcium
releases endogenous catecholaminsa
inhibits adenosine receptors

52
Q

Methylxanthine side effects:

A

> 20mcg/ml: n/v, diarrhea, headache, sleep disturbances
30mcg/ml: seizures, tachy dysrhythmias, CHF

53
Q

when should methylxanthine be discontinued prior to surgery?

A

the evening before

54
Q

What is an anesthesia specific consideration for methylxanthine?

A

check a serum level

55
Q

inhaled corticosteroids are preferred over systemic because:

A

they have less systemic side effects being absorbed directly in the respiratory system

56
Q

Side effects of inhaled corticosteroids:

A

oral pharyngeal canditis
easy bruising
osteoporosis
increased intraocular pressures

57
Q

How long should an individual be on systemic corticosteroids?

A

no greater than 2 weeks
3-10 days/no taper

58
Q

side effects of systemic corticosteroids:

A

htn, hyperglycemia, adrenal suppression, increased infections, cataracts, dermal thinning, psychosis

59
Q

Inhaled corticosteroids MOA:

A

acts on bronchioles- stimulate intracellular steroid receptors which decreases inflammatory protein synthesis

60
Q

Anticholinergics/cholinergic antagonist MOA:

A

act on m3 receptor to decrease tone.

61
Q

T/F Anticholinergics are used for maintenance therapy

A

FALSE

62
Q

T/F Ipratropium is similar to atropine but doesn’t cross BBB which decreases neuro side effects

A

TRUE

63
Q

Ipratropium dose:

A

200unit/inhal 2 puffs QID

64
Q

what is the ONLY long acting anti cholinergic used for treating COPD?

A

tiotropium

65
Q

Which surgery necessitates pretreating with anticholinergics?

A

Gi surgery: large amount of vagal stimulation

66
Q

What is the MOA of leukotriene modifiers?

A

inhibits 5-lipoxygenase enzyme- decrease leukotriene synthesis which decreases bronchospasm, vasoconstriction, eosinophil recruitment

67
Q

T/F montelukast is used in the management of acute bronchospasm

A

FALSE

68
Q

what is the most abused methylxanthine?

A

caffeine

69
Q

When should we stop giving albuterol when pt has ETT present?

A

when tachycardia occurs

70
Q

What is our first step to breaking a bronchospasm?

A

increase volatile gas bc it is PNS innervation

Pharm Exam 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions