unit 4 adrenergic bronchodiltors

Question 1

lumen of airway reduced. can be due to bronchospasm, mucosal edema or secretions

Answer 1

bronhoconstriction

Question 2

muscle constriction

Answer 2

bronchospasm

Question 3

swelling

Answer 3

mucosal edema

Question 4

occluded airways

Answer 4

airway secretions

Question 5

what are some agents that will provide bronchospasm relief?

Answer 5

• sympathomimetic
• parasympatholytic agents
• methylxanthines

Question 6

what are some agents that will relieve mucosal edema?

Answer 6

• alpha adrenergic agents

- corticosteroids

Question 7

what are some agents the will relieve airway secretions?

Answer 7

mucolytic agents

Question 8

bronchospasm always results in what?

Answer 8

bronchoconstriction

Question 9

not all bronchoconstrictions is caused by what?

Answer 9

bronchospasm

Question 10

what kind of bronchodilators would be needed for relaxation of airway smooth muscle in the presence of reversible airflow obstruction?

Answer 10

adrenergic bronchodilators

Question 11

what would be some diseases that would indicate the need for adrenergic bronchodilators?

Answer 11

• asthma
• bronchitis
• emphysema
• bronchiectasis
• other obstructive diseases

Question 12

stimulation of B2 receptor, activation of Gs protein, release of adenylyl cyclase, synthesis of 3’5 cAMP would indicate what theory?

Answer 12

Beta receptor theory

Question 13

in the beta receptor theory what does the synthesis of 3’5 cAMP do?

Answer 13

• direct bronchodilation

- inhibit mast cell degranulation

Question 14

Name the three ultra short acting agents?

Answer 14

• epinephrine
• racemic epinephrine
• isoetharine

Question 15

in what kind of situation would ultra short acting agents be used in ?

Answer 15

emergency situations

Question 16

all ultra short acting agents are catecholamine what is the duration it last?

Answer 16

less than 3 hours

Question 17

what medication is used for 1st line treatment for anesthesia induced post op ghasping?

Answer 17

Vaponepherine

Question 18

what are 5 short acting agents?

Answer 18

• metaproterenol
• albuterol
• pirbuterol
• levabuterol
• bitolterol

Question 19

what are indications that a short acting agent need to be used?

Answer 19

Acute reversible obstruction

Question 20

how long does a short acting rescue agent usually last?

Answer 20

4 to 6 hours

Question 21

what is an example of a Resorcinal and is available as a nebulizer?

Answer 21

metaproterenol

Question 22

what are 3 examples of a Saligenin?

Answer 22

• Albuterol
• pirbuterol
• levabuterol

Question 23

what are 3 long acting agents?

Answer 23

• salmererol
• formoterol
• Arformoterol

Question 24

what kind of agents would you use to maintenance bronchodilation and control of bronchospasm and nocturnal symptoms in asthma or other obstructive diseases?

Answer 24

long acting “controller” agents

Question 25

what agent is usually given with anti-inflammatory medications?

Answer 25

Long acting agents

Question 26

what is the duration of a long acting agent?

Answer 26

12 hours

Question 27

enzyme found in liver and kidneys degrades catechols and is short acting? metabolized buy what?

Answer 27

COMT

Question 28

unsuitable for oral administration because they are inactivated in the gut and liver?

Answer 28

catecholamines

Question 29

what is stored in an amber colored bottle or a foil protected wrapper because its inactivated by heat light or air?

Answer 29

racemic epinephrine or catecholamines

Question 30

what color of rainout in the nebulizer or patients secretions would indicate aerosols of catecholamines?

Answer 30

may be pink

Question 31

catecholamines inactive by heat or light and is a phenomenon know as what?

Answer 31

beta blockade

Question 32

what are some side effects for catecholamines?

Answer 32

- tachycardia - hypertension - tremor - glycogenesis - CNS stimulation

Question 33

what are three naturally occurring catecholamines?

Answer 33

- epinephrine - dopamine - norepinephrine

Question 34

what are two man made catecholamines?

Answer 34

- isoproterenol | - isoetharine

Question 35

Natural epinephrine isomers occurs where?

Answer 35

R isomer or the( L,-) levo

Question 36

Man made epinephrine, albuterol and salmeterol is a 50:50 racemic mixture of what?

Answer 36

(R) and (S) sinister

Question 37

(S) sinister is also known as what?

Answer 37

(D, + ) dextro

Question 38

why are isomers mirror images of themselves?

Answer 38

because they rotate light in opposite directions

Question 39

is the single (R) isomer form of racemic albuterol and contains no (S) isomer?

Answer 39

Levalbuterol

Question 40

ultra short acting epinephrine, racemic epinephrine, isoetharine lack ------ but have lots of cardiac effects

Answer 40

B2 specificity

Question 41

how is epinephrine administered in emergency situations? it is a alpha and beta

Answer 41

inhalation or injection not to be given by mouth

Question 42

used for adrenergic vasoconstriction effects also used to dectease airway swelling after extubation, during epiglottitis, croup, nasal swelling or to control airway bleeding what are 3 racemic epinephrines?

Answer 42

- vaponefrin - microNefrin - asthmaNefrin

Question 43

the larger the catecholamine side chain the more -----specific?

Answer 43

B2

Question 44

is a short acting resorcinol agent used for premature labor and is oral or injection?

Answer 44

Terbutaline

Question 45

what is the peak effect for short acting agents?

Answer 45

30 to 60 minutes

Question 46

what is the onset of short acting agents?

Answer 46

5 to 8 minutes

Question 47

Albuterol contains what isomer?

Answer 47

both (R) and (S)

Question 48

levalbuterol (xopenex) is available as MDI and nebulizer solution what is the doses?

Answer 48

0. 31mg/3mL 0. 63mg/3mL 1. 25mg/3mL 1. 25 mg/0.5 mL concentrate

Question 49

what are some effects of (S) ?

Answer 49

- slower metabolism than (R) - enhances airway responsiveness - activity is blocked by atropine

Question 50

long acting agents such as salmeterol, formoterol, and Arformoterol are they saligenin, resorcinol or catecholamines?

Answer 50

Saligenins

Question 51

extended release albuterol vospire is available in tablet for in what mg? and activity time?

Answer 51

- 4 or 8 mg tablet | - 8 to 12 hours activity time

Question 52

what is the bronchodilator salmeterol (serevent) peak bronchodilating effect? and the duration?

Answer 52

- 3 to 5 hours- peak effect | - duration 12 hours

Question 53

formoterol (foradil) is used for asthma, exercise induced bronchospasm and copd what is the peak effect and the duration?

Answer 53

- peak effect- 3 minutes | - 12 hours duration

Question 54

Arformoterol is also known as what?

Answer 54

Brovana

Question 55

Arformoterol is single isomer version of the long acting dry power inhaled formoterol power approved for what type of patient?

Answer 55

COPD

Question 56

Ultra long DPI used once daily in Europe only for COPD?

Answer 56

Indacaterol

Question 57

a receptor what mode of action?

Answer 57

vasoconstriction of lungs and blood vessels

Question 58

B1 receptor what mode of action?

Answer 58

increased heart rate and contractile force

Question 59

B2 receptor what mode of action?

Answer 59

relaxation of bronchial smooth muscle , bronchodialation of lungs and blood vessels

Question 60

Binds to ---rectptor, ultimately causing increased synthesis of cAMP

Answer 60

B receptor activation

Question 61

inhibits release of neurotransmitter from presynaptic neuron, but may also lower synthesis of intracellular cAMP?

Answer 61

a receptor activation

Question 62

a1 receptor activation release agonists such as what?

Answer 62

- phenylephrine | - Epinephrine

Question 63

what drugs are lipophilic (stick to receptor site) and approaches B receptor laterally?

Answer 63

- salmeterol - formoterol - Arformoterol

Question 64

continuous nebulization is generally how many mg/hour?

Answer 64

10 to 15 mg/hour