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What is the correct breathing pattern for the best deposition of aerosolized medications?
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What are the advantages of aerosolized administration of medications?
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Pharmacology Exam 2
| Question | Answer |
|---|---|
| What is the correct breathing pattern for the best deposition of aerosolized medications? | Inhale full and hold breath for 3-5 seconds |
| What are the advantages of aerosolized administration of medications? | Immediate/ rapid onset of drug action, reduced systemic side effects, drug delivery is targeted for local pulmonary effect, smaller doses than systemic, patients can be taught to self administer, and painless and convenient |
| What is the device that is used to proved a reservoir and improve drug delivery when giving an MDI? | Spacer |
| How can you tell if an MDI canister is empty? | Place canister in water, if empty, it will float on its side |
| What is the purpose of the breath hold during an aerosol treatment? | Improves deposition of the drug |
| Ultra-Short Acting, SABA's, and LABA's are considered _________ door drugs. | Front |
| Anti-cholinergic are considered _________ door drugs. | Back |
| Xanthines are considered ___________ door drugs. | Side |
| What is the mechanism of action for Sympathomimetics? | Bronchodilation by breaking down ATP to cAMP |
| What is the mechanism of action for anti-cholinergics? | Bronchodilation of the large airways by decreasing cGMP |
| What is the mechanism of action for xanthines? | Inhibits phosphodiesterase to prevent breakdown of cAMP |
| What is the indication for the use of bronchodilators? | Presence of reversible airway obstruction |
| Is Albuterol a rescue or a maintenance drug? | Rescue |
| Is Salmeterol a rescue or a maintenance drug? | Maintenance |
| Is Levalbuterol a rescue or a maintenance drug? | Rescue |
| Are aerosolized corticosteroids considered maintenance or rescue drugs? | Maintenance |
| Are systemic corticosteroids considered maintenance or rescue drugs? | Maintenance |
| Are leukotrienes considered rescue or maintenance drugs? | Maintenance |
| Is cromolyn sodium considered a rescue or a maintenance drug? | Maintenance |
| Is metproterenol a rescue or a maintenance drug? | Rescue |
| What is the Ultra-Short acting bronchodilator? | Racemic epinephrine |
| What are the brand names for racemic epinephrine? | Nephron, micronefrin, vaponefrin, S2 |
| What is the duration time for racemic epinephrine? | 0.5-2 hours |
| What are the short acting beta adrenergics? | Levalbuterol, albuterol, and metaproterenol |
| What is the brand name for Levalbuterol? | Xopenex |
| What is the duration time for Levalbuterol? | 5-8 hours |
| What are the brand names for Albuterol? | Ventolin and proventil |
| What is the duration time for albuterol? | 5-8 hours |
| What is the brand name for metaproterenol? | None |
| What is the duration time for metaproterenol? | 2-6 hours |
| What are the five LABAs? | Salmeterol, arformoterol, formoterol, indacaterol, and olodaterol |
| What is the brand name for salmeterol? | Serevent diskus |
| What is the duration time for salmeterol? | 12 hours |
| What is the brand name for arformoterol? | Brovana |
| What is the duration time for arformoterol? | 12 hours |
| What is the brand name for formoterol? | Foradil |
| What is the duration time for formoterol? | 12 hours |
| What is the brand name for indacaterol? | Arcapta neohaler |
| What is the duration time for indacaterol? | 24 hours |
| What is the brand name for olodaterol? | Striverdi Respimat |
| What is the duration time for olodaterol? | 12 hours |
| Which drug is the R-isomer of albuterol? | Levalbuterol |
| What is the dosage for albuterol? | 0.5 mL of a 0.5% solution (2.5 mg) Q4-Q6 |
| What is the dosage of ipratropium bromide? | SVN: 500 mcg TID/ QID or MDI: 17 mcg/ puff, 2 puffs QID |
| What is the dosage for levalbuterol? | 0.63mg/ 3mL TID or 1.25mg/ 3mL TID |
| What is the dosage for racemic epinephrine? | SVN: 0.25-0.5 mL of a 2.25% solution QID |
| What are the five anti cholinergic drugs? | Ipratropium bromide, tiotropium bromide, oxitropium bromide, aclidinium bromide, and umecidium bromide |
| What is the brand name for ipratropium bromide? | Atrovent |
| What is the brand name for tiotropium bromide? | Spiriva |
| What is the brand name for oxitropium bromide? | Oxivent |
| What is the brand name for aclidinium bromide? | Tudorza Pressair |
| What is the brand name for umecidium bromide? | Incruse Ellipta |
| What are the recommended flow rates for SVN treatments? | 6-10L/ min, 3mL-6L/min, or 5mL-10L/min |
| What are the routes of administration for xanthines? | IV, injection, or tablet |
| List the examples of bland aerosols. | Normal (isotonic) saline, hypotonic saline, hypertonic saline, sterile water |
| What is the brand name for N-Acetylcysteine? | Mucomyst (10% or 20%) |
| What are the indications for N-Acetylcysteine? | Patients with thick, viscous, or inspissated secretions OR acetaminophen OD |
| What is the mode of action for N-Acetylcysteine? | Reduces viscosity of mucus by breaking down disulfide bonds |
| What are the indications for Cromolyn Sodium? | Prophylactic drug for asthma |
| What is the mode of action for Cromolyn Sodium? | Prevents degranulation or breakdown by thickening of mast cells to prevent the release of histamine and other inflammatory mediators |
| What is the brand name for Dornase alfa? | Pulmozyme |
| What are the indications for Dornase alfa? | Management of cystic fibrosis |
| What is the mode of action for Dornase alfa? | Hydrolyzes the DNA in sputum and reduces viscosity |
| What is the brand name for Budesonide? | Pulmicort |
| What are the adverse effects of inhaled corticosteroids? | Cushingoid appearance, candida albicans (thrush), adrenal suppression, obsesity, and hypertension |
| What can be done to prevent oral fungal infections caused by inhaled corticosteroids? | Rinse mouth with water after treatment |
| What is the neurotransmitter at the sympathetic receptor site? | Norepinephrine |
| What is the neurotransmitter at the parasympathetic receptor site? | Acetylcholine |
| Adrenergic receptors respond to what neurotransmitter? | Norepinephrine |
| Choinergic receptors respond to what neurotransmitter? | Acetylcholine |
| What are the adrenergic receptors? | Alpha, Beta 1, and Beta 2 |
| What are the cholinergic receptors at the effector site? | Muscarinic 1, 2, and 3 |
| At what point during the breath, should you instruct a patient to activate the MDI canister? | At the start of inhalation |
| Name the alpha-adrenergic sympathomimetic? | Racemic Epinephrine |
| What is the main indication for alpha adrenergic drugs? | Upper airway edema |
| What are the three causes of bronchoconstriction? | Bronchospasm, muscosal edema (inflammation) and retained secretions |
| What type of drug is used to treat bronchospasm? | Bronchodilators - sympathomimetics, anti-cholinergics, and xanthines |
| What type of drug is used to treat mucosal edema? | Corticosteroids and alpha adrenergics |
| What type of drug is used to treat retained secretions? | Mucolytics |
| What are the pulmonary surfactant drugs? | Beractant, calfactant, and poractant alfa |
| What is the brand name for beractant? | Survanta |
| What is the brand name for calfactant? | Infasurf |
| What is the brand name for poractant alfa? | Curosurf |
| What are surfactants primarily composed of? | 85% phospolipids: lecithin |
| What is the function of surfactant? | Reduce alveolar surface tension |
| What type of cells produce surfactant? | Alveolar type 2 cells |
| How is surfactant normally produced? | Breathing, yawning |
| Which two drugs are in Duoneb and Combivent? | Albuterol and Ipratropium Bromide |
| What are the three Leukotriene inhibitors (modifiers)? | Montelukast, zafirlukast, and zileuton |
| What is the brand name for Montelukast? | Singulair |
| What is the brand name for Zafirlukast? | Acculate |
| What is the brand name for Zileuton? | Zyflo |
| Should a bronchodilator be given before or after a corticosteroid? | Before |
| Which of the following terms is NOT synonymous with Sympatholytic? A. Beta 2 - antagonist B. Anti - adrenergic C. Beta 2 - agonist | A |
| Which of the following terms is NOT synonymous with Parasympatholytic? A. Agonist B. Anti - Cholinergic C. Back door | A |
| Which of the following terms is NOT synonymous with Sympathomimetic? A. Beta - agonist B. Front door C. Anti -adrenergic D. Beta - adrenergic | C |
| What type of effect would an anti-cholinergic drug have on the heart rate? | Decrease |
| What type of effect would a cholinergic drug have on the bronchioles? | Bronchoconstriction |
| What drug can be used to treat an acetaminophen overdose? | N-Acetylcysteine (Mucomyst) |
| What are two causes of upper airway edema? | Croup and Post-extubation stridor |
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