Pharm Test 3; Respiratory Drugs/bronchodilators/antihistamines/mucolytics

Front 1

Epinephrine is used for:
A.
B.
C.

Back 1

A. acute allergic rxn
B. anaphylaxis
C. bronchospasm

Front 2

Epinephrine routes:
A.
B.
C.

Back 2

A. SQ
B. IV
C. inhaled

Front 3

Epinephrine long-acting drug:

Back 3

Susphrine; SQ, oil prep

Front 4

Epinephrine OTC inhaler:

Back 4

racemic epienphrine (Primatene)

Front 5

T/F: nonselective beta 1 and 2 adrenergic bronchodilators are rarely in use.

Back 5

T: cause more cardiac effects

Front 6

T/F: Beta 2 selective cause no cardiac effects.

Back 6

F: still cause some, and lose specificity with higher doses

Front 7

Beta 2 adrenergic bronchodilator used for:
A.
B.

Back 7

A. bronchodilation
B. inhibit inflammatory cell release of mediators

Front 8

Beta 2 adrenergic bronchodilator effects:
A.
B.
C.
D.

Back 8

A. nervousness/tremor
B. weakness
C. HA
D. insomnia

Front 9

Toxicity of beta adrenergic bronchodilators:
A.
B.
C.
D.

Back 9

A. tachycardia
B. high BP
C. arrhythmias
D. CNS stimulation

Front 10

How is toxicity usually reached with beta adrenergic bronchodilators?

Back 10

Over use of short-acting agents

Front 11

Administration of beta adrenergic bronchodilators:

Back 11

MDI/nebulizer; some oral for kids

Front 12

Albuterol (Proventil, Ventolin) is what type of drug?

Back 12

Short-acting beta adrenergic bronchodilator

Front 13

Short-acting beta adrenergic bronchodilator uses:
A.
B.
C.

Back 13

A. prevention, dosed up to 4 X/day
B. prior to aggravating conditions
C. "rescue" inhaler

Front 14

long-acting beta adrenergic bronchodilator uses:
A.
B.
C.

Back 14

A. prevent exacerbations
B. increase symptom free days
C. reduce rescue inhaler use

Front 15

Salmeterol (Serevent) is what type of drug?

Back 15

long-acting beta adrenergic bronchodilator

Front 16

T/F: there is a debate on whether long-acting beta adrenergic bronchodilators should be used alone because may cause rare, severe asthma exacerbations.

Back 16

T

Front 17

Corticosteroid/glucocorticoid are suggested for which patients?

Back 17

Patients requiring beta 2 agonists more than 4 times/week

Front 18

T/F: Corticosteroids cause less systemic effects.

Back 18

T

Front 19

Corticosteroid use:
A.
B.

Back 19

A. prophylaxisis but takes several weeks
B. lower use of rescue inhalers/reduce exacerbations

Front 20

Corticosteroid adverse effects:

Back 20

Systemic absorption from swallowing drug during inhalation; worse with higher doses

Front 21

How to prevent thrush from developing form use of corticosteroids:
A.
B.

Back 21

A. rinse mouth after use
B. use spacer

Front 22

Triamcinolone (Azmoacort) is what type of drug?

Back 22

Corticosteroid/glucocorticoid

Front 23

How should glucocorticoid be used with a beta agonist?

Back 23

beta administered first, wait 15 minutes, than administer glucocorticoid

Front 24

The only recommended use of long-acting beta agonists are:

Back 24

combinations with corticosteroids

Front 25

Fluticasone/Salmeterol (Advair) and Formoterol/budesonide (Symbicort) are what kinds of drugs?

Back 25

Combination with corticosteroid

Front 26

T/F: Corticosteroids are also rescue inhalers.

Back 26

F: for maintenance

Front 27

Anticholinergic agents perform by:
A.
B.
C.

Back 27

A. reduce cholinergic effects
B. enhance andrenergic effects
C. bronchodilation

Front 28

T/F: Anticholinergic agents have a slower onset than beta 2 agonists.

Back 28

T

Front 29

T/F: anticholinergic agents cause tolerance over time.

Back 29

F

Front 30

Adverse effects of anticholinergic agents:
A.
B.

Back 30

A. little tachycardia/cardiac effects
B. little effect on glaucoma unless sprayed in eyes

Front 31

T/F: anticholinergic agents aren't the 1st line of therapy for acute asthma exacerbations

Back 31

F: but used in combo with beta 2 agonsts

Front 32

Ipratropium (Atrovent) and Tiotropium (Spriva) are what type of drug?

Back 32

anticholinergic agents

Front 33

Atrovent is often used with which drug?

Back 33

Albuterol

Front 34

T/F: spacer device for MDI shows improved inhaled drug ration

Back 34

T: decreases patient need to coordinate inhalation and discharge of medication

Front 35

T/F: MDI and nebulizers are equally effective

Back 35

T: only if both used correctly; nebulizers preferred for elderly or kids

Front 36

T/F: Dry power inhalers need a strong inhalation to administer.

Back 36

T

Front 37

Derivatives of theophylline include:
A.
B.
C.

Back 37

A. aminophylline
B. caffeine
C. thebromine

Front 38

Theophylline is what type of drug?

Back 38

Methylxanthines

Front 39

How do methylxanthine drugs work?
A.
B.
C.
D.
E

Back 39

A. bronchodilation
B. increase CO
C. inhibit release of mast cell spasmogens
D. enhance mucociliary clearance
E. inhibit inspiratory muscle fatigue

Front 40

T/F: Adverse effects of methylxanthine drugs are dose-related.

Back 40

T

Front 41

Adverse effects of methylxanthine:

Back 41

CNS stimulation

Front 42

T/F: toxicity in methylxanthine can be mild to severe.

Back 42

T

Front 43

Mild toxicity in methylxanthine:
A.
B.
C.

Back 43

A. N/V
B. diarrhea
C. CNS stimulation/HA

Front 44

Severe toxicity in methylxanthine:
A.
B.
C.
D.
E.

Back 44

A. tremor
B. tachycardia
C. N/V/D
D. HTN
E. can lead to dysrhythmia, agitation, seizures, confusion

Front 45

therapeutic range for methylxanthine:

Back 45

10-20 mcg/mL

Front 46

T/F: toxic effects can occur in the therapuetic range.

Back 46

T: 15-20 mcg/mL

Front 47

Use of methylxanthine in acute bronchospasm is given via:

Back 47

IV; loading dose than infusion

Front 48

Use of methylxanthine chronically for which patients?
A.
B.

Back 48

A. COPD
B. asthma; but debateable because there are less toxic drugs

Front 49

What do leukotrienes have to do with respiratory?

Back 49

released in asthma and cause bronchospasm, airway edema, increased mucus produciton

Front 50

Leukotriene receptor agonists are used for:
A.
B.
C.

Back 50

A. asthma prevention
B. seasonal allergies
C. some use with COPD

Front 51

Leukotriene receptor agonist adverse effects:
A.
B.

Back 51

A. GI upset
B. psychiatric rxn (agitation, depression, sucidial thoughts)

Front 52

Zafirlukast (Accolate) is what type of oral agent?

Back 52

Leukotriene receptor agonist

Front 53

Ziluetion (Zyflo) is what type of drug?

Back 53

Leukotriene synthesis inhibition

Front 54

Zyflo use used for:

Back 54

asthma prevention

Front 55

What do mast cell stabilizers do?

Back 55

prevent mast cell degranulation

Front 56

Do mast cell stabilizers have a slow or fast onset?

Back 56

Slow; > than a week

Front 57

T/F: Mast cell stabilizers are for any type of asthma.

Back 57

F: not for acute, only mod-severe

Front 58

Mast cell stabilizer effects:
A.
B.
C.
D.

Back 58

A. bad taste
B. cough
C. bronchospasm
D. sore throat

Front 59

Cromolyn sodium (Intal) and medocromil (Tilade) are what type of drug?

Back 59

mast cell stabilizers

Front 60

T/F: Tilade can also be used for opthalmic use d/t allergies.

Back 60

T

Front 61

Anti IgE agents prevent:

Back 61

exacerbations

Front 62

T/F: anti IgE agents are for adults and adolescents over 12 yo only.

Back 62

T

Front 63

Anti IgE administration:

Back 63

SQ q 2-4 weeks

Front 64

Adverse effects of anti IgE:
A.
B.

Back 64

A. stinging at injection site
B. possibility of cancer (?)

Front 65

Omalizumab (Xolair) is what type of drug?

Back 65

anti IgE

Front 66

System corticosteroids work by:

Back 66

suppressing immune system

Front 67

systemic corticosteroids used for:

Back 67

Acute bronchospasm

Front 68

T/F: System corticosteroids can be stopped abruptly.

Back 68

F: canc ause Addisonian crisis

Front 69

T/F: system corticosteroid administration should be as low dosed and as short of time as possible

Back 69

T

Front 70

Expectorants cause:

Back 70

stimulation of flow of respiratory secretions

Front 71

Exectorants are included in many types of what medications?

Back 71

cough

Front 72

T/F: expectorants have a debateable efficacy

Back 72

T

Front 73

Guafenesin (Robitussin, Mucinex) is what type of drug?

Back 73

expectorant

Front 74

Antihistamines focus on which receptor?

Back 74

H1

Front 75

H1 histamine antagonist drugs work by:

Back 75

inhibiting vasodilation by blocking increased capillary permeability

Front 76

H1 histamines are less effective against:
A.
B.

Back 76

A. bronchospasm
B. bronchoconstriciton

Front 77

T/F: H1 histamine antagonists can cause CNS stimulation or depression.

Back 77

T

Front 78

H1 histamine side effects:

Back 78

anticholinergic

Front 79

T/F: H1 histamine antagonists should not be mixed with ETOH or CNS depressants.

Back 79

T

Front 80

T/F: H1 histamine antagonists are teratogenic.

Back 80

T; but only some agents

Front 81

H1 histamine antagonist uses:
A.
B.
C.
D.
E.

Back 81

A. reduce symptoms in allergic disease
B. motion sickness
C. Vertigo
D. sedation
E. N/V

Front 82

Diphenhydramine (Benadryl) is what type of drug?

Back 82

1st generation H1 histamine antagonist

Front 83

T/F: 1st generation H1 histamine antagonist cross BBB.

Back 83

T

Front 84

T/F: H1 histamines are recommended in asthma.

Back 84

F: dries secretions

Front 85

Promethazine (Phenergan) is what type of drug?

Back 85

antiemetic 1st generation H1 histamine antagonist

Front 86

Hydroxyzine (Atarax/Vistaril) is what type of drug?

Back 86

antiemetic/antipruritis 1st generation H1 histamine antagonist

Front 87

Dimenhydrinate (Dramamine) is what type of drug?

Back 87

motion sickness 1st generation H1 histamine antagonist

Front 88

Cyclizine (Marazine) and meclizine (Antivert) are what types of drugs?

Back 88

1st generation H1 histamine antagonist

Front 89

T/F: 2nd generation H1 histamine antagonists don't cross BBB.

Back 89

T: less sedation and anticholinergic effects

Front 90

Loratadine (Claritin), desloratadine (Clarinex), and fexofendadine (Allegra) are what type of drugs?

Back 90

2nd generation H1 histamine antagonists

Front 91

Azelastine (Astelin) and ketotifen (Zaditor) are what type of drugs?

Back 91

Nasal spray; 2nd generation H1 histamine antagonists

Front 92

Olopatadine (Patanol) is what type of drug?

Back 92

Ophthalmic 2nd generation H1 histamine antagonists