Respiratory Drugs

Question 1

Xanthines cause bronchodilation by increasing levels of energy producing substance cAMP. Competitively inhibit phosphodiesterase, the enzyme responsible for breaking down cAMP. (higher cAMP contributes to smooth muscle relaxation and inhibits Ig-E induced chemical mediators

Answer 1

Animophylline

Question 2

Prodrug of theophylline, that is metabolized to theophylline in the body

Answer 2

aminophylline

Question 3

Sometimes given to patients with status asthmaticus that haven’t responded to fast acting b-agonists such as epinephrine

Answer 3

aminophylline

Question 4

Adverse effects such as nausea, vomiting, anorexia, GI reflux, transient urination and hyperglycemia, and cardiac AE.

Answer 4

Xanthine derivatives

Question 5

Consist of plant alkaloids caffeine, theobromine, and theophylline

Answer 5

Xanthine derivatives (natural)

Question 6

Increase the levels of cAMP

Answer 6

xanthine derivatives

Question 7

Potential overdose of xanthine derivatives

Answer 7

charcoal

Question 8

Method for taking respiratory corticosteroid meds

Answer 8

shake, inhale, rinse mouth. Should use aerochamber

Question 9

Important patient teaching to rinse mouth and gargle with warm water after admin. to prevent development of oral fungal infections.

Answer 9

Fluticasone

Question 10

If taking a b-agonist bronchodilator, the bronchodilator should be taken several minutes before to provide bronchodilation before admin. of corticosteroid.

Answer 10

Fluticasone patient teaching

Question 11

Drugs used in treatment of acute asthma attack

Answer 11

Short acting b2-agonists (sympathomimetics)

Question 12

Inhaled ipratropium treatment for

Answer 12

acute asthma attack

Question 13

inhaled corticosteroids and LABA (specifically budesone and formoteral - Symbicourt use)

Answer 13

acute asthma attack

Question 14

Corticosteroid adverse effects

Answer 14

Irritation, dry mouth, oral fungal infections
Can affect any organ (systemic)

Question 15

The nurse is teaching a group of patients about the use of bronchodilators. It is important to remind them that using bronchodilators too frequently can cause which AE? select all
a) blurred vision
b) increased heart rate
c) decreased heart rate
d) nausea
e) nervousness
f) tremors

Answer 15

b, d, e, f

Question 16

What health teaching must the nurse provide to a patient on leukotriene agonist therapy?
a) if a dose is missed, the patient may take double the dose to maintain therapeutic blood levels
b) the patient should gargle or rinse mouth after taking
c) the drug should be taken at the first sign of bronchospasm
d) improvement should be seen within one week of use

Answer 16

d) improvement should be seen within 1 week of use

Question 17

Which drug acts by blocking leukotrienes, thus reducing inflammation in the lungs?
a) salbutamol
b) methylprednisalone
c) theophylline
d) montelukast

Answer 17

d) montelukast

Question 18

A patient is experiencing status asthmaticus. What priority drug should the nurse prepare to administer?
a) salbutamol
b) epinephrine
c) theophylline
d) montelukast

Answer 18

b) epinephrine

Question 19

Which adverse effect should the nurse monitor for a patient taking parenteral xanthine derivatives, such as aminophylline?
a) decreased respirations
b) hypotension
c) tachycardia
d) hypoglycemia

Answer 19

c) tachycardia

Question 20

A patient who is taking a B-adrenergic agonist for bronchodilation may also take which type of inhaled drug for it’s anti-inflammatory effects?
a) corticosteroid
b) anticholinergic
c) xanthine derivatives
d) antileukotriene

Answer 20

a) corticosteroids

Question 21

A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. Which medication will the nurse choose for this situation?
a) a b-agonist
b) a leukotriene receptor agonist, such as montelukast
c) a corticosteroid, such as fluticasone
d) an anticholinergic, such as ipratropium

Answer 21

a) a b-agonist

Question 22

After a nebulizer treatment with the b-agonist salbutamol, a patient reports feeling a little “shakey”, with slight tremors of the hands. The patients heart rate is 98 bpm, increased from the pretreatment rate of 88 bpm. The nurse knows that this reaction is a result of which effect?
a) an expected AE of the med
b) an allergic reaction from the med
c) an indication that he has received an overdose of the med
d) an idiosyncratic reaction to the med

Answer 22

a) an expected AE of the med

Question 23

A patient has been recieving an aminophylline (xanthine derivative) infusion for 24 hrs. The nurse needs to observe for which adverse effects when assessing the patient during the infusion?
a) CNS depression
b) sinus tachycardia
c) increased appetite
d) temporary urinary retention

Answer 23

b) sinus tachycardia

Question 24

During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast (Singular), the nurse will tell the patient that the drug has which therapeutic effect?
a) improves the respiratory drive
b) loosens and removes thickened secretions
c) reduces inflammation in the airway
d) stimulates immediate bronchodilation

Answer 24

c) reduces inflammation in the airway

Question 25

After a patient takes a dose of an inhaled corticosteroid such as fluticasone (Flovent), what is the most important action the patient needs to do next?
a) hold the breath for 60 seconds
b) rinse mouth with water
c) follow the corticosteroid with a bronchodilator inhaler if ordered
d) repeat the dose in 15 min if feeling SOB

Answer 25

b) rinse the mouth with water

Question 26

The nurse is teaching a patient about the inhaler Advair (Salmeterol and fluticasone). Which statements by the patient indicate a correct understanding of this medication? select all
a) I will rinse my mouth with water after each dose
b) I need to use this inhaler whenever I feel SOB but make sure its not less than 4 hrs between doses
c) this medication is taken twice a day, every 12 hrs
d) I can take this inhaler if I get SOB while exercising
e) I will call my doctor if I notice white patches inside my mouth

Answer 26

a, c, e