Hth 102 midterm 1
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| A 2 year old child is seen in the ER w croup. Physician orders dose of racemic epi via svn for subglottic swelling. What size aerosol particle is most likely to deposit in this region? | Particles 5-10
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| For pulmonary diagnostics and therapeutic applications, particle size range of interest is what? | 1-10 micrometer
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| Which of the following statements are true about recommended volume of solution when delivering aerosol treatment svn ? | Volume between 3-5ml of solution Increasing volume results in decrease in concentration of drug remaining in dead volume when nebulization ceases 3. Pt compliance is directly proportionally to convenience
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| Physician has orerd pt to receive continuous admin of heliox w racemic epinephrine secondary to postectubation stridor. As you approach bedside to deliver svn racemic epi, what outcomes should be expected w gas glow of 10lpm? | Two fold increase in nebulization time compared to that of oxygen as a power gas
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| Pt is receiving gentamicin via SVN to compensate for increased viscosity of aerosol solutions what should be done? | Set gas flow 12lpm (high viscocity antibiotic = higher O2 flow)
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| By the year 2008 all MDI must be powered by what? | Hydrofluoroalkanes (HFA’s)
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| When teaching proper MDI technique to a pt, should explain that failure to shake device before actuation may result in… | Reduction of total dose , or an increase in total dose
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| Barring any issue regarding pt coordination or ability to correctly use device, how should it be suggested that pt administer drug w MDI if no spacer available? | Hold the MDI several centimeters in front of the mouth
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| Physician has requested pt be provided w reservoir device to use w MDI given chouce what type would be given to pt? | Antitstatic valved holding chamber
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| One standard teaspoon is the equivalent of how many mm? | 5ml
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| You administer 0.5ml of a 1:200 strength drug; how many mg of active ingredient are you giving? | 2.5mg
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| you have 3mg/ml of active ingredient; what is the percent solution in this drug? | 0.3%
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| how much 20% acetylcysteine solution will you use to prepare 5ml of a 6% solution? | 1.5ml
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| atrovent is supplied as a 0.02% solution. if you administer 2.5ml to a pt, how many mg are you giving? | 0.5
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| micro is what value | 1/1,000,000
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| milli is what value | 1/1000
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| centi is what value | 1/100
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| deci is what value | 1/10
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| somatic portion of the nervous system controls what? | skeletal muscle
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| how is the neurotransmitter AcH inactivated at the parasympathetic terminal receptor site? | by the enzyme cholinesterase
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| your patient is accidentally give large dose of parasympathetic drug what are side effects expected? | salivating, lacrimation, urination, defication SLUDG
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| after administrating sympathetic drug to pt, what areas would you expect to see an upward trend? | heart rate, BP, blood sugar
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| direct acting cholinergic agent often used in bronchial challege test to assess the degree of airway activity is? | methacholine
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| what type of impulses travel from the brain to the neuroeffector site? | efferent
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| epi stimulates what sites? | alpha, beta1, beta 2
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| stimulation of which receptor site produces bronchial smooth muscle relaxation? | beta 2
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| what drugs are sympathomimetic agents? | salmeterol, dopamine
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| parasympathetic effect is the same as what? | muscarinic effect
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| pt w bronchospasm is being given albuterol, what other drug might you recomend? | anticholinergic bronchodilator
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| adregeneric bronchodilators mimic the actions of what? | epinephrine
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| your pt has postextubation stridor you recomend racemic epi why? | alpha adrenergic vasoconstricting effect
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| what percent solution does racemic epi come in? | 2.25%
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| catecholamines are inactivated by? | COMT
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| catecholamines shouldn't be given by what route? | oral
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| smooth muscle relaxation most likely occurse as a result of what | increase in cAMP
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| dosage recomended by NAEPP EPR 2 for continuous nebulization of adrenergic agents is? | 10-15 mg/hr
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| what complications should we look for if pt is receiving 3 continous neb of alb? | hypokalemia, cardiac arrhythmias, hyperglycemia, PVC's, tremor
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| what is the rationale for using the single-isomer agent levalbuterol instead of racemic alb? | s isomer is thought to promote bronchoconstriction
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| whats the main difference between salmeterol and formoterol? | formotorol has a quicker onset and peak effect than salmeterol
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| atrovent is approved for? | maintance treatement of airflow obstruction in COPD
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| combivent is a mix of what two drugs? | albuterol and atrovent
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| mucociliary slowing, bronchodilation, and increased heart rate are result of what drug? | anticholinergic agents
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| ipratropium agents are indicated to treat what? never to be used in what? | allergic rhinitis, non allergic, common cold. never for allergies of peanuts
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| quaternary ammonium compounds cause bronchodilation by | blocking cholinergic sites
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| activating atrovent inhaler may cause what? | pupil dilation
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| whats the only one a day anticholinergic on market? | tiotropium bromide
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| theophylline is classified as a bronchodilator because | it stimulates B2 adrenergic sites
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| what is the current recommended blood serum levels of theophyline for ashtma | 5-15 micrograms/ml
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| what is the therapuetic range for theophyline? | 10-20 microgram/ml
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| in the peripheral airways the rate of mucociliary tranpsort in normal peripheral airway is approximately | 1.5mm/min
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| the cholinergic response in terms of mucociliary clearance is? | increased ciliary beat and increased mucus production
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| what are the hazards associated w use of acetylcysteine? | nausea, rhinorrhea, bronchospasm
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| the standard dose of dornase alfe for aerosolization is? | 2.5mg in 2.5ml of dilutent
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| you have a pt with COPD strugling to expel viscid mucus plug, what med recomended? | acetylcysteine
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| acetylcysteine is oncompatible in solution what what? | certain antibiotics
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| how does dornase alfa work? | breaks down DNA content in sputum
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| how does acetylcystein work? | substitutes sulfhydryl radicals for disulfide bonds in mucus
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| a significant side effect of corticosteroid use is inhbition of | HPA axis
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| what are the types of corticosteroids produced in adrenal cortex is? | glucocorticoids, mineralocorticoids, sex hormones
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| what type of asthma is associated with allerfic reactions? | extrinsic
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| cromolyn sodium is effective in preventing bronchospasms by? | inhibiting mast cell degranulation
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| cromolyn sodium may take how long to take effect? | 2-4 weeks
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| the usual dose of nebulized cromolyn sodium is? | 20mg 4 times a day
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| intal and tilade are effective as antiinflamatory agents by blocking the transport of what into inflammatory cells? | chloride
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| zileuton interacts with what resp therapy drug? | theophylline and warfarin
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| whats the only antileukotrine approved for peds? | singulair
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| what nonsteroidal antiasthma agent is formulated as an MDI? | nedocromil
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| what drug is lipid-soluble intracellular receptor agonist that prevents an inflammatory response? | flovent
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| pentamidine is what type of an agent? | antiprotozoal agent
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| trade name for pentamadine is? indicated for? | nebupent, prevention of pcp
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| approved dose of pentamidine by aerosol for pervention of PCP is? | 300 mg once every 4 weeks
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| local airway side effects of aerosolized pentamidine are what? | wheezing, coughing, SOB, bad taste, spontaneous poeumothoraces
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| ribavirin is classified as? | virostatic
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| ribivirin indicated for what? | influenza virus, RSV, herpes
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| SPAG unit opperates off of what principal | jer shearing
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| what nebulizer is used to aerosolized ribavirin | SPAG
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| RSV can cause what side effects? | bronchiolitis, and pna
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| what drug is used to prevetn serious olower resp tract infections w RSV in children under 24 mths of age | respigam
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| the disease that aerosolizes antibiotics have been most consistently used for are? | cystic fibrosis
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| aminoglycoside antibiotics are effective in treating? | gram - bacteria
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| Zanamivir is indicated for what? | uncomplicated influenza
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| pt with pneumocystic pna been treated for infection without success u recomend aerosolizing what? | pentamidin
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| tobramycin is a member of what antiobiotic group? | aminoglycosides
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| aminoglycosides are used primarily for | gram negative infections
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| what are tetracyclines effective against? | protozoa, mycoplasmas, rickettsiae, gram +-
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| what is a major tocis effect pf amphotericin b? | renal impairment
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| what are some antimycobacterials used to treat TB | isoniazid, rifampin, pyrazinamide
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| a wheal and flare reaction is characterized by what? | welt formation, local redness, local swelling
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| what are the typical antihistamine found in common cold medications? | h1 receptro antagonist
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| first generation antihistamines can cause what? | drying of upper airway secretions, sedation, decreased rhinitis, decreased sneezing, drowsiness
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| the defense mechanism to protect the upper airway form ittitants is what? | cough
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| cough suppresents act by? | depressing the cough center in the medulla
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| what type of drug is used to dry up a runny nose? | antihistamine
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| what receptor site would be targeted for the atihistamine (zantac) | H2
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| what drug is intended for a therapy of congenital alpha 1 antitrypsin deficiency? | prolastin
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| if a physician suspects a pt has alpha 1 antitypsin deficiency what disease would confirm? | panacinar emphysema
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| what is the major limitation of prolastin therapy? | cost
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| the recomended doseage of prolastin is? | 60mg/kg once weekly
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| bupropion is a medication used with nicotine replacement to treat what? | depression
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| smoking cessation drugs are available in which of the following forms? | gum, nasal spray, transdermal patch, tablets
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| Zyban is an example of what? | an antidepresant
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| the recommended dose of nitric oxide is? | 20 ppm
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| true or false dopamine administered in the range of 1-5 micro gram/kg/min stimulates receptros in the splanchnic and renal arteriol beds increasing blood flow to these organs? | false
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| t/f adverse effects of dopamine include tachyarrhythmias, ectopic beat, palpitations, and decreased perfusion | true
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| what agent is a parasympatholytic used in full arrest? | atropine
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| what do cardiac glycoside do? | increase myocardial contractility
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| clas IA agents are effective in treating what? | atrial and ventrical arrhythmias
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| class IB antiarrythmics are limited to treating what? | ventricular arrythmias
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| lidocaine is used to treat what? | ventricular arrhythmias
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| according to vaughan williams classification system, whcih class of antiarrhytmic agents consists mainly of b blockers? | class II
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| according to VW classification what class of antyarrhthmic agents consists of only two calcium channel blockers used for afib | class IV
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| your pt is a 67 y/o homeless male w malnutrition labs show hypomagnesemia, what arrhythmia should w look for? | torsades de points
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| whats the drug classification for dobutamine? | inotropic
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| whats the drug classification for dopamine? | catecholamine
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| whats the drug clasification for procainamide? | antiarrhythmic
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| t/f nondepolarizing agents cause muscle to fasciculate and reamin in a refractory state? | false
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| t/f potential side effect of nondepolarizing blocking agents include tachycardia and hypertension? | true
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| what is the nuerotransmitter released by all somatic motor nerves? | Ach
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| the termination of the nerve acon on the skeletal muscle fiber is called? | neuromuscular junction
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| when does skeletal muscle contraction occur? | depolarization
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| quadriceps, bronchial wall, biceps, diaphragm, and cardiac fibers are examples of what? | skeletal muscles
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| agents that paralyze skeletal muscle by simple competitive inhibition of acetylcholine at muscle receptor sites are called? | nondepolarizing
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| how are nondepolarizing agents administered? | parenterally
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| nondepolarizing neuromuscular blocking agents exhibit which characteristics? | they are quaternary ammonium drugs, reach a peak effect quickly, poorly absorbed form GI tract
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| what's the maximal paralyzing effect of succinylcholine reached? | 60-90 seconds
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| what are some adverse effects of nondepolarizing neuromuscular blocking agents? | bronchospasm, tachycardia, apnea, increased airway resistance, increased blood pressure
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| what is the main reason succinylcholine is given? | for patient intubation
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| what are some characteristics of depolarizing neuromuscular blocking agents? | not easily reversed, shorter acting than nondepol, cause fasciculation, cause total paralysis in 60-90 seconds
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| how are nondepolarizing blocking agents reversed? | cholinesterase inhibitors
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| agents that act to lower blood pressure by stopping conversion of angiotensin I to angiotensin II are what? | ACE inhibitors
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| the first-line agents for treatment of uncomplicated HTN is? | thiazide diuretics and beta blockers
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| angiotensin-converting enzyme inhibitors (ACEIs) produce what effects? | reduction of peripheral arterial pressure, increase in renal blood flow, increase in cardiac output
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| What are ACEI's indicated for? | heart failure, systolic disfunction, secondary prevention of mi, HTN, diabetic neuropathy
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| what's the most common side effect for ACEI's? | persistant dry cough
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| thiazade diuretics increase exertion of? | sodium, chloride, potassium, and magnesium
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| a great example of an antiplatelet agent is? | aspirin
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| you'r 27 y/o patient has bp of 185/125 no current s/s of acute organ complications what would his condition be labeled? | HTN urgency, HTN crisis
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| what is the most potent group of diuretic agents? | loop
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| what does aldosterone do? | increase sodium and water reabsorption
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| Osmotic diuretics function by | blocking reabsorption of NaCl in the proximal tubule and decending limb of the loop henle
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| the use of carbonic anhydrase inhibtors will result in what? | metabolic acidosis
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| thiazide diuretics work by | blocking sodium and chloride reabsorption in the distal tubule
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| what agents block reabsorption of sodium in the distal tubule | potassium sparing diuretics
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| NSAIDS are used to? | treat moderate pain
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| t/f once a drug is released for general clinical use, detailed reporting system reamins in place for 10 years? | false
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| where are the listing of a drug and the amount of a drug found in the prescription? | inscription
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| what's the brand name given to a drug by a particular manufacturer? | trade name
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| in order to find official info about drugs according to FDA where do you look? | united states pharmacopia national formulary (USP-NF)
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| what is an orphan drug? | one that is used for a rare disease or one that won't recover the costs
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| how much is spent in today's market per new drug on research, development, preclinical and postclinical trials | 900million
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| regarding the therapuetic potential of a drug the code AA symbolizes? | an important therapeutic agent, for aids fast track
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| the abreviation ac means | before meal
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