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Respiratory System > Respiratory Pharmacology (SUDWEEKS) > Flashcards

Respiratory Pharmacology (SUDWEEKS) Flashcards

1
Q

(T/F)

Bronchial smooth muscle contains both sympathetic and parasympathetic innervation.

A

False

note: bronchial smooth muscle do not contain sympathetic neuron innervation

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2
Q

Discuss the Autonomic control of Bronchial smooth muscle:

  • Which of the following innervates bronchial smooth muscle?
    • A. Sympathetic system
    • B. Parasympathetic system
  • Which of the following causes bronchoconstriction?
    • A. Sympathetic system
    • B. Parasympathetic system
  • What type of receptors are found on bronchial smooth muscle? (2)
  • What stimulates the 2 receptors above?
A

Autonomic Control of Bronchial Smooth Muscle

  • Which of the following innervates bronchial smooth muscle?
    • A. Sympathetic system
    • B. Parasympathetic system
  • Which of the following causes bronchoconstriction?
    • A. Sympathetic system
    • B. Parasympathetic system
  • What type of receptors are found on bronchial smooth muscle? (2)
    • Muscarinic and Beta2 adrenergic receptors
  • What stimulates the 2 receptors above?
    • Ach = muscarinic receptors
    • Epi = Beta2 receptors

Sympathetic = bronchodilation

Parasympathetic = bronchoconstriction

note: Bronchial smooth muscle DONT have sympathetic neuron innervation
note: Beta2 adrenergic receptors are NOT stimulated by Norepinephrine (only Epi)

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3
Q

(T/F)

To get bronchodilation you can either use a sympathetic antagonist or parasympathetic agonist

A

False

Correct statement: To get bronchodilation you can either use a sympathetic agonist or parasympathetic antagonist

Sympathetic = bronchodilation

Parasympathetic = bronchoconstriction

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4
Q

All of the following are true regarding asthma EXCEPT:

A. Intermittent attacks of shortness of breath

B. Inflammation of the airways

C. Bronchial hyper-reactivity

D. Leads to irreversible airway obstruction

E. All of the above are true

A

D. Leads to irreversible airway obstruction

note: asthma can be caused by cold air, allergens and some drugs

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5
Q

_________ is acute severe asthma that usually requires hospitalization.

A

Status asthmaticus

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6
Q

Discuss Immediate vs Late phases of asthma:

A

Immediate phase:

  • Allergen activates mast cells
  • cysLTs and chemotaxins are released
  • cysLTs causes bronchospasms
  • Reversed by:
    • Beta2 adrenoceptor agonist
    • CysLT-receptor antagonist
    • Theophylline

Late phase:

  • Chemotaxins that were activated by mast cells activates the Th2 response and eosinophils
  • cysLTs lead to airways inflammation and airway hyper-reactivity
  • EMBP and ECP leads to epithelial damage which also contributes to airway hyper-reactivity
  • The result of the 2 bullets above is bronchospasms, wheezing and coughing
  • Inhibited by glucocorticoids
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7
Q

All of the following are true regarding the Immediate phase of asthma EXCEPT:

A. activation of cysLTs causes bronchospasms

B. reversed by beta2 agonist

C. reversed by cysLT-receptor antagonist

D. reversed by glucocorticoids

E. reversed by theophylline

A

D. reversed by glucocorticoids

Late phase asthma = inhibited by glucocorticoids

Early phase asthma is reversed by:

  • Beta2-agonist
  • cysLTs-receptor antagonist
  • theophylline
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8
Q

All of the following are true regarding the Late phase of asthma EXCEPT:

A. associated with Th2 response

B. associated with EMBP and ECP

C. leads to bronchospasms, wheezing and coughing

D. inhibited by glucocorticoids

E. all of the above are true regarding the late phase of asthma

A

E. all of the above are true regarding the late phase of asthma

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9
Q

What are the two main drug classes used to tx asthma?

  • Which of the two classes of drugs used to tx asthma mainly targets the immediate phase?
A

Bronchodilators = Immediate phase

Anti-inflammatory agents = Immediate and Late phase

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10
Q

All of the following are examples of Bronchodilators EXCEPT:

A. Fluticasone

B. Montelukast

C. Ipratropium

D. Albuterol

E. Salmeterol

A

A. Fluticasone

Bronchodilators:

  • Albuterol
  • Ipratropium
  • Montelukast
  • Salmeterol

Anti-inflammatory agents:

  • Fluticasone
  • Budesonide
  • Prednisolone
  • Salbutamol
  • Hydrocortisone
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11
Q

Bronchodilators are:

A. Beta1 agonist

B. Beta2 agonist

C. Beta1 antagonist

D. Beta2 antagonist

A

B. Beta2 agonist

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12
Q

Which of the following is a Beta2 agonist that may be supplied as an inhalent, tablet, or syrup and is shorter acting?

A. Albuterol

B. Salmeterol

C. Ipratropium

D. Montelukast

A

A. Albuterol

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13
Q

Which of the following is a short acting Beta2 agonist?

A. Albuterol

B. Salmeterol

C. Ipratropium

D. Montelukast

A

A. Albuterol

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14
Q

Which of the following is a short acting Muscarinic ACh antagonist?

A. Albuterol

B. Salmeterol

C. Ipratropium

D. Montelukast

A

C. Ipratropium

Short acting bronchodilators:

  • Albuterol = beta2 agonist
  • Ipratropium = Muscarinic ACh antagonist
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15
Q

Which of the following is a longer acting Beta2 agonist that is supplied as a dry-powder?

A. Albuterol

B. Salmeterol

C. Ipratropium

D. Montelukast

A

B. Salmeterol

Albuterol = short acting beta2 agonist

Salmeterol = long acting beta2 agonist (dry-powder)

Ipratropium = short acting muscarinic ACh antagonist

Montelukast = leukotriene receptor antagonist

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16
Q

Which of the following is a Leukotriene receptor antagonist?

A. Albuterol

B. Salmeterol

C. Ipratropium

D. Montelukast

A

D. Montelukast

Albuterol = short acting beta2 agonist

Salmeterol = long acting beta2 agonist (dry-powder)

Ipratropium = short acting muscarinic ACh antagonist

Montelukast = leukotriene receptor antagonist

note: Montelukast (Singulair) is only sold as a tablet and is used as an adjunct to beta agonist if a stronger effect is required. It can help decrease the need for corticosteroids in chronic asthma

17
Q

All of the following are Anti-inflammatory agents used to tx asthma EXCEPT:

A. Fluticasone

B. Budesonide

C. Montelukast

D. Prednisolone

E. Hydrocortisone

A

C. Montelukast

18
Q

All of the following are Anti-inflammatory agents used to treat Status Asthmaticus EXCEPT:

A. Fluticasone

B. Salbutamol

C. Hydrocortisone

D. Prednisolone

A

A. Fluticasone

Status asthmaticus tx:

  • Salbutamol
  • Hydrocortisone
  • Prednisolone
19
Q

(T/F)

Glucocorticoid medications are usually given prophylactically to prevent attacks.

20
Q

A possible side effect of glucocorticoid use is oropharyngeal candidiasis. A “rescue course” of oral ______ can be used if the clinical condition is rapidly deteriorating.

A. Fluticasone

B. Salbutamol

C. Hydrocortisone

D. Prednisolone

A

D. Prednisolone

21
Q

Which of the following is given I.V.?

A. Fluticasone

B. Salbutamol

C. Hydrocortisone

D. Prednisolone

A

C. Hydrocortisone

note: tx of status asthmaticus includes oxygen nebulized salbutamol, i.v. hydrocortisone, often followed by oral prednisolone

22
Q

Discuss each of the following Anti-inflammatory agents:

  • Fluticasone
  • Budesonide
A

Glucocorticoids like Fluticasone can be added on top of beta agonist in more severe cases.

  • Usually administered with a powdered inhaler
  • Nasal spray also available for allergic rhinitis

Budesonide is more potent and can be used if fluticasone isn’t providing enough relief

note: glucocorticoid medications are usually given prophylactically to prevent attacks

23
Q

The nasal spray _______ is available for allergic rhinitis.

A. Fluticasone

B. Salbutamol

C. Hydrocortisone

D. Prednisolone

A

A. Fluticasone

24
Q

Oxygen nebulized ________ is initial tx of Status Asthmaticus.

A. Fluticasone

B. Salbutamol

C. Hydrocortisone

D. Prednisolone

A

B. Salbutamol

25
Q

List the tx in order for treating Status Asthmaticus:

A
  1. oxygen nebulized Salbutamol
  2. i.v. hydrocortisone
  3. oral prednisolone
26
Q

Which of the following is used to treat COPD?

A. Fluticasone

B. Salbutamol

C. Hydrocortisone

D. Prednisolone

E. Ipratropium

A

E. Ipratropium

27
Q

Which of the following is a short acting antimuscarinic used to tx COPD?

A. Ipratropium

B. Tiotropium

C. Salmeterol

D. Dextromethorphan

E. Diphenhydramine

A

A. Ipratropium

28
Q

Which of the following is a long acting antimuscarinic used to tx COPD?

A. Ipratropium

B. Tiotropium

C. Salmeterol

D. Dextromethorphan

E. Diphenhydramine

A

B. Tiotropium

note: the brand name of Tiotropium is Spiriva

29
Q

Which of the following is a beta2 agonist used to tx COPD?

A. Ipratropium

B. Tiotropium

C. Salmeterol

D. Dextromethorphan

E. Diphenhydramine

A

C. Salmeterol

30
Q

Glucocorticoids are just as effective in treating COPD as they are in treating asthma. Treatment may reverse disease progression of COPD.

A. First statement is ture, second is false

B. First statement is false, second is true

C. Both statements are true

D. Both statements are false

A

D. Both statements are false

Correct statements:

Glucocorticoids are not as effective in treating COPD as in asthma. Treatment does NOt reverse the disease progression of COPD.

31
Q

Which of the following is used to tx respiratory emergencies due to a severe allergic rxn?

A. Ipratropium

B. Tiotropium

C. Salmeterol

D. Dextromethorphan

E. Diphenhydramine

A

E. Diphenhydramine

Note: Treatment of respiratory emergencies due to severe allergic rxns includes both diphenydramine (benadryl) and Epinephrine

32
Q

Which of the following is used to tx respiratory emergencies due to a severe allergic rxn?

A. Ipratropium

B. Tiotropium

C. Salmeterol

D. Dextromethorphan

E. Epinephrine

A

E. Epinephrine

Note: Treatment of respiratory emergencies due to severe allergic rxns includes both diphenydramine (benadryl) and Epinephrine

33
Q

All of the following are Antitussives (inhibitors of coughing) EXCEPT:

A. Dextromethorphan

B. Salmeterol

C. Codeine

D. Morphine

E. All of the above are Antitussives

A

B. Salmeterol

Antitussives (inhibitors of coughing):

  • Dextromethorphan
  • Codeine
  • Morphine
34
Q

Which of the following is used as a cough suppressant in palliative care in severe cases such as terminal lung cancer?

A. Dextromethorphan

B. Salmeterol

C. Codeine

D. Morphine

A

D. Morphine

35
Q

Which of the following is a common cough suppressant that has fewer side effects?

A. Dextromethorphan

B. Salmeterol

C. Codeine

D. Morphine

A

A. Dextromethorphan

36
Q

List all 3 of the Antitussives (inhibitors of coughing):

A

Dextromethorphan, Codeine and Morphine

37
Q

Which of the following is parasympathetic?

A. drugs that are beta agonist

B. drugs that antimuscarinic

A

B. drugs that antimuscarinic

Parasympathetic = Muscarinic receptors (ACh)

Sympathetic = beta agonist

Respiratory System (5 decks)

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