Respiratory

Question 1

First Generation: Diphenhydramine, Dimenhydrinate, Chlorpheniramine and Doxylamine

2nd Generation: Loratidine, Fexofenadine, Desloratadine and Cetirizine

CLINICAL USE: Allergy

ADVERSE EFFECTS:
Sedation
Antimuscarinic
2nd Generation - far less sedating

Answer 1

H1 Receptor Blockers (Antihistamines)

Question 2

Antihistamine NR

Answer 2

Avoid Alcohol
Advise to avoid Driving
Administer with food or milk
Increase Oral intake

Question 3

To decrease inflammation or Edema
Beclomethasone, Fluticasone, Mometasone and Budesonide

Answer 3

Intranasal Corticosteroids

Question 4

Topical / Oral Route

Promote Constriction of vessels and decrease in mucosal edema and airway resistance

Pseudoephedrine, Phenylephrine and Oxytazoline

Answer 4

a - Adrenergic Agonist

Question 5

COUGH:

DRUG: Guaifenesin

ACTION: Facilitates the clearing of RR Mucus

SE:
Dizziness
Drowsiness
Headache
Rash
GI Upset

Answer 5

CLASS: Expectorant

Question 6

COUGH:

DRUG: Acetylcysteine

ACTION: Thins and loosens mucus

SE:
Bronchospasm
Rash
GI Upset

Answer 6

CLASS: Mucolytic

Question 7

COUGH:

DRUG: Dextromethorphan and Butamirate

ACTION: Depresses medullary cough center

SE:
Decrease Ciliary activity
Constipation
Dizziness
Drowsiness

Answer 7

CLASS: Antitussive

Question 8

COUGH NR

Answer 8

Evaluate lung sounds to determine if secretions are being removed

Assess frequently and nature of cough

Observe signs of deoendency

Warn patient about engaging in activities that require mental alertness

Question 9

Chronic Inflammatory disease of the airway characterized by increased airflow obstruction which is reversible and airway hyper responsiveness

Answer 9

Asthma

Question 10

Characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases

Answer 10

Chronic Obstructive Pulmonary Disorder

Question 11

Block effect of acetylcholine on M3 receptor and relax smooth muscle

Answer 11

Anticholinergics

Question 12

Stimulate B2 receptors thus relax airway smooth muscle

Answer 12

Beta 2 agonists

Question 13

B2 Agonist:

Bronchodilation is maximal at 1.) __ Minutes and persists for 2.) __to__ hours

Long Acting Beta agonist:
3.) Must always be with inhaled corticosteroids

4.) May used as monotherapy

Answer 13

1.) 15 minutes

2.) 3-4 Hours

3.) Asthma

4.) COPD

Question 14

Exact MOA controversial antagonize bronchoconstriction thru phosphodiesterase inhibition in smooth muscle non broncho dilatory effects

Answer 14

Methylxanthines

Question 15

Short Acting: Salbutamol and Terbutaline
Long Acting: Salmeterol, Formoterol, Indacaterol and Bambuterol

Reliever

Relaxes Airway smooth muscle and inhibit release of mediators for bronchoconstriction

Preferred Reliever for Asthma: ICS + Formoterol

Answer 15

B2 Agonist

Question 16

B2 Agonists SE:

Answer 16

Tremors
Palpitations
Tachycardia

Question 17

Reliever

Relaxes smooth muscle and reduces inflammation

Narrow Therapeutic index

Answer 17

Methylxanthines

Question 18

Short Acting: IPRATROPIUM
Long Acting: TIOTROPIUM

Prevent contraction of airway smooth muscles and decrease mucus secretion

Answer 18

Anticholinergic Drugs

Question 19

Methylxanthines SE:

Answer 19

Nervousness into Convulsions

Tachycardia into Arrhythmia

Question 20

Poor absorption to circulation and poor entry to CNS

Answer 20

IPRATROPIUM

Question 21

Controller

Anti inflammatory effect

Reduces bronchial hyperreactivity

Reduce Frequency of exacerbation

Decrease airway obstruction

Route: Inhalation, oral or parenteral

Answer 21

Corticosteroids

Question 22

Corticosteroids SE:

Answer 22

Oropharyngeal Candidiasis

Hoarseness

Osteoporosis, cataracts

Question 23

Corticosteroids NR

Answer 23

Drug doses must not be missed

Do not stop abruptly

Question 24

1.) Prevents Leukotriene synthesis

2.) Prevents binding of leukotriene to receptors

Answer 24

1.) Zileuton
2.) Montelukast / Zafirlukast

Question 25

Not as effective as low dose ICS for control

Used for aspirin induced asthma

Answer 25

Leukotriene Inhibitors

Question 26

Leukotriene Receptor Antagonists:

5-Lipoxygenase Inhibitor:

Answer 26

Montelukast / Zafirlukast

Zileuton