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DNURS 836 Advanced Pharmacology for Anesthesia II > Respiratory Medications - Quiz 5 > Flashcards

Respiratory Medications - Quiz 5 Flashcards

1
Q

What is the technique for using Inhalers?

A

Slow Deep Breath over 5 seconds, Hold for 10 seconds, then Blow all out

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2
Q

What is the problem w/ using a Metered Dose Inhaler?

A

Only 12% gets to lungs, even less w/ ETT

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3
Q

How much more med is needed w/ a Nebulizer vs. an MDI?

A

6-10x more needed

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4
Q

How should Bronchodilators & Corticosteroids be adminstered?

A

Bronchodilators BEFORE Corticosteroids

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5
Q

Which Muscarinic Receptors are Stimulatory?

A

M1, M3, M5

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6
Q

Which Muscarinic Receptors are Inhibitory?

A

M2 & M4

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7
Q

What are the effects of Inhaled Atropine?

A

↓Airway Resistance

&

↑Dead Space

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8
Q

Which COPD meds contain Glycopyrrolate?

A

Seebri

Lonhala

Bevespi

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9
Q

When is Glycopyrrolate NOT indicated?

A

Acute COPD Symptoms

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10
Q

Which meds are Short Acting Muscaranic Antagonists (SAMA)?

A

Atropine

Glycopyrrolate

Ipratropium

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11
Q

What are the advantages of using Ipratropium?

A

Minimal Systemic Absorption

No Bronchodilator Tolerance

More effective for Chronic Bronchitis/Emphysema

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12
Q

What are the disadvantages of using Ipratropium alone vs. a Beta Agonist?

A

Slower Onset (30-90 min)

&

Less Effective

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13
Q

How does Tiotropium (Spiriva) work?

A

Blocks M1 & M3 Muscarinic Receptors

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14
Q

What does Tiotropium (Spiriva) do?

A

Bronchdilation

&

↓Secretions

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15
Q

How does Aclidinium compare to Tiotropium?

A

Faster Onset to Peak

Take BID vs Daily

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16
Q

Aclidinium + Formoterol = ?

A

Duaklir

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17
Q

Which meds are Long Acting Muscarinic Antagonist (LAMA)?

A

Tiotropium

Aclidinium

Umeclidinium

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18
Q

What are side effects of Inhaled Anticholinergics?

A

Glaucoma

&

Urinary Retention

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19
Q

What is the Gold Standard for treating Acute Bronchospasms?

A

Beta 2 Agonists

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20
Q

What gives Beta-2 Agonist their long duration of action?

A

They’re Non-Catecholamines - resistant to COMT

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21
Q

What is the advantage of using newer Inhaled Beta-2 Agonists at therapeutic doses?

A

Relax Bronchial Smooth Muscle WITHOUT stimulating the Heart

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22
Q

What are Inhaled Beta-2 Agonists used for?

A

Treats & Prevents Acute Asthma

↑Airflow

↑Exercise Tolerance

Tocolytic Therapy

Treats Hyperkalemia

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23
Q

How long do Short Acting Beta 2 Agonist (SABA) last?

A

3-6 hours

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24
Q

How long do Long Acting Beta 2 Agonists (LABA) last?

A

> 12 hours

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25
Q

Which pressors have Beta-2 effects, but also a lot of Non-Respiratory side effects?

A

Ephedrine

&

Epinephrine

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26
Q

Which med was reapproved to treat Mild Asthma?

A

Primatene Mist - Inhaled Epinephrine

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27
Q

What is the preferred Beta-2 Agonist for Acute Bronchospasms?

A

Albuterol

Onset: 15 min

Peak: 1 hour

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28
Q

What is the R-Enantiomer of Albuterol?

A

Levoalbuterol (Xopenex)

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29
Q

Which Beta-2 Agonists were used as Tocolytics?

A

Terbutaline

&

Ritodrine

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30
Q

Which meds are Long Acting Beta 2 Agonists (LABA)?

A

Salmeterol

Vilanterol

Formoterol

Aformoterol

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31
Q

Which meds are Short Acting Beta 2 Agonists (SABA)?

A

Albuterol

&

Levoalbuterol

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32
Q

What are the side effects of Inhaled Beta 2 Agonists?

A

Tremors

Tachycardia

Hyperglycemia

Hypokalemia

Hypomagnesemia

33
Q

What is the Black Box Warning for Long Acting Beta 2 Agonists?

A

DONT USE ALONE - ↑Asthma Death

34
Q

What does Cromolyn do?

A

Prevents Histamine Release & Secretory Response

Does NOT Relax Bronchial Smooth Muscle or treat Acute Asthma

35
Q

Which meds are Methylxanthines?

A

Theophylline/Aminophylline

Caffeine

Theobromine

36
Q

What do Methylxanthines do?

A

Stimulate CNS

↑BP

↑Contractility

↑HR

Relax Smooth Muscles

37
Q

How does Methylxanthines work?

A

Non-Selectively Inhibits PDE

&

Competes for Adenosine Receptors

38
Q

What is Theophylline used for?

A

Treats Acute Asthma & Premie Apnea

39
Q

What side effects would you see with Theophylline levels of 15-25 mcg/mL?

A

GI Upset

&

Tremors

40
Q

What side effects would you see with Theophylline levels of 25-35 mcg/mL?

A

Tachycardia

&

PVCs

41
Q

What side effects would you see with Theophylline levels over 35 mcg/mL?

A

V-Tach

&

Seizures

42
Q

What does Caffeine do?

A

Stimulate CNS

Cerebral Vasoconstrictor

Secrete Gastric Acids

43
Q

What is Caffeine clinically used for?

A

Premie Apnea

PDPH

Offset Sedation from Cold Medicine

44
Q

What happens when Histamine binds to the H1 Receptors?

A

GI & Respiratory Smooth Muscle Contraction

Pruritis

Sneezing

Vasodilation

↓HR

Coronary Vasoconstriction

45
Q

What are the CV effects of activated H1 & H2 Receptors by Histamine?

A

↑Capillary Permeability

Hypotension

Tachycardia

Flushing

Headache

46
Q

What happens when H2 Histamine Receptors are activated?

A

↑cAMP

↑Gastric H+ Ion

↑Myocardial Contractility

↑HR

Coronary Vasodilation

47
Q

Which Histamine receptors need to be blocked to completely block Vasodilation?

A

H1 & H2

48
Q

What is the Triple Response (Wheal & Flare) regarding Histamines?

A

Edema

Dilated Arteries - Flare

Pruritis

49
Q

How does the H1 Histamine Receptor affect the Airway?

A

Bronchial Constriction

50
Q

How do H2 Histamine Receptor affect the Airway?

A

Bronchial Relaxation

51
Q

Histamine Receptor Antagonists are both _____ & ______

A

Histamine Receptor Antagonists are both COMPETITIVE & REVERSIBLE

52
Q

How do Histamine Receptor Antagonist work?

A

Keeps the receptor in Inactive Form, but does NOT Inhibit Histamine Release

53
Q

What are the differences b/t 1st Gen H1 Blockers vs 2nd Gen H1 Blockers?

A

1st Gen: Sedating & Non Selective

2nd Gen: Non-Sedating

54
Q

What are the effects of 1st Gen H1 Blockers?

A

Sedation

Anticholinergic Effects

Tachycardia

QT Prolongation

Dysrhythmias

55
Q

What are H1 Blockers used for?

A

Allergies

Pretreats Bronchospasms

Itching

Antiemetic

Sedation

56
Q

Which meds are 2nd Gen H1 Blockers?

A

Cetirizine

Levocetirizine

Loratidine

Fexofendaine

57
Q

What is the Outer Layer of the Adrenal Cortex & What does it release?

A

Zona Glomerulosa - Releases Mineralocorticoids

58
Q

What is the Middle Layer of the Adrenal Cortex & What does it release?

A

Zona Fascicula - Releases Glucocorticoids

59
Q

What is the Inner Layer of the Adrenal Cortex & What does it release?

A

Zona Reticularis - Releases Weak Androgens

60
Q

What causes a release of Cortisol?

A

Stress

61
Q

What does Aldosterone do?

A

Mineralocorticoid that

↑K+ Excretion

↑Na+ & Water Retention

↑Blood Volume

62
Q

Cortisol levels are ____ in the AM and ____ in the PM

A

Cortisol levels are HIGH in the AM and LOW in the PM

63
Q

What is Addison’s Disease?

A

Primary Adrenocortical Insufficiency - Adrenals dont secrete Cortisol or Aldosterone at all

64
Q

How is Addison’s Disease managed?

A

Replacement therapy including Glucocorticoids AND Mineralocorticoids

65
Q

What causes Secondary Adrenocortical Insufficiency?

A

Chronic Steroid Use

&

Supressed HPA Axis

66
Q

How is Secondary Adrenocortical Insufficiency managed?

A

Replacement therapy of ONLY Glucocorticoids

67
Q

What do Corticosteroids INCREASE?

A

CO

RR

GLuconeogensis

Pain Tolerance

68
Q

What do Corticosteroids DECREASE?

A

Inflammation

Immune System

Digestion

69
Q

What are Synthetic Glucocorticoids?

A

Prednisone, Prednisolone, Methylprednisolone

Betamethasone

Dexamethasone

Triamcinolone

70
Q

Which med is a Synthetic Mineralocorticoid?

A

Fludrocortisone

71
Q

How much more potent is the Anti-Inflammatory effects of Dexamethasone & Betamethasone compared to Cortisol?

A

25x more Potent w/ ZERO Sodium Retaining effects

72
Q

Which meds are Inhaled Corticosteroids?

A

Fluticasone

Beclometasone

Mometasone

Budesonide

Cicleonide

73
Q

What are the Endocrine Side effects of Steroids?

A

HPA Axis Supression

Cushing’s

Hyperglycemia

74
Q

What are the CV Side Effects of Steroids?

A

Dyslipidemia

HTN

Thrombosis

Vasculitis

75
Q

What are the CNS Side Effects of Steroids?

A

Cataracts

Glaucoma

Mood Changes

Psychosis

Cerebral Atrophy

76
Q

How do Steroids affect Fat Distribution?

A

Buffalo Hump

Moon Face

Skinny Arms & Legs

77
Q

How do Steroids affect blood levels?

A

↑Hct

&

↑WBC

78
Q

How should steroids be prescribed to avoid HPA Axis Supression?

A

Every Other Day & Less than 3 Weeks

DNURS 836 Advanced Pharmacology for Anesthesia II (12 decks)

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