Respiratory Pharmacology II

Question 1

Most effective treatment of asthma consists of

Answer 1

bronchodilation and anti-inflammation

Question 2

Benefits of airway delivery

Answer 2

speedy delivery of the active compounds, delivers medication to the appropriate site, and minimizes systemic side effects

Question 3

Asthma therapy goals

Answer 3

1. achieve and maintain control of asthma symptoms
2. maintain normal activity levels, including exercise
3. maintain pulmonary function as close to normal as possible
4. prevent asthma exacerbations
5. avoid adverse effects from asthma medications
6. prevent asthma mortality

Question 4

Approach to treatment of intermittent exacerbations of bronchoconstriction

Answer 4

smooth muscle relaxation and anti-inflammatory medications

Question 5

Approach to chronic or maintenance of airway patency

Answer 5

primarily anti-inflammatory; maintenance of bronchodilation

Question 6

Approach to prevention of conditions contributing to mediator release

Answer 6

also anti-inflammatory directed at preventing mast cell degranulation or blocking action of mediators

Question 7

Delivery of medications directly to the airway mucosa by inhalation provides

Answer 7

1. provides more rapid delivery of the medication to the target tissue and 2. avoids systemic effects of the medications

Question 8

Ways to deliver bronchodilators

Answer 8

nebulizers, metered-dose inhalers, metered-dose inhalers with spacers, dry powder inhalers

Question 9

What does a nebulizer do

Answer 9

creates an aerosol from liquid medication that can be inhaled; mixes medication, solution and air or oxygen (sometimes warmed)

Question 10

What kind of patients are nebulizers generalized reserved for

Answer 10

generally reserved for patients who are unable to use an inhaler property (children, patients with COPD)

Question 11

What do inhalers do

Answer 11

aerosolize medication using a propellant from a pressurized canister

Question 12

What must you do with an inhaler before it can deliver the medication

Answer 12

the canister must be actuated to deliver the proper dose of medication (shaken and released prior to inhalation)

Question 13

COPD similarities to asthma

Answer 13

airway inflammation, bronchoconstriction, mucus plug formation

Question 14

COPD differences with asthma

Answer 14

structural changes to airway, fibrosis, acute exacerbations more likely acute inflammation than histamine or leukotriene release, recurrent infection

Question 15

4 potentially reversible causes of airflow limitation in a disease state that has largely fixed obstruction

Answer 15

1. bronchial smooth muscle contraction
2. bronchial mucosal congestion and edema
3. airway inflammation
4. increased airway secretions

Question 16

Therapeutic approach to stage I COPD

Answer 16

reduction of risk factors (influenza vaccine); short-acting bronchodilator as needed

Question 17

Therapeutic approach to stage II COPD

Answer 17

add long-acting bronchodilators; cardiopulmonary rehabilitation

Question 18

Therapeutic approach to stage III COPD

Answer 18

add inhaled glucocorticoids if repeated exacerbations

Question 19

Therapeutic approach to stage IV COPD

Answer 19

add long-term oxygen therapy; consider surgical options such as LVRS and lung transplantation

Question 20

Used more commonly than short-acting bronchodilators with COPD

Answer 20

long-acting beta-agonists and anticholinergic agents

Question 21

Not used as monotherapy and may increased risk of infection with COPD

Answer 21

inhaled steroids

Question 22

General strategies with nasal allergies

Answer 22

avoidance of triggers, antihistamines, nasal steroids, anti-leukotrienes

Question 23

first generation antihistamines

Answer 23

diphenydramine, chlorpheniramine, and hydroxyzine

Question 24

second generation antihistamines

Answer 24

fexofenadine, loratadine, certirizine

Question 25

Nasal steroids

Answer 25

mometasone, fluticasone

Question 26

decongestants

Answer 26

pseudoephedrine or phenylephrine