Bio 137 Pharm

Front 1

True or False:
Mixing an aerosol medication in normal saline will dilute the concentration of the drug.

Back 1

True

Front 2

What is the adult dose for a unit dose of albuterol and normal saline?

Back 2

2.5 mg in 2.5 ml normal saline

Front 3

Which of the following bronchodilator drugs is commonly used as a tocolytic (labor slowing) medication when given IV?

Back 3

Terbutaline

Front 4

If the patient's heart rate increased to 128 after the first treatment which of the following would you recommend if another treatment were needed to quickly relieve the patient's dyspnea?

Back 4

Atrovent

Front 5

True or False:
Maintenance agents are slow to peak but have prolonged bronchodilation activity.

Back 5

True

Front 6

What are the standard doses for Xopenex?

Back 6

0.63 mg to 1.26 mg

Front 7

Parasympathetic innervation and muscarinic receptors are concentrated:

Back 7

In the larger airways gradually diminshing in numbers at the respiratory bronchioles

Front 8

True or False:
Ipratropium Bromide and Atropine Sulfate are both parasympatholytic, only Ipratropium Bromide has systemic side effects.

Back 8

False

Front 9

A parasympathomimetic agent that intensifies the level of bronchial tone to the point of bronchial constriction and is used in bronchial provocation testing is:

Back 9

Methacholine

Front 10

Which of the following are considered common side effects of aerosolized bronchodilator adminstration? (pick as many as appropriate)

Back 10

Tachypnea
Insomnia
Tremors
Nausea

Front 11

Dosage
Isoetharine

Back 11

(1%) solution of 0.25 ml to 0.5 ml in 3 ml normal saline

Front 12

Dosage
Racemic epinephrine

Back 12

(2.25%) solution of 0.25 ml to 0.5 ml in 3 ml normal saline

Front 13

Dosage
Albuterol (unit dose)

Back 13

2.5 mg in 2.5 ml normal saline

Front 14

Dosage
Metaproterenol

Back 14

0.15 ml to 0.3 ml in 3 ml normal saline

Front 15

Dosage
Xopenex

Back 15

0.63 mg/3ml to 1.25 mg in 2.5 ml saline

Front 16

Accumulative Effect

Back 16

A drug not cleared from the body because of liver or kidney failure

Front 17

Anaphalaxis

Back 17

A life threatening allergic reaction to a drug

Front 18

Agonist Effect

Back 18

Stimulates receptor

Front 19

Antagonist Effect

Back 19

A drug that blocks another drug's action

Front 20

Tachyphalaxis

Back 20

Rapid tolerance to a drug - a higher dose is needed to get the desired result

Front 21

Muscle tremor side effect with beta agonists is due to stimulation of which receptors in skeletal muscle?

Back 21

beta 2

Front 22

A physician orders 2% lidocaine be instilled down a patient's endotracheal tube to prepare for a bronchoscopy procedure. You have 10 ml of a 5% lidocaine solution at hand. How many ml of dilute must be added to arrive at the prescribed concentration?

Back 22

15 ml

Front 23

True or False:
Normally there is a base level of bronchomotor tone caused by sympathetic activity.

Back 23

False

Front 24

Which of the following aerosolized medications would you suggest at this time, if after the first treatment no benefit showed but if after the second treatment you heard diminished breath sounds with faint wheezing.

Back 24

Albuterol

Front 25

True or False
Methacholine is a parasympatholytic.

Back 25

False

Front 26

Which of the following is responsible for the intracellular reaction in bronchial smooth muscle that causes it to relax?

Back 26

C-AMP

Front 27

Which of the following occurs when Beta 1 receptors are stimulated? (pick as many as appropriate)

Back 27

Increased heart rate
Increased cardiac contration

Front 28

Can there be tachycardia with Levalbuterol, a preferentially beta 2 agonist?

Back 28

Yes
Beta 2 receptors are also found in the heart

Front 29

Which of the following beta 2 agonists is considered to have the longest duration of effect?

Back 29

Sameterol

Front 30

True or False
Atrovent is approved as a rescue drug in COPD airflow obstruction.

Back 30

False

Front 31

Which of the following enzymes is responsible for breaking down c-AMP into 3,5 AMP?

Back 31

Phosphodiasterase

Front 32

True or False
Reflex bronchoconstriction due to irritant aerosols, cold air, high flow rates etc, can be blocked by 4% lidocaine aerosol.

Back 32

True

Front 33

In comparing anticholinergic and beta adrenergic agents, anticholinergic agents are associated with which of the following:

Back 33

No development of tolerence

Front 34

What is the trade name for Metaproternenol?

Back 34

Alupent

Front 35

True or False
Beta adrenergic bronchodilators are only available in inhaled form.

Back 35

False

Front 36

True or False
Rescue agents are short acting beta 2 agonists, given for relief of acute reversible airflow obstruction.

Back 36

True

Front 37

True or False
Irritating sensory C fiber afferent neurons by irritant aerosols, cold air, high flow rates etc, results in a reflex bronchoconstriction and mucus release.

Back 37

True

Front 38

If after the first treatment no benefit showed but if after the second treatment you heard diminished breath sounds with faint wheezing, how would you chart the treatment results?

Back 38

Asthma symptoms relieved

Front 39

Which of the following describes quaternary amonium compounds?

Back 39

They do not cause CNS changes

Front 40

True or False
Cholinergic stimulation of muscarinic receptors causes release of mucus from submucosal glands in the airways.

Back 40

True

Front 41

Which of the following is considered a catacholamine beta 2 agonist?

Back 41

Isoetherine (Bronkosol)

Front 42

Which of the following bronchodilators is considered an anticholinergic?

Back 42

Atrovent

Front 43

Which of the following is a prodrug?

Back 43

Tornalate

Front 44

An RT from another school complains to you, a CCSD graduate, that the patient appears to be staring at him more after the Atrovent treatment. You observe dilated pupils in the patient and tell the RT who went to the other school to:

Back 44

Adjust the face mask better so the anticholinergic aerosol is not sprayed into the eyes.

Front 45

True or False
Hyperkalemia can cause life threatening arrhythmias, and can be treated with albuterol.

Back 45

True

Front 46

A common side effect of the anticholinergic Atrovent is:

Back 46

dry mouth and dysphagia

Front 47

A known COPD patient calls you, the RT, in the pulmonary rehabilitaion department and tells you that she has been taking Spiriva twice per day for the past 2 days. You should tell the patient to:

Back 47

Reduce the treatment to once a day

Front 48

Resorcinol agents were created by modifying the catechol nucleus, so it would no longer be inactivated by:

Back 48

COMT

Front 49

Muscarinic receptors types on submucosal glands and smooth muscle are:

Back 49

M3

Front 50

Which of the following is true of tertiary amonium compounds?

Back 50

They are associated with more CNS side effects than are quartenary amonium compounds.

Front 51

Which of the following are components of the bronchial lumen and lamina propria?

Back 51

Submucosal glands
Cilia
Parasympathetic
Pseudostratified Columnar
Blood Vessels
Goblet Cells

Front 52

Which of the following bronchodilators is catagoried as a anticholinergic medication?

Back 52

ipratropium bromide

Front 53

Which of the following aerosolized medications is considered a catacholamine drug?

Back 53

Isoproterenol

Front 54

True or False
Albuterol is being used by some in exercise for muscle buildup.

Back 54

True

Front 55

Which of the following medications can be used for upper airway swelling because of it's alpha effect?

Back 55

Racemic epinephrine

Front 56

Which of the following is considered the less likely brochodilator to have cardiac side effects and is a split isomer of albuterol?

Back 56

Levalbuterol

Front 57

What is the trade name for the combination of ipratropium bromide and albuterol sulfate?

Back 57

Combivent

Front 58

Decongestion agents for nasal passages stimulate which receptors?

Back 58

Alpha

Front 59

In regards to pharmacology the potentiation effect has to do with:

Back 59

Two drugs combined having many times the

Front 60

The size, or MMAD, of aerosol particles that deposit within the nose and mouth is:

Back 60

10-15 microns

Front 61

Accumulative Effect

Back 61

A drug not cleared from the body because of liver or kidney failure

Front 62

Agonist Effect

Back 62

Stimulates receptor

Front 63

Tachyphalaxis

Back 63

Rapid tolerance to a drug - a higher dose is needed to get the desired result

Front 64

Antagonist Effect

Back 64

A drug that blocks another drug's action

Front 65

Anaphalaxis

Back 65

A life threatening allergic reaction to a drug

Front 66

The average dose of sodium nitroprusside is 3 micrograms/Kg/min. If you have a prepared-strength vial of of sodium nitroprusside at 50 micrograms/mL, how much of that drug preparation should you give to a 70Kg man?

Back 66

4.2 ml/min

Front 67

What does the term PO mean when applied to drug delivery

Back 67

Absorbsion in the gastrointestinal tract

Front 68

True or False
An orphan drug is used in the treatment of common diseases.

Back 68

False

Front 69

A child's cough medicine comes as 0.2% solution. The pediatrician orders 3ml, what is the dose in mgs?

Back 69

6mg

Front 70

Which of the following is likely to escape the first pass effect?

Back 70

Nitroglycerin pill

Front 71

A patient has been taking a drug for several months; lately the patient requires more of the drug to produce the same effect. This is called:

Back 71

Tolerance

Front 72

When two drugs are taken together, one will greatly amplify the affect of the other. An example is valium and alcohol:

Back 72

Potentiation Effect

Front 73

True or False
ung is the symbol for unguent or salve ointment.

Back 73

True

Front 74

Which of the following is the only route of administration that cannot exert a local effect?

Back 74

Oral

Front 75

Which of the following organ system is responsible for biotransformation or breaking down of a drug in the body?

Back 75

Liver

Front 76

Which route of administration would have to cross the endothelial barrier in order to circulate systemically ?

Back 76

II. IM
III. Subcutaneous

Front 77

The Pharmaceutical phase of drug action includes which of the following?

Back 77

Route of administration

Front 78

A ________________ is a substance that is dissolved in a solution.

Back 78

Solute

Front 79

Which drug is more potent? Drug A (ED50 =10mg) or Drug B (ED50 = 6mg)?

Back 79

Drug B

Front 80

A small volume nebulizer is best for use by which of the following individuals?

Back 80

A patient with poor inspiratory capacity and who is tachypneic.

Front 81

How much of the total drug is delivered to the lung, regardless of the delivery device used?

Back 81

10%

Front 82

Pharmacology as a science has to do with:

Back 82

Curing of infection
Alleviation of symptoms of disease
Prevention of disease

Front 83

True or False
Pharmacognosy is the science of identification of the sources of drugs, from plants and animals.

Back 83

True

Front 84

A special case of synergism where one drug has no effect on its own but can increase the activity of another drug, is an example of:

Back 84

Potentiation

Front 85

True or False Pharmacogenetics is the study of the interrelationship of genetic differences and drug effects.

Back 85

True

Front 86

Which of the following is the main site of drug metabolism?

Back 86

Liver

Front 87

Which of the following is the best example of direct drug delivery?

Back 87

Ointment applied for sunburn.

Front 88

True or False
An over-the-counter (OTC) drug means a prescription is necessary

Back 88

False

Front 89

Which of the following is the main site of drug elimination?

Back 89

Kidney

Front 90

Bioavailability is a measure of the drug in the _____?

Back 90

plasma

Front 91

True or False
The inscription is the part of the prescription that lists the name and the quantity of drug being prescribed.

Back 91

True

Front 92

Which of the following is considered "enteral route"?

Back 92

I oral
III. Colorectal

Front 93

A high L/T ratio means:

Back 93

good bronchoactivity

Front 94

Of the following routes of administration, which gets the drug to the target cells or tissues the fastest?

Back 94

Intravenous

Front 95

Which of the following is included in the pharmacokinetic phase of medication effect on the body?

Back 95

Metabolism of the drug in the liver

Front 96

True or False
A Phase 3 study is part of the new New Drug Application (NDA) process.

Back 96

False

Front 97

True or False
Toxicology studies examine mutagenicity and teratogenicity for developing drugs.

Back 97

True

Front 98

What particle size of an aerosol would increase delivery to the lung parenchyma?

Back 98

0.8 to 3.0 microns

Front 99

Which of the following aerosol devices could be used for a child 6 months old, admitted to the ED with a diagnosis of bronchiolitis?

Back 99

SVN

Front 100

Heparin comes as 1000U/mL. How many mL do you need to deliver 650 U of Heparin?

Back 100

0.65mL

Front 101

True or False
Caffeine citrate is preferred for premature infants because it has a higher therapeutic index and fewer side effects compared with theophylline.

Back 101

True

Front 102

True or False
Because people metabolize Theophylline at different rates, it is estimated that the optimal therapeutic dose for asthma treatment is 5 to 15 micrograms/ml and 10 to 12 micrograms/ml for COPD.

Back 102

True

Front 103

All of the following drugs increase ciliary beat except:

Back 103

Corticosteroids

Front 104

What is the trade name for Acetylcysteine?

Back 104

Mucomyst

Front 105

Which of the following mucolytics works by breaking the disulfide bonds of secretions?

Back 105

Acetylcysteine

Front 106

Why is caffeine citrate used with premature infants?

Back 106

It works on the CNS to stimulate breathing.

Front 107

True or False
Methylxanthines are generally recommended for the treatment of acute exacerbations of asthma, even if other bronchodilators work.

Back 107

False

Front 108

Three types of methylxanthines are

Back 108

I Theophylline.
II Caffeine.
III Theobromine

Front 109

Cystic Fibrosis(CF) is associated with chronic airway infection, often with:

Back 109

Pseudomonas aeruginosa

Front 110

True or False
According to the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD), IV aminophylline should NOT be used to manage acute exacerbation of COPD.

Back 110

False

Front 111

True or False
Theophylline stimulates the CNS more than caffeine.

Back 111

False

Front 112

True or False
Theophylline relaxes smooth muscle more than caffeine.

Back 112

True

Front 113

True or False
A non-bronchodilating effect of Theophylline is to directly strengthen the diaphragm.

Back 113

True

Front 114

True or False
Serum concentrations of caffeine of 5-20 mg/L have been effective in treating apnea of prematurity (AOP).

Back 114

True

Front 115

Common side effects with Pulmozyme do NOT include:

Back 115

Thrush

Front 116

True or False
An added benefit of Theophylline is that it can increase cardiac output and reduce pulmonary vascular resistance, thus decreasing the workload on the heart.

Back 116

True

Front 117

True or False
Secretory structures that contribute to the sol and gel layers of mucus, are ciliated epithelial cells, surface goblet cells, Clara cells and submucosal glands (which have both serous and mucus cells). The submucosal glands provide most of the mucus transported to the airway surface by ciliated ducts. Sputum is all this plus upper airway secretions, bacteria, particulate matter and any other products of inflammation.

Back 117

True

Front 118

When administering N acetyl Cysteine by aerosol it is important to include which of the following to reduce the incidence of bronchospasm?

Back 118

Rapid onset bronchodilator

Front 119

True or False
Theophylline is not effective below 5 micrograms/mL. Over 20 micrograms/mL side effcts start to show. These are Nausea above 20 micrograms/mL , cardiac dysrhythmias above 30 micrograms/mL and seizures above 40 micrograms/mL.

Back 119

True

Front 120

True or False
Conventional Chest Physiotherapy (CPT) incorporating postural drainage results in significantly higher expectoration in patients with cystic fibrosis.

Back 120

True

Front 121

What is the trade name for alpha dornase?

Back 121

Pulmozyme

Front 122

What is the most common side effect of delivering ACETYLCYSTEINE solution via the aerosol route?

Back 122

Bronchospasm

Front 123

Which of the following mucolytics works to dissolve mucus by breaking the DNA chains of the secretions?

Back 123

Alpha Dornase

Front 124

True or False
Mucus is a complex molecule called a glycoprotein. A healthy individual produces about 100ml of mucus per day of which 10ml reaches the glottis. This amount is greatly increased in diseased persons.

Back 124

True

Front 125

True or False
Theophylline is a safe alternative to inhaled bronchodilators in treating COPD.

Back 125

False

Front 126

True or False:
Natural corticosteroids are produced by the cortex of the adrenal gland

Back 126

True

Front 127

Which of the following is considered the mode of action for surfactant?

Back 127

To replace missing surfactant.

Front 128

For an alveolus, LaPlace’s Law which states the relationship of the vessel radius, the internal pressure, and the surface tension, is written as:

Back 128

Pressure = (2 x surface tension)/radius

Front 129

Which of the following is a very common side effect of inhaled corticosteroids?

Back 129

Oral candidiasis: is an infection of yeast fungi of the genus Candida on the mucous membranes of the mouth

Front 130

The product combining an inhaled steroid and a bronchodilator is:

Back 130

Advair.

Front 131

Symbiocort is a combination of:

Back 131

Budesonide and Formoterol

Front 132

Which of the following are approved indications for surfactant therapy?

Back 132

I. Prophylaxis in very low birth weight (<1250 g) infants
II. Prophylaxis in infants of higher birth weight (>1250 g) but with immature lungs
III. Rescue treatment in infants with respiratory distress syndrome

Front 133

True or False:
Prednisone is a corticosteroid that can be given as an aerosol:

Back 133

False

Front 134

A major stimulus for secretion of surfactant into the alveolus is:

Back 134

lung inflation.

Front 135

A significant side effect of corticosteroid use is inhibition of:

Back 135

HPA axis.

Front 136

True or False:
An allergic asthmatic normally has a higher eosiniphil count. After treatment with glucocorticoids the asthmatic will show a lower eosiniphil count.

Back 136

True

Front 137

The term used to describe surfactant produced outside of the patient’s body is:

Back 137

exogenous

Front 138

Which of the following are currently used methods for delivering surfactant into infants?

Back 138

I. Instillation through side-port adapter
II. Instillation through catheter

Front 139

A patient complains of oral thrush and hoarseness since she has been using fluticasone by MDI. The physician asks you to make a suggestion to help her without discontinuing the drug. You suggest:

Back 139

add a spacer and rinse the mouth after use.

Front 140

In chronic obstructive pulmonary disease (COPD), the primary inflammatory cells are:

Back 140

neutrophils.

Front 141

True or False:
Natural corticosteroids enhance Beta 2 receptor response and may provide protection from beta 2 receptor tolerance to bronchodilator drugs.

Back 141

True

Front 142

Which of the following are natural surfactant preparations?

Back 142

II. Curosurf
III. Survanta
IV. Infasurf

Front 143

Use of systemic corticosteroids can cause all of the following, except:

Back 143

increased endogenous steroid production.

Front 144

The inflammatory process includes which of the following activities?

Back 144

I. Mediator cascade: Histamine and chemoattractant factors are released at the site of injury, and various inflammatory mediators such as complement and arachidonic acid products are generated.
II. Increased vascular permeability: an exudate (any fluid that filters from the circulatory system into lesions or areas of inflammation) is formed in the surrounding tissues
III. Leukocytic infiltration: white cells emigrate through capillary walls (diapedesis) in response to attractant chemicals (chemotaxis)
IV. Phagocytosis: White cells and macrophages (in the lungs) ingest and process foreign material such as bacteria

Front 145

You are in the room of a 36-week gestational baby that has just been born. The newborn weighs 2200 g. On assessment you find the baby has good color, no retractions, no nasal flaring, a respiratory rate (RR) of 25 breaths/min, a heart rate (HR) of 110 beats/min, and pulse-ox of 96% on room air. Which of the following would you choose?

Back 145

No indication for drug therapy at this time

Front 146

The early phase of an asthmatic reaction occurs during what time frame?

Back 146

15 minutes to 1 hour

Front 147

True or False:
Exogenous surfactant agents enter the alveolar pool and replace deficient natural surfactant.This explains why lung mechanics improve after only one or two administrations of exogenous surfactant.

Back 147

True

Front 148

Side effects of aerosolized steroid use include all of the following except:

Back 148

osteoporosis.

Front 149

A patient has been taking oral prednisone for 1 week following a severe episode of asthma. In order to switch to an aerosol corticosteroid:

Back 149

begin the aerosol and begin to gradually taper off of the oral dose.

Front 150

Systemic administration side effects of corticosteroids include:

Back 150

Decreased activity of the immune system.
Osteoporosis.
Fluid retention and changes in integrity of the skin.

Front 151

In what dosage form is/are corticosteroids available for use in the United States?

Back 151

DPI
MDI
Nebulizer solution

Front 152

Which of the following are examples of steroids available for inhalation?

Back 152

I. Flunisolide
II. Azmacort
III. QVAR

Front 153

The rationale for giving an IV bolus of steroid in acute asthma that is not responding to beta adrenergics is:

Back 153

glucocorticoids restore beta adrenergic response

Front 154

All of the following are types of corticosteroids produced in the adrenal cortex except:

Back 154

corticotropin-releasing factor.

Front 155

All the following are considered natural surfactants except:

Back 155

Dornase alfa.

Front 156

The major cells responsible for an inflammatory response in asthma are:

Back 156

mast cells and eosinophils.

Front 157

Steroid diabetes is term that describes:

Back 157

Gluconeogenesis and increased plasma glucose levels

Front 158

Lack of pulmonary surfactant in respiratory distress syndrome of the newborn results in:

Back 158

high surface tension of alveolar liquid.

Front 159

Another name for surface-active agents is:

Back 159

detergent

Front 160

All the following are hazards or complications of exogenous surfactant except:

Back 160

tachycardia.

Front 161

You are in the room of a 26-week gestational baby that has just been born. The newborn weighs 1200 g. On assessment you find the baby has poor color, substernal retractions, nasal flaring, a RR of 45 breaths/min, and a HR of 140 beats/min. You note that the baby is difficult to ventilate using an AMBO bag. Which of the following agents would you recommend?

Back 161

Beractant

Front 162

Surfactant is composed primarily of:

Back 162

phospholipids.

Front 163

Natural surfactant is obtained by all of the following methods except:

Back 163

in vitro preparation.

Front 164

Your patient tells you that she is having chest tightness and wheezing four to six times per week, plus she wakes up with chest tightness and wheezing about once per week. She uses albuterol each time, with relief. She is taking no other medication, except her albuterol MDI. What other medication would you suggest be prescribed to her?

Back 164

Beclomethasone MDI

Front 165

A newborn baby weighing 1000 g exhibits symptoms of respiratory distress syndrome (RDS), including poor color, suprasternal retractions, nasal flaring, and desaturation. The therapist should recommend

Back 165

Poractant alfa

Front 166

Which of the following pulmonary infections occurring in cystic fibrosis patients is often treated with aerosolized antibiotics?

Back 166

Pseudomonas aeruginosa

Front 167

Zileuton interacts with which of the following respiratory care drugs?

Back 167

I. Theophylline
III. Warfarin

Front 168

Advantages to the use of antileukotrienes include all of the following except:

Back 168

effective in more than 90% of patients.

Front 169

Inhalation of nebulized Tobramycin is associated with an increase in airway reactivity (bronchospasm). What would be the recommended method to avoid this problem?

Back 169

pretreatment with an aerosolized beta agonist

Front 170

Ribavirin is classified as a(n):

Back 170

virostatic

Front 171

Pentamidine is a(n):

Back 171

antifungal agent

Front 172

Which type of aerosol device must be used for the delivery of Ribavirin to infants with RSV pneumonia?

Back 172

Small particle aerosol generator

Front 173

The most commonly reported side effect of cromolyn sodium is:

Back 173

nasal congestion.

Front 174

Nedocromil sodium is administered by:

Back 174

MDI

Front 175

When delivering aerosolized antibiotic medication to a patient which of the following are precautions that should be taken?

Back 175

The patient should be monitored carefully for any adverse drug reaction
The RT should be careful not to expose themselves to the medication exhaled out
Care should be taken to prevent the aerosolized medication from entering the machine of a mechanically ventilated patient
An antibiotic should not be given in the same nebulizer as Mucomyst

Front 176

Zafirlukast is a:

Back 176

leukotriene receptor antagonist.

Front 177

Pentamidine can be administered by which of the following routes?

Back 177

I. Inhaled aerosol
II. Intramuscular
V. Intravenously

Front 178

RSV-IGIV would be used to:

Back 178

prevent RSV infections.

Front 179

The approved dose of pentamidine by aerosol for prevention of Pneumocystis carinii pneumonia (PCP) is:

Back 179

300 mg, once every 4 weeks.

Front 180

The normal dose of ribavirin administration is:

Back 180

20 mg/ml nebulized for 12 to 18 hours per day, for 3 to 7 days.

Front 181

What antimicrobial agent has been given orally in the treatment of Pneumocystis jirovecii?

Back 181

trimethoprim-sulfamethoxazole

Front 182

Which type of asthma is associated with allergic reactions?

Back 182

Extrinsic

Front 183

The brand name for cromolyn sodium is:

Back 183

Intal

Front 184

After a patient begins using cromolyn sodium, how long may it take before clinical improvement in patient symptoms is seen?

Back 184

2 to 4 weeks

Front 185

True or False:
TOBI is usually inhaled after other medications like bronchodilators and alpha dornase, but could also be given in the same nebulizer with alpha dornase.

Back 185

False

Front 186

The only antileukotriene agent currently approved for use in pediatric patients is:

Back 186

Singulair.

Front 187

The aminoglycoside antibiotics are effective in treating:

Back 187

Gram-negative infections

Front 188

It has been suggested that Intal and Tilade are effective as antiinflammatory agents by blocking transport of what ion into inflammatory cells?

Back 188

Chloride

Front 189

Tilade is effective as an antiinflammatory by inhibiting activation and activity of which of the following

Back 189

I. Sensory neurons
II. Mast cells
III. Airway epithelial cells
IV. Eosinophils

Front 190

True or False:
Antileukotrienes are more effective and broader antiinflamatory drugs for use in asthma than corticosteroids.

Back 190

False

Front 191

What is the clinical indication for use of leukotriene modifiers, such as montelukast, in asthma?

Back 191

As an alternative to, or in combination with, inhaled steroids.

Front 192

Pentamidine is administered by aerosol with which nebulizer?

Back 192

Respirgard II

Front 193

Which of the following drugs is available in a DPI?

Back 193

Zanamivir

Front 194

Relenza is a(n)

Back 194

antiviral agent.

Front 195

Local airway side effects of aerosolized pentamidine include which of the following?

Back 195

I. Wheezing
II. Coughing
III. Shortness of breath
IV. Bad taste
V. Spontaneous pneumothorax

Front 196

Respiratory syncytial virus (RSV) can cause which of the following?

Back 196

II. Bronchiolitis
IV. Pneumonia

Front 197

The disease that aerosolized antibiotics have been most consistently used for is:

Back 197

cystic fibrosis

Front 198

True or False:
In mild to moderate asthma, antileukotrienes improve lung function, reduce the need for rescue beta agonists and in moderate to severe asthma there is an additive effect that lowers the need for steroids.

Back 198

True

Front 199

Which of the following microbial agents is used for treatment of pneumocystis caranii pnuemonia in AIDs patients?

Back 199

Pentamadine

Front 200

Tobramycin is a member of which antibiotic group?

Back 200

Aminoglycosides

Front 201

The general indication for clinical use of nonsteroidal antiasthma agents is:

Back 201

prophylactic management of mild persistent asthma

Front 202

Zanamivir would be indicated for:

Back 202

uncomplicated influenza

Front 203

When treating an infant for RSV pneumonia, which of the following medications are used?

Back 203

Ribavirin

Front 204

The small particle aerosol generator (SPAG) unit operates on what principle?

Back 204

Jet shearing

Front 205

Which of the following is a monoclonal antibody used to treat asthma?

Back 205

Omalizumab

Front 206

Cromolyn sodium is available in all of the following forms except:

Back 206

Tablet

Front 207

Systemic side effects of aerosolized pentamidine can include which of the following?

Back 207

I. Pancreatitis
II. Conjunctivitis
III. Neutropenia
IV. Renal insufficiency
V. Rash

Front 208

Nonsteroidal antiasthma drugs are:

Back 208

controllers

Front 209

Which of the following are antileukotrienes?

Back 209

I. Zafirlukast
II. Zileuton
IV. Montelukast

Front 210

The usual dose of nebulized cromolyn sodium is:

Back 210

20 mg four times per day.

Front 211

A drug that is used to prevent serious lower respiratory tract infections with RSV in children under 24 months of age is:

Back 211

RespiGam.

Front 212

Cromolyn sodium is effective in preventing bronchospasm by:

Back 212

inhibiting mast cell degranulation.

Front 213

Ribavirin is active against which of the following?

Back 213

II. Influenza virus
III. RSV
V. Herpes simplex virus

Front 214

Aerosolized antibiotics should not be mixed in the same nebulizer preparation with which of the following drugs?

Back 214

acetylcysteine

Front 215

Leukotrienes exhibit which of the following effects?

Back 215

I. Increased mucus secretion.
II. Inhibition of normal ciliary action.
III. Increased airway edema.
IV. Bronchoconstriction
V. Recruitment of other inflammatory cells into airways

Front 216

Your patient is suffering from cerebral edema. Which group of diuretic agents would you expect to be administered?

Back 216

Osmotic diuretics

Front 217

You are treating a patient who has severe asthma. Which classification of drugs may pose some risk of bronchoconstriction and should be carefully utilized in patients with asthma and chronic obstructive pulmonary disease?

Back 217

Non-cardio specific β Blockers

Front 218

Identify two drugs you could use prior to reversing the effect of non depolarizing vagolytic drugs like vecuronium, in order to minimize unwanted muscarinic side-effects like bradycardia, peristalsis and salivation.

Back 218

Atropine and Glycopyrollate

Front 219

Which of the following medications would be used to prevent thrombus formation in the legs?

Back 219

Heparin

Front 220

True or False:
Succinylcholine is a long acting non-depolarizing neuromuscular agent.

Back 220

False

Front 221

True or False:
Vecuronium is almost entirely excreted by the kidneys, unlike other non-depolarizing neuromuscular agents that excrete metabolite byproducts through the bile as a route to the feces.Accordingly Vecuronium should not be given to patients with renal failure.

Back 221

True

Front 222

Which of the following formulas is used to calculate the total amount of blood pumped by the heart per minute, or cardiac output?

Back 222

rate x SV

Front 223

True or False:
Physostigmine can cross the blood brain barrier.

Back 223

True

Front 224

True or False:
Edrophonium is a short lived agent that reverses neuromuscular blockers.

Back 224

True

Front 225

Stimulant drugs are used to treat narcolepsy, ADHD, AOP or recreationally as when one drinks too much coffee to stay awake. How are these different from Narcan (Naloxone)used to counter drug overdose?

Back 225

Narcan is an opiod receptor antagonist, the others are sympathomimetics.

Front 226

True or False:
Morphine depresses rate and tidal volume, and will cause death by progressively suppressing the hypercapnic and hypoxic respiartory drives, with increasing overdose.

Back 226

True

Front 227

True or False:
Pyridostigmine is the longest acting agent that can reverse neuromuscular blockers. It is orally given for Myasthenia Gravis.

Back 227

True

Front 228

Shock is:

Back 228

a life threatening drop in blood pressure

Front 229

True or False:
A dangerous side effect of Succinylcholine is that it causes hyperkalemia and consequent cardiac arrythmias, even cardiac arrest.

Back 229

True

Front 230

Which cardiac agent may be administered endotracheally?

Back 230

Epinephrine
Lidocaine
Atropine

Front 231

A drug is termed a hypnotic medication when it is used to:

Back 231

Induce sleep

Front 232

Which of the following is considered the antidote for opiate based analgesics such as morphine?

Back 232

Naloxone

Front 233

Benzodiazepines are used to:

Back 233

Reduce anxiety

Front 234

One major side effect of most non-depolarizing neuromuscular agents is that they cause the release of histamine, a potent bronchodilator. Which one has no histamine release and can be safely used as a muscle relaxant for asthmatics.

Back 234

Vecuronium

Front 235

True or False:
There are multiple agents that reverse the effect of Succinylcholine.

Back 235

False

Front 236

A patient is in cardiac shock with a blood pressure of 70/30. Which of the following drugs would you recommend to help correct the hypotension?

Back 236

Dopamine (Intropin)

Front 237

Which of the following is the drug of choice to treat frequent PVCs?

Back 237

Lidocaine

Front 238

True or False:
Acetylcholinesterase is an enzyme that inactivates acetylcholine. Because acetylcholinesterase is itself blocked by Neostigmine, the levels of acetylcholine increase and can compete with neuromuscular blockers. Thus neostigmine can reverse neuromuscular blockers.

Back 238

True

Front 239

Pain control by blocking transmission of the pain impulse from the damaged area is achieved through the use of:

Back 239

local anesthetics

Front 240

True or False:
Succinylcholine is contraindicated in patients with head trauma because it can elevate ICP.

Back 240

True

Front 241

Which of the following would be used to treat a patient having a stroke or coronary artery occlusion to break up the clot?

Back 241

Antithrombitic medication

Front 242

True or False:
Atracurium and Cisatracurium should not be used in patients with cranial injury as their metabolite byproduct Landanosine can cross the blood brain barrier and cause seizures.

Back 242

True

Front 243

True or False:
Reversing non depolarizing vagolytic agents causes other, muscarinic sites to be stimulated, causing bradycardia, peristalsis and salivation.

Back 243

True

Front 244

A patient has increased systemic vascular resistance resulting in hypertension. Which of the following drugs would be used to treat this condition?

Back 244

Nitroprusside (Nipride)

Front 245

Cardiac glycosides would:

Back 245

increase myocardial contractility.

Front 246

Any substance that increases urine flow is termed a(n):

Back 246

diuretic

Front 247

True or False:
Sedative drugs can also be used as hypnotics depending on the dose and strength of the drug.

Back 247

True

Front 248

Which of the following is not considered an inotropic agent?

Back 248

Lidocaine

Front 249

Morphine, codeine, Dilaudid, Demerol, and Darvon are all examples of:

Back 249

Analgesics

Front 250

Your patient is suffering from heart failure secondary to decreased contractility and has a confirmed severe allergy to sulfites. Which of the following inotropic medications would you not recommend?

Back 250

Dobutamine

Front 251

Which of the following is the desired result from medication that is classified as an inotropic drug?

Back 251

Increased strength of cardiac muscle contraction

Front 252

β1 Receptor stimulation will:

Back 252

increase heart rate and contractile force.

Front 253

Which of the following is considered the mainstay for improving hypotensive episodes?

Back 253

Fluids

Front 254

Which of the following is the drug of choice for hypotension in the ICU setting and can be used to increase renal perfusion, cardiac contractility and vasoconstriction depending on the dose?

Back 254

Dopamine

Front 255

Your patient requires a dose of adenosine for confirmed SVT. At present his only line is a peripheral IV in the right arm. How should you proceed?

Back 255

Both, hold the patient’s right arm in an upright position and administer the dose quickly and follow with a
saline flush.

Front 256

All of the following are considered common complications of hypertension except:

Back 256

Decreased perfusion to vital organs

Front 257

True or False:
Non-depolarizing neuromuscular agents like Pancuronium may cause a vagolytic effect producing tachycardia and increase MAP by unopposed sympathetic activity.

Back 257

True

Front 258

True or False:
Atracurium and Cisatracurium self destruct with pH changes. These non-depolarizing neuromuscular agents are advised for patients with kidney failure.

Back 258

True

Front 259

In a hospitalized patient suffering from a pulmonary embolus, where would the most likely site of the original clot formation occur?

Back 259

Deep veins of the legs (DVT)

Front 260

Succinylcholine is a:

Back 260

depolarizing neuromuscular relaxant

Front 261

Which of the following drugs is indicated in cases of sinus bradycardia?

Back 261

Atropine sulfate

Front 262

Neuromuscular blocking agents cause muscle paralysis:

Back 262

but do not block the sensation of pain.

Front 263

Succinylcholine is contraindicated for:

Back 263

male children under 12.

Front 264

Which agent is a parasympatholytic used in cardiac resuscitation for asystole?

Back 264

Atropine

Front 265

Lidocaine is used to treat:

Back 265

ventricular arrhythmias.

Front 266

The most important factor in the management of sudden cardiac death is:

Back 266

timely/efficient CPR and defibrillation.

Front 267

Which of the following conditions are detected by the ECG?

Back 267

I. Abnormal heart rhythms
II. Conduction problems
III. Location of damaged heart muscle

Front 268

What is a primary use for digitalis drugs?

Back 268

Cardiotonic in congestive heart failure.

Front 269

During a bronchoscopy with biopsy the patient starts to bleed. Which of the following would be injected down the bronchoscope to stop the bleeding?

Back 269

Epinephrine

Front 270

Atropine would be given to:

Back 270

increase heart rate.

Front 271

When stimulated, the sympathetic fibers cause an increase in the:

Back 271

I. heart rate.
II. AV conduction.
III. cardiac contractility.
IV. excitability.

Front 272

Vagolytic agents competitively block post synaptic ________receptors

Back 272

Nicotinic and Muscarinic

Front 273

A heartbeat that did not originate from the SA node is called?

Back 273

Ectopic beat

Front 274

Epinephrine stimulates which sites?

Back 274

I. α
II. β1
III. β2

Front 275

Your patient is a 67-year-old homeless male who suffers from malnutrition. His labs show that he suffers from hypomagnesemia. What arrhythmia should you be on the lookout for until a dose of magnesium can be administered?

Back 275

Torsades de pointes