mid term

Question 1

abbreviation BID

Answer 1

twice daily

Question 2

abbreviation PRN

Answer 2

as needed

Question 3

abreviation NPO

Answer 3

nothing by mouth

Question 4

abbreviation Q4h

Answer 4

every 4 hours

Question 5

drug administration

Answer 5

how drugs are delivered to the body

Question 6

routes of administration

Answer 6

enteral
parenteral
transdermal
inhalation
topical

Question 7

pharmacokinetics

Answer 7

what the body does to the drug

-absorption
-distribution
-metabolism
-elimination

Question 8

primary organ for excretion

Answer 8

kidney

Question 9

primary organ for metabolism

Answer 9

liver

Question 10

drug half life affect dosing frequency

Answer 10

short T 1/2- more frequently
long T 1/2 life- less often

Question 11

what percentage of inhaled aerosol reaches the lower respiratory tract with current devices?

Answer 11

10-30%

Question 12

pharmacodynamics

Answer 12

what the drug does to the body

Question 13

L/T ratio

Answer 13

proportion of drug availability from the lung out of the total systemically available drug

-higher ratio=more efficient aerosol drug delivery to resp trach

Question 14

Bioavailability
oral vs inhaled

Answer 14

proportion of drug that reaches systemic circulation

*oral-not 100%–>first pass effect, very little reach systemic circulation

*inhaled- 100%–>surpasses first pass effect, higher amount reach circulation

Question 15

pharacogenetics

Answer 15

patients response to drugs due to hereditary differences

Question 16

agonist vs antagonist

Answer 16

agonist- drug or chemical that binds to corresponding receptor and initiates cellular effect

antagonist- drug or chemical that is able to ind to receptor but cause no response

Question 17

what is the parasympathetic system

Answer 17

“rest and digest”
-decrease Hr
-decrease pupil dilation(miosis)
-increase mucus
-increase digestion
-bronchoconstriction

Question 18

what is the sympathetic system

Answer 18

‘fight or flight’
-increase Hr
-increaseBP
-increase pupil dilation(mydriasis)
-bronchodilation
-decrease digestion
-

Question 19

what is the neuotransmitter for parasympathetic system

Answer 19

acetycholine

Question 20

what is the neurotransmitter for sympathetic system

Answer 20

norepinephrine

Question 21

receptor site for the parasympathetic system and acetylcholine effects

Answer 21

M1- CNS
M2- heart–decrease HR
M3- smooth muscle and submucosal glands–bronchoconstriction

Question 22

receptor sites for sympathetic system and epinephrine effects

Answer 22

alpha 1- vessels- vasoconstriction
beta 1- heart- increase hr
beta2- lungs- bronchodilation

Question 23

overstimulation of parasympathetic system leads to what?

Answer 23

SLUD
salivation, lacrimation, urination, defecation

Question 24

what inactivates acetylcholine at parasympathetic terminal receptor site

Answer 24

cholinesterase

Question 25

agent/drug that inhibits parasympathetic system effects/ blocks acetylcholine

Answer 25

parasympatholytic/ anticholinergic agent

Question 26

agent/drug that mimics parasympathetic nervous system/ mimics acetylcholine

Answer 26

parasympathomimetic/ cholinergic agent

Question 27

a direct acting cholinergic agent used in bronchial challenge test

Answer 27

methacholine-bronchoconstriction

Question 28

agent/drug that mimics sympathetic system effects

Answer 28

sympathomimetic/adrenergic agent

Question 29

agent/drug that inhibits the effect of sympathetic system

Answer 29

sympatholytics/ antiadrenergic agent

Question 30

what enzyme breaks down epinephrine

Answer 30

COMT and MAO

Question 31

why do parasympatholytic drugs like atropine increase Hr

Answer 31

-block acetyolcholine receptors *anticholinergic agent

Question 32

what effect does adrenergic stimulation have on bronchial smooth muscle

Answer 32

dilation epinephrine stimulates beta 2 receptors

Question 33

what effect does propranolol have on bronchodilator therapy in asthma

Answer 33

propranolol is a beta blocker antagonistic effect

Question 34

how are drugs that block acetylcholine receptors classified

Answer 34

anticholinergic agents

Question 35

3 types of adrenergic bronchodilators

Answer 35

ultra short- <3 hrs short acting- 4-6 hrs long acting- 12-24hrs

Question 36

clinical indication for adrenergic bronchodilators

Answer 36

relaxation of smooth airway muscle in the presence of reversible obstruction -asthma, bronchitis, emphysema, bronchiectasis

Question 37

ultra short acting agent

Answer 37

racemic epinephrine - used for the alpha 1: vasconstriction relieve inflammation

Question 38

short acting agent

Answer 38

"rescue" 4-6hrs -albuterol -levabuterol

Question 39

long acting agents

Answer 39

12-24 hrs maintenance, control bronchospasm, and control nocturnal symptoms -salmeterol -formoterol -arformoterol -indacaterol -olodaterol

Question 40

inhaltion route benefits

Answer 40

-rapid onset -smaller doses -reduce side effects -drug delivered directly to target organ -relatively safe

Question 41

continuous nebulization of albuterol

Answer 41

manage asthma especially during acute exacerbations -reduce frequent treatment -constantly stimulating beta 2 receptors

Question 42

primary indication for anticholinergic bronchodilator

Answer 42

COPD maintenance

Question 43

benefit of combined beta 2 agonist and anticholinergic

Answer 43

beta 2- keep airways open anticholinergic- will prevent bronchoconstriction ex: combivent, duoneb

Question 44

Ipratropium bromide

Answer 44

-atrovent-MDI,SVN,Nasal -short acting, treats acute bronchoconstriction -6 hrs -used more frequently

Question 45

tiotroprium bromide

Answer 45

-spirva-DPI, once daily -long lasting, maintenance therapy of bronchoconstriction -24hrs

Question 46

how do corticosteroids benefit patients with COPD

Answer 46

reduce inflammation prevent exacerbations reduce mucus production improve symptoms

Question 47

explain the anti-inflammatory mechanism of inhaled corticosteroids asthma management

Answer 47

-inhibit inflammatory response -reduce mucus production -reduce airways swelling

Question 48

how can systemic corticosteroids suppress the hypothalamic-pituitary- adrenal HPA axis

Answer 48

decrease production of cortisol

Question 49

primary inflammation cells for asthma and copd

Answer 49

asthma- mast cells, eosinophil copd-neutrophils

Question 50

asthmatic reaction

Answer 50

early-exposed to allergens trigger response-->peak 15 min-1hr, activation of mast cells-->release of histamine=immediate bronchoconstriction late-response 6-8 hrs, cells involved: eosinophils, neutrophils and t cells= prolonged inflammation

Question 51

strategies to prevent oral thrush in pt using inhaled corticosteroids

Answer 51

minimal dose use reservoir rinse mouth after use

Question 52

how do spacers affect drug delivery and side effects in MDI use

Answer 52

reduce orophrangeal deposition and increase lung deposition

Question 53

strategies to increase lung deposition of inhaled medication

Answer 53

-educating on proper techniques -breath holding

Question 54

why do COPD patients have hypoxemia and hypercapnia

Answer 54

air trapping and limitations to airflow