Unit 2: Ch 79-80

Question 1

What causes chronic bronchitis?

Answer 1

hypertrophy of mucus-secreting glands in the epithelium and larger airways

Question 2

What causes emphysema?

Answer 2

enlargement of air spaces within bronchioles and alveoli
alveoli lose elasticity

Question 3

What are the main pharmacologic classes for asthma?

Answer 3

Anti-inflammatory agents
Bronchodilators

Question 4

What are the advantages of inhalation drug therapy?

Answer 4

Therapeutic effects are enhanced
Systemic effects are minimized
Relief of acute attacks is rapid

Question 5

What are the different types of inhalation devices?

Answer 5

Metered-dose inhalers (MDI)
Respimats
Dry-powder inhalers (DPIs)
Nebulizers

Question 6

What are inhaled glucocorticoids?

Answer 6

First line therapy for management of inflammatory component of asthma

Question 7

Are inhaled glucocorticoids a fixed schedule, PRN, or both?

Answer 7

Fixed Schedule

Question 8

Why are inhaled glucocorticoids a better route of administration than oral glucocorticoids?

Answer 8

Has fewer systemic side effects
Safer as inhaled for long-term therapy

Question 9

What are the adverse effects of inhaled glucocorticoids?

Answer 9

Oropharyngeal candidiasis
Dysphonia
Bone loss
Slow growth in children

Question 10

What are the interventions to inhale glucocorticoid adverse effects?

Answer 10

Gargle and rinse mouth with water after each administration
Use a spacer with MDIs

Question 11

Explain Sympathomimetic Beta2 adrenergic agonists

Answer 11

cause bronchodilation, histamine suppression, and improved cilia motility

Question 12

Are Sympathomimetic Beta2 adrenergic agonists used for acute attacks or long-term management?

Answer 12

Long-term management

Question 13

Explain Short-Acting Beta2 Agonist (SABA)

Answer 13

Used as a quick relief and helps prevent exercise-induced bronchospasm

Question 14

What are the adverse effects of Albuterol?

Answer 14

Tremors
Tachycardia

Question 15

Which drug class must be used when treating asthma with a SABA?

Answer 15

A glucocorticoid

Question 16

Why do you want to give a bronchodilator first and then a glucocorticoid?

Answer 16

The bronchodilator will help open up the lungs so the glucocorticoid can be more effective

Question 17

Explain Long-Acting Beta2 Agonist (LABA)

Answer 17

Used for long-term control
prevents exercise-induced bronchospasm

Question 18

Explain Anticholinergics- Ipratropium inhalation

Answer 18

SAMA
inhibits muscarinic receptors which helps cause bronchodilation
Used for COPD bronchospasm

Question 19

Is Anticholinrgic- Ipratropium inhalation drug a rescue inhaler?

Answer 19

No

Question 20

Explain Tiotropium

Answer 20

LAMA
Blocks muscarinic receptors in the lungs

Question 21

Is Tiotropium more or less effective than Ipratropium?

Answer 21

More effective

Question 22

What is the therapeutic onset of Tiotropium?

Answer 22

1 week or 8 consecutive doses

Question 23

List the initial therapies for acute severe exacerbation

Answer 23

Oxygen
Nebulized, high-dose SABA
Systemic glucocorticoid
Nebulized ipratropium

Question 24

List the pharmacologic management of stable COPD

Answer 24

Bronchodilators (LABAs & LAMAs)
Glucocorticoids (inhaled)
Phosphodiesterase-4 (PDE4) Inhibitors (has both bronchodilator and anti-inflammatory effects)

Question 25

List the pharmacologic management of COPD Exacerbations

Answer 25

SABAs Systemic glucocorticoids Antibiotics Supplemental oxygen

Question 26

Which drugs should be avoided with asthma?

Answer 26

NSAIDs Beta Blockers

Question 27

A patient with asthma is prescribed albuterol 2 puffs 3 times/day. The nurse should teach the patient to: A. rinse the mouth after taking the prescribed dose. B. take an extra dose if breathing is compromised. C. wait 1 minute between puffs from the inhaler. D. take adequate amounts of calcium and vitamin D.

Answer 27

C

Question 28

Which of the following is NOT a serious adverse effect of long-term oral glucocorticoid therapy? A. Adrenal suppression B. Osteoporosis C. Hypoglycemia D. Peptic ulcer disease

Answer 28

C (causes HYPERglycemia)

Question 29

What is allergic rhinitis?

Answer 29

Inflammatory disorder of the upper airway

Question 30

What is the difference between seasonal and perennial allergic rhinitis?

Answer 30

Seasonal: reaction to outdoor allergens Perennial: indoor allergen triggers, dust mite and pet dander

Question 31

What are the classes of drugs used for allergic rhinitis?

Answer 31

Glucocorticoids (intranasal) Antihistamines (oral or intranasal) Sympathomimetics (oral and intranasal)

Question 32

Explain the treatment and onset for intranasal glucocorticoids

Answer 32

First choice for treatment Onset of relief for seasonal allergies can be 1-2 weeks and 2-3 weeks for perennial

Question 33

Explain the treatment of antihistamines

Answer 33

Helps relieve allergic rhinitis symptoms except for nasal congestion

Question 34

Explain how Sympathomimetics work

Answer 34

Reduce nasal congestion by activating alpha1-adrenergic receptors on nasal blood vessels

Question 35

What are some examples of opioid antitussives?

Answer 35

Codeine

Question 36

Explain how nonopioid antitussives work

Answer 36

block effects of histamine, which will inhibit the allergy related coughing

Question 37

Explain how Expectorants work

Answer 37

stimulates production of mucus by reducing the thickness/stickiness of the mucus so it can be removed from the lungs more easily

Question 38

What are some examples of expectorant drugs?

Answer 38

Guaifenesin

Question 39

Explain how Mucolytics work

Answer 39

Break down the structure of the molecules that form the mucus to make it more watery

Question 40

What are some examples of nonopioid antitussive drugs?

Answer 40

Acetylcysteine

Question 41

What should be notes about Pediatric OTC cold remedies?

Answer 41

There is no proof of efficacy/safety, but there is proof of harm, so OTC cold remedies shouldn't be given to children under 2

Question 42

A patient has codeine prescribed as an antitussive. Which symptom will the nurse observe for as an adverse effect of this medication? A. Respiratory depression B. Increased heart rate C. Productive cough D. Restlessness

Answer 42

A

Question 43

A patient asks what medication would be most effective in the treatment of seasonal hay fever. The nurse will teach the patient about the use of which drug? A. Azelastine [Astelin] B. Chlorpheniramine [Chlor-Trimeton] C. Fluticasone [Flonase] D.Pseudoephedrine [Sudafed]

Answer 43

C