Respiratory

Question 1

Asthma: extrinsic atopic type 1

Answer 1

immediate response by IgE, histamine is released, usually family hx of allergies (think children)

Question 2

prognosis for Asthma extrinsic atopic type 1

Answer 2

good

Question 3

Asthma: Intrinsic (non-atopic) idiopathic type2

Answer 3

adult onset (>30yr old), chronic bronchitis, poor prognosis

Question 4

Asthma: exercised induced triggers

Answer 4

cold, hypocapnia

Question 5

early asthma response occurs within how many minutes, recovery time? cause?

Answer 5

s/s within 20 mins, recovery 60 mins, caused by IgE on mast cells

Question 6

Late asthma response occurs how soon? duration? cause?

Answer 6

3-5 hours after exposer, lasts days or weeks, caused by release of chemical mediators from mast cells, macrophages and epithelial cells

Question 7

Beta 2 Adrenergic agonist, Mexthylxanthine, Anticholinergics are all what class of drugs?

Answer 7

bronchodilators

Question 8

Beclometasone [Qvar], Fluticasone propionate [flovent]

Answer 8

inhaled steriod

Question 9

how do inhaled steroids work?

Answer 9

they bind to cytosolic glucocorticoid receptors and reduce eosinophils/mast cells in airway, they reduce histamine responsiveness

Question 10

are inhaled steroids long-term or short-term?

Answer 10

long term

Question 11

systemic corticosteroids mechanism of action

Answer 11

prevent cytokine and mediator release, inhibit IgE release, suppreses airway inflammation

Question 12

are systemic corticosteroids short term? long term?

Answer 12

short term

Question 13

Leukotriene modifier example

Answer 13

Montelukast [singulair]

Question 14

Leukotriene: MOA

Answer 14

block bronchconstriction by preventing leukotrienes from binding to receptor sites

Question 15

Leukotriene modifiers: Contraindications

Answer 15

acute bronchospasm, lactation, liver impairment

Question 16

Leukotriene modifiers: ADRs

Answer 16

neurophychiatric (stop if you see this), muscle pain, elevated LFTs

Question 17

when would you put someone on Montelukast [Singulair]? (Leukotriene modifier)

Answer 17

maintenance therapy for asthma >1 year, prevention of EIA>15 years old, allergic rhinitis

Question 18

what do Leukotriene modifiers (Montelukast [Singulair]) bind to?

Answer 18

plasma proteins

Question 19

Mast cell Stabilizers are used for acute or chronic phases?

Answer 19

chronic

Question 20

Mast cell Stabilizers: MOA

Answer 20

stop calcium influx across cell membrane from mast cell mediators, suppresses inflammatory cells

Question 21

How are mast cell stabilizers (Cromolyn) given?

Answer 21

nebulizer

Question 22

Mast cell stabilizer example

Answer 22

Cromolyn

Question 23

Beta-Adrenergic Agonists examples

Answer 23

Albuterol

Salmeterol (not given alone)

Question 24

Beta-Adrenergic Agonists MOA

Answer 24

stimulate B receptors in smooth muscle which dilated bronchi (they stimulate B1 receptors in the heart which increases HR)

Question 25

Beta-Adrenergic Agonists Contraindications

Answer 25

ischeminc heart disease, hypertension, arrhythmias, seizures, hyperthyroidism

Question 26

Beta-Adrenergic Agonists ADRs

Answer 26

increased HR, tremor, hypokalemia, hyperglycemia

Question 27

Methylxanthines

Answer 27

cause direct muscle relaxation, induce diuresis, gastric acid secretion

Question 28

Methylaxanthines exaples

Answer 28

Theophylline, Aminophylline

Question 29

how doMethylaxanthines effect the heart

Answer 29

increased cardiac output, decreased venous pressure

Question 30

Anticholinergic drug examples

Answer 30

Atrovent, spiriva

Question 31

Anticholinergic drugs (Atrovent, spiriva) are used for?

Answer 31

COPD

Question 32

Anticholinergic drugs (Atrovent, spiriva) mechanism of action and how fast does it work

Answer 32

it drys everything, blocks muscarinic cholinergic receptors in bronchi, works quickly

Question 33

Combivent, advair diskus, breo Ellipta, Symbicort, Dulera are all what?

Answer 33

combo products

Question 34

what is ok for mild asthma attacks?

Answer 34

inhaled bronchodilators (albuterol)

Question 35

what is ok for frequent attacks?

Answer 35

oral or inhaled steroids and an inhaled bronchodilator

Question 36

what is ok for EIB?

Answer 36

inhaled bronchodilators, inhaled mast cell stabilizer (Cromolyn)

Question 37

intermittent asthma

Answer 37

symptoms <2/week, <2/month at night

Question 38

mild persistent asthma

Answer 38

symptoms >2/week but <1/day, >2/month at night, Its effecting their acitivity

Question 39

moderate persistant asthma

Answer 39

daily episodes, effects activities >2/week, >1/week at night

Question 40

severe persistant asthma

Answer 40

continual s/s, frequent episodes, limits activity, frequent night episodes

Question 41

When should a steroid be introduced for pt with asthma?

Answer 41

if patient is having episodes >2/week even with beta2 agonist