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Hth 102 midterm 1

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