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Hth 102 midterm 1
| Question | Answer |
|---|---|
| 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 |
| For pulmonary diagnostics and therapeutic applications, particle size range of interest is what? | 1-10 micrometer |
| 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 |
| 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 |
| 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) |
| By the year 2008 all MDI must be powered by what? | Hydrofluoroalkanes (HFA’s) |
| 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 |
| 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 |
| 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 |
| One standard teaspoon is the equivalent of how many mm? | 5ml |
| You administer 0.5ml of a 1:200 strength drug; how many mg of active ingredient are you giving? | 2.5mg |
| you have 3mg/ml of active ingredient; what is the percent solution in this drug? | 0.3% |
| how much 20% acetylcysteine solution will you use to prepare 5ml of a 6% solution? | 1.5ml |
| atrovent is supplied as a 0.02% solution. if you administer 2.5ml to a pt, how many mg are you giving? | 0.5 |
| micro is what value | 1/1,000,000 |
| milli is what value | 1/1000 |
| centi is what value | 1/100 |
| deci is what value | 1/10 |
| somatic portion of the nervous system controls what? | skeletal muscle |
| how is the neurotransmitter AcH inactivated at the parasympathetic terminal receptor site? | by the enzyme cholinesterase |
| your patient is accidentally give large dose of parasympathetic drug what are side effects expected? | salivating, lacrimation, urination, defication SLUDG |
| after administrating sympathetic drug to pt, what areas would you expect to see an upward trend? | heart rate, BP, blood sugar |
| direct acting cholinergic agent often used in bronchial challege test to assess the degree of airway activity is? | methacholine |
| what type of impulses travel from the brain to the neuroeffector site? | efferent |
| epi stimulates what sites? | alpha, beta1, beta 2 |
| stimulation of which receptor site produces bronchial smooth muscle relaxation? | beta 2 |
| what drugs are sympathomimetic agents? | salmeterol, dopamine |
| parasympathetic effect is the same as what? | muscarinic effect |
| pt w bronchospasm is being given albuterol, what other drug might you recomend? | anticholinergic bronchodilator |
| adregeneric bronchodilators mimic the actions of what? | epinephrine |
| your pt has postextubation stridor you recomend racemic epi why? | alpha adrenergic vasoconstricting effect |
| what percent solution does racemic epi come in? | 2.25% |
| catecholamines are inactivated by? | COMT |
| catecholamines shouldn't be given by what route? | oral |
| smooth muscle relaxation most likely occurse as a result of what | increase in cAMP |
| dosage recomended by NAEPP EPR 2 for continuous nebulization of adrenergic agents is? | 10-15 mg/hr |
| what complications should we look for if pt is receiving 3 continous neb of alb? | hypokalemia, cardiac arrhythmias, hyperglycemia, PVC's, tremor |
| what is the rationale for using the single-isomer agent levalbuterol instead of racemic alb? | s isomer is thought to promote bronchoconstriction |
| whats the main difference between salmeterol and formoterol? | formotorol has a quicker onset and peak effect than salmeterol |
| atrovent is approved for? | maintance treatement of airflow obstruction in COPD |
| combivent is a mix of what two drugs? | albuterol and atrovent |
| mucociliary slowing, bronchodilation, and increased heart rate are result of what drug? | anticholinergic agents |
| ipratropium agents are indicated to treat what? never to be used in what? | allergic rhinitis, non allergic, common cold. never for allergies of peanuts |
| quaternary ammonium compounds cause bronchodilation by | blocking cholinergic sites |
| activating atrovent inhaler may cause what? | pupil dilation |
| whats the only one a day anticholinergic on market? | tiotropium bromide |
| theophylline is classified as a bronchodilator because | it stimulates B2 adrenergic sites |
| what is the current recommended blood serum levels of theophyline for ashtma | 5-15 micrograms/ml |
| what is the therapuetic range for theophyline? | 10-20 microgram/ml |
| in the peripheral airways the rate of mucociliary tranpsort in normal peripheral airway is approximately | 1.5mm/min |
| the cholinergic response in terms of mucociliary clearance is? | increased ciliary beat and increased mucus production |
| what are the hazards associated w use of acetylcysteine? | nausea, rhinorrhea, bronchospasm |
| the standard dose of dornase alfe for aerosolization is? | 2.5mg in 2.5ml of dilutent |
| you have a pt with COPD strugling to expel viscid mucus plug, what med recomended? | acetylcysteine |
| acetylcysteine is oncompatible in solution what what? | certain antibiotics |
| how does dornase alfa work? | breaks down DNA content in sputum |
| how does acetylcystein work? | substitutes sulfhydryl radicals for disulfide bonds in mucus |
| a significant side effect of corticosteroid use is inhbition of | HPA axis |
| what are the types of corticosteroids produced in adrenal cortex is? | glucocorticoids, mineralocorticoids, sex hormones |
| what type of asthma is associated with allerfic reactions? | extrinsic |
| cromolyn sodium is effective in preventing bronchospasms by? | inhibiting mast cell degranulation |
| cromolyn sodium may take how long to take effect? | 2-4 weeks |
| the usual dose of nebulized cromolyn sodium is? | 20mg 4 times a day |
| intal and tilade are effective as antiinflamatory agents by blocking the transport of what into inflammatory cells? | chloride |
| zileuton interacts with what resp therapy drug? | theophylline and warfarin |
| whats the only antileukotrine approved for peds? | singulair |
| what nonsteroidal antiasthma agent is formulated as an MDI? | nedocromil |
| what drug is lipid-soluble intracellular receptor agonist that prevents an inflammatory response? | flovent |
| pentamidine is what type of an agent? | antiprotozoal agent |
| trade name for pentamadine is? indicated for? | nebupent, prevention of pcp |
| approved dose of pentamidine by aerosol for pervention of PCP is? | 300 mg once every 4 weeks |
| local airway side effects of aerosolized pentamidine are what? | wheezing, coughing, SOB, bad taste, spontaneous poeumothoraces |
| ribavirin is classified as? | virostatic |
| ribivirin indicated for what? | influenza virus, RSV, herpes |
| SPAG unit opperates off of what principal | jer shearing |
| what nebulizer is used to aerosolized ribavirin | SPAG |
| RSV can cause what side effects? | bronchiolitis, and pna |
| what drug is used to prevetn serious olower resp tract infections w RSV in children under 24 mths of age | respigam |
| the disease that aerosolizes antibiotics have been most consistently used for are? | cystic fibrosis |
| aminoglycoside antibiotics are effective in treating? | gram - bacteria |
| Zanamivir is indicated for what? | uncomplicated influenza |
| pt with pneumocystic pna been treated for infection without success u recomend aerosolizing what? | pentamidin |
| tobramycin is a member of what antiobiotic group? | aminoglycosides |
| aminoglycosides are used primarily for | gram negative infections |
| what are tetracyclines effective against? | protozoa, mycoplasmas, rickettsiae, gram +- |
| what is a major tocis effect pf amphotericin b? | renal impairment |
| what are some antimycobacterials used to treat TB | isoniazid, rifampin, pyrazinamide |
| a wheal and flare reaction is characterized by what? | welt formation, local redness, local swelling |
| what are the typical antihistamine found in common cold medications? | h1 receptro antagonist |
| first generation antihistamines can cause what? | drying of upper airway secretions, sedation, decreased rhinitis, decreased sneezing, drowsiness |
| the defense mechanism to protect the upper airway form ittitants is what? | cough |
| cough suppresents act by? | depressing the cough center in the medulla |
| what type of drug is used to dry up a runny nose? | antihistamine |
| what receptor site would be targeted for the atihistamine (zantac) | H2 |
| what drug is intended for a therapy of congenital alpha 1 antitrypsin deficiency? | prolastin |
| if a physician suspects a pt has alpha 1 antitypsin deficiency what disease would confirm? | panacinar emphysema |
| what is the major limitation of prolastin therapy? | cost |
| the recomended doseage of prolastin is? | 60mg/kg once weekly |
| bupropion is a medication used with nicotine replacement to treat what? | depression |
| smoking cessation drugs are available in which of the following forms? | gum, nasal spray, transdermal patch, tablets |
| Zyban is an example of what? | an antidepresant |
| the recommended dose of nitric oxide is? | 20 ppm |
| 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 |
| t/f adverse effects of dopamine include tachyarrhythmias, ectopic beat, palpitations, and decreased perfusion | true |
| what agent is a parasympatholytic used in full arrest? | atropine |
| what do cardiac glycoside do? | increase myocardial contractility |
| clas IA agents are effective in treating what? | atrial and ventrical arrhythmias |
| class IB antiarrythmics are limited to treating what? | ventricular arrythmias |
| lidocaine is used to treat what? | ventricular arrhythmias |
| according to vaughan williams classification system, whcih class of antiarrhytmic agents consists mainly of b blockers? | class II |
| according to VW classification what class of antyarrhthmic agents consists of only two calcium channel blockers used for afib | class IV |
| your pt is a 67 y/o homeless male w malnutrition labs show hypomagnesemia, what arrhythmia should w look for? | torsades de points |
| whats the drug classification for dobutamine? | inotropic |
| whats the drug classification for dopamine? | catecholamine |
| whats the drug clasification for procainamide? | antiarrhythmic |
| t/f nondepolarizing agents cause muscle to fasciculate and reamin in a refractory state? | false |
| t/f potential side effect of nondepolarizing blocking agents include tachycardia and hypertension? | true |
| what is the nuerotransmitter released by all somatic motor nerves? | Ach |
| the termination of the nerve acon on the skeletal muscle fiber is called? | neuromuscular junction |
| when does skeletal muscle contraction occur? | depolarization |
| quadriceps, bronchial wall, biceps, diaphragm, and cardiac fibers are examples of what? | skeletal muscles |
| agents that paralyze skeletal muscle by simple competitive inhibition of acetylcholine at muscle receptor sites are called? | nondepolarizing |
| how are nondepolarizing agents administered? | parenterally |
| nondepolarizing neuromuscular blocking agents exhibit which characteristics? | they are quaternary ammonium drugs, reach a peak effect quickly, poorly absorbed form GI tract |
| what's the maximal paralyzing effect of succinylcholine reached? | 60-90 seconds |
| what are some adverse effects of nondepolarizing neuromuscular blocking agents? | bronchospasm, tachycardia, apnea, increased airway resistance, increased blood pressure |
| what is the main reason succinylcholine is given? | for patient intubation |
| 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 |
| how are nondepolarizing blocking agents reversed? | cholinesterase inhibitors |
| agents that act to lower blood pressure by stopping conversion of angiotensin I to angiotensin II are what? | ACE inhibitors |
| the first-line agents for treatment of uncomplicated HTN is? | thiazide diuretics and beta blockers |
| angiotensin-converting enzyme inhibitors (ACEIs) produce what effects? | reduction of peripheral arterial pressure, increase in renal blood flow, increase in cardiac output |
| What are ACEI's indicated for? | heart failure, systolic disfunction, secondary prevention of mi, HTN, diabetic neuropathy |
| what's the most common side effect for ACEI's? | persistant dry cough |
| thiazade diuretics increase exertion of? | sodium, chloride, potassium, and magnesium |
| a great example of an antiplatelet agent is? | aspirin |
| 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 |
| what is the most potent group of diuretic agents? | loop |
| what does aldosterone do? | increase sodium and water reabsorption |
| Osmotic diuretics function by | blocking reabsorption of NaCl in the proximal tubule and decending limb of the loop henle |
| the use of carbonic anhydrase inhibtors will result in what? | metabolic acidosis |
| thiazide diuretics work by | blocking sodium and chloride reabsorption in the distal tubule |
| what agents block reabsorption of sodium in the distal tubule | potassium sparing diuretics |
| NSAIDS are used to? | treat moderate pain |
| t/f once a drug is released for general clinical use, detailed reporting system reamins in place for 10 years? | false |
| where are the listing of a drug and the amount of a drug found in the prescription? | inscription |
| what's the brand name given to a drug by a particular manufacturer? | trade name |
| in order to find official info about drugs according to FDA where do you look? | united states pharmacopia national formulary (USP-NF) |
| what is an orphan drug? | one that is used for a rare disease or one that won't recover the costs |
| how much is spent in today's market per new drug on research, development, preclinical and postclinical trials | 900million |
| regarding the therapuetic potential of a drug the code AA symbolizes? | an important therapeutic agent, for aids fast track |
| the abreviation ac means | before meal |
Created by:
janeth4035