Respiratory

Question 1

How do mucolytics/expectorants work?

Answer 1

Reduce viscosity of secretions making cough more efficient

Question 2

Name two mucolytics

Answer 2

Guafenesin, NAC (Mucomyst)

Question 3

Name three cough suppressant’s

Answer 3

Codeine, dextromethorphan, benzonatate (Tessalon pearls)

Question 4

What is the nickname for people who abuse dextromethorphan?

Answer 4

Syrup heads

Question 5

Define asthma

Answer 5

Hyper reactive bronchi causing chronic inflammation

Question 6

Describe what it means to say asthma is a polygenic disorder

Answer 6

Histamine, leukotrienes, and prostaglandins all play an inflammatory role

Question 7

What is a life-threatening asthma attack requiring IV steroids and potential intubation called?

Answer 7

Status asthmaticus

Question 8

Describe the three step approach to asthma treatment

Answer 8

Prevent allergen exposure, reduce inflammation/hyperactivity, dilate narrowed bronchi

Question 9

Which kind of drug is the mainstay of asthma treatment?

Answer 9

Inhaled Glucocorticoids (can also be given PO or IV)

Question 10

What is an adverse effect of glucocorticoid inhalation? How can it be prevented?

Answer 10

Thrush- gargle with water after using inhaler

Question 11

What is the benefit of using an inhaled glucocorticoid rather than another form?

Answer 11

No systemic effects and little risk of immune suppression

Question 12

What is a stress dose and when is it used?

Answer 12

Increase steroid dose in times of bodily stress due to rapid metabolism

Question 13

Which kind of drug can cause growth stunting in children?

Answer 13

Systemic steroids

Question 14

What are Cromolyn and Nedocromil?

Answer 14

Mast cell stabilizers that reduce histamine release in inflammatory reaction

Question 15

Are cromolyn and Nedocromil preventative or acute asthmatic treatments?

Answer 15

Preventative therapy (does not terminate acute attacks)

Question 16

Which type of coughs should be suppressed?

Answer 16

Useless (unproductive), and useful (productive) cough when exhausting to patient

Question 17

Name a short acting and 4 long acting B2 agonists

Answer 17

Short acting: albuterol (rescue agent)

Long acting: salmeterol, formoterol, bambuterol, salbutamol

Question 18

Which long-acting B2 agonist has the quickest onset and greatest potency?

Answer 18

Formoterol (Foradil/ Perforomist)

Question 19

Why is albuterol PO rarely used?

Answer 19

Less B2 selectivity (causes tachycardia)

Question 20

Which patients should be especially careful to avoid nonselective beta blockers, especially if on beta-2 agonists?

Answer 20

Patients with asthma

Question 21

Describe a tocolytic and give an example

Answer 21

Delays labor/delivery

Ex. Turbutaline a beta-2 agonist with effects on smooth muscle

Question 22

Name two anti-cholinergics used as adjunct in asthmatics

Answer 22

Ipratropium (Atrovent), Spiriva

Question 23

How do anti-cholinergics work to treat asthma?

Answer 23

Parasympatholytic effects cause bronchodilation

Question 24

When are Leukotriene receptor antagonists like Singulair and Accolate used?

Answer 24

Usually second line agents to MDIs (not as effective but benign adverse effects)

Question 25

Which type of (new) drug is indicated for COPD with chronic bronchitis (not emphysema)?

Answer 25

PDE-4 inhibitors

Question 26

How do PDE-4 inhibitors result in bronchodilation?

Answer 26

Increase levels of cAMP to provide long term prevention

Question 27

Name one adverse effect of PDE-4 inhibitors

Answer 27

Suicidal ideation

Question 28

Describe the physiology behind status asthmaticus

Answer 28

Causes lactic acidosis due to carbon dioxide buildup

Question 29

What is an MDI?

Answer 29

Metered dose inhalers containing active ingredient pressurized by a propellant

Question 30

Which kind of propellant is more common in MDIs now?

Answer 30

HFA’s are now used in place of CFCs, which interfere with the Ozone

Question 31

What is the attachment called in inhalers for children and elderly?

Answer 31

Spacer

Question 32

Which test can be used to determine the quantity left in an inhaler?

Answer 32

Water drop test – if it floats, it’s empty

Question 33

What is a nebulizer?

Answer 33

A device that converts solutions/suspensions of drugs into aerosols via ionization (vibrations)

Question 34

Name the combination products containing beta-2 agonist and steroid

Answer 34

Advair diskus