Week 8 Pulmonary Disease Flashcards
According to the EPR 3, step 1 treatment for intermittent asthma in adults and children
SABA as needed
Mechanism of Action: Beta adrenergic agents
Relax smooth muscle by directly stimulating beta adrenergic receptors in the airway
Mechanism of Action: Corticosteroids
Decrease airway inflammation, attenuate airy hyper responsiveness, and minimize mucus production and secretion
Mechanism of Action: Anticholinergics / Muscarinic Antagonists
Inhibit the effects of acetylcholine on muscarinic receptors and protect against cholinergic mediated bronchoconstriction
Mechanism of Action: Leukotrine receptor antagonists (montelukast, zafirlukast)
Competitively antagonize the effects of leukotriene D4 resulting in decreased inflammation
Theophylline (a methylxanthine) has limited use because it has a ________________ therapeutic index
Narrow
Mechanism of Action: Phosphodiesterase-4 inhibitors
Reduce inflammation by inhibiting the breakdown of cAMP
Another name for anticholinergic
Long or short acting muscarinic antagonists
The preferred combination inhaler for COPD
LABA / LAMA
Most common pathogen in community acquired pneumonia
Streptococcus pneumonia
Encourage patients to rinse mouth with water after using this class of inhaler
ICS - inhaled corticosteroid
Physical assessment technique which will help identify consolidation with pneumonia
percussion and egophony
Assessment tools that can be used to determine symptom severity in COPD
Modified MRC or CAT
Severity of symptoms in an individual who needs to stop for breath when walking on their own on the level
High symptom severity
Recommended first treatment for Group A COPD
SABA or SAMA prn
Recommended treatment of COPD in group D if exacerbations on LABA + LAMA
LABA + LAMA + ICS
According to EPR 3 Step 2 preferred management in adults involves adding
A low dose ICS
According to EPR 3, Step 3 preferred treatment for adults recommends
Adding a LABA or increasing ICS to medium dose ICS
Empiric CAP antibiotic treatment for recommended for a previously healthy adult outpatient
macrolides or doxycline
Empiric CAP monotherapy antibiotic treatment for a patient with DM or COPD
Flouroquinalones
The two interferon gamma release assay (IGRA) tests available for TB
Quantiferon TB Gold In-Tube (QFT-GIT) and T-Spot
12 week direct observed therapy for latent TB includes these two drugs
Isoniazid and Rifapentin
Isoniazid can cause hepatitis. Patients should be educated to avoid
Alcohol
Adverse effects of Rifampin include
Orange discoloration of urine, tears, saliva and can interfere with contr
The most serious problem with treatment of TB is
patient nonadherence
The only two SABA that can be prescribed for children younger than age 4 are…
Albuterol and metaproterenol
How pulmonary function and response to bronchodilators should be monitored
With use of a peak flow meter
What should be done for a patient on digitalis before they are started on a beta agonist?
An ECG for baseline and routinely during therapy to detect cardiac arrhythmias that may occur.
Proper inhaler use involves…
First, exhale and tilt head slightly back and place inhaler mouthpiece either 2 inches from the open mouth or between the open lips. While inhaling, the pt should press down on the canister, breathe in slowly and deeply, and hold his or her breath for 10 seconds (count of 10) or as long as comfortable. If 2 puffs prescribed, wait 1 minute between inhalation’s.
Key points to cover regarding nebulizer use with a patient…
Accurate measurement of the medication and appropriate cleaning of the device.
Overuse of beta2-agonist bronchodilators can lead to…
P.350
Seizures, hypokalemia, anginal pain, and hypertension
Lifestyle management of asthma includes all of the following EXCEPT:
A) self-monitor respiratory status with a peak flow meter
B) avoid/stop smoking
C) avoid environmental triggers for asthma at home, work, and school
D) eat three meals a day focusing on high antioxidant foods (e.g., blueberries, spinach, kale, etc.)
D) while beneficial in general, eating a well balanced diet is not a focus for lifestyle management of asthma.
P. 350
Theophylline is chemically similar to what common psychoactive drug?
Caffeine
Anticholinergics are use primarily in:
A) asthma
B) COPD
C) CHF
D) none of the above
B) inhaled anti-cholinergics are used primarily to treat COPD, although ipratropium may be used in combination with albuterol as the emergent treatment of an asthma exacerbation or when a patient is intolerant to beta2 agonists.
