Pharm ch 10 & 11
The major stimulus for secretion of surfactant into the alveolus is
lung inflation
The major cells responsible for an inflammatory response in asthma are:
mast cells and eosinophils
The early phase of an astmatic reaction occurs during what time frame?
15 min to an hour
The usual method of administering exogenous surfactant to babies is:
direct instillation to the airway
All the following are considered natural surfactants except:
dornase alfa
Which of the following is considered the mode of action for surfactant?
to replace missing surfactant
A significant side effect of corticosteroid use is inhibition of
HPA axis
Use of oral steroids for long periods of time can
HPA suppression
Another name for surface-active agents is:
. detergent
Side effects of systemic steroid treatment include which of the following? I. HPA suppression II. cough III. dysphonia IV. psychiatric reactions
I. HPA suppression IV. psychiatric reactions
Which of the following are examples of steroids available for inhalation? I. flunisolide II. azmacort III. QVAR IV. interleukin
I. flunisolide II. azmacort III. QVAR
Which of the following are currently used methods for delivering surfactant into infants? I. instillation through side-port catheter II. instillation through catheter III. nebulization IV. ECMO
I. instillation through side-port catheter II. instillation through catheter II. instillation through catheter
The inflammatory process includes which of the following activities? I. mediator cascade II. incr vasular permeability III. leukocytic infiltration IV. phagocytosis
I. mediator cascade II. incr vasular permeability III. leukocytic infiltration IV. phagocytosis
Which of the following are approved indications for surfactant therapy? I. prophylaxis in very low birth wight (<1250 g infants) II. prophylaxis in infants of higher birth weight (>1250 g) but with immature lungs III. rescue treatment in infants with respiratory distress syndrome IV. acute respiratory distress syndrome in the adult
I. prophylaxis in very low birth wight (<1250 g infants) II. prophylaxis in infants of higher birth weight (>1250 g) but with immature lungs III. rescue treatment in infants with respiratory distress syndrome
Which of the following are natural surfactant preparations?
II. curosurf III. survanta IV. infasurf
A patient complains of oral thrush and hoarseness since she has been using fluticasone by MDI. The physician asks you to make a suggestion to help her without discontinuing the drug. You suggest:
add a spacer and rinse the mouth after use
The product combining an inhaled steroid and a bronchodilator is:
advair
In what dosage form is/are corticosteroids available for use in the US? a. DPI b. MDI c. nebulizer solution d. all of the above
all of the above
Surfactant is produced by
alveolar type II cells
The steroids responsible for secondary male sex characteristics are known as: A. androgenic
androgenic
Corticosteroids are used with asthmastics and COPD patients to achieve which effect?
antiinflammatory
Your patient tells you that she is having chest tightness and wheezing four to six times per week, plus she wakes up with chest tightness and wheezing about once per week. She uses albuterol each time, with relief. She is taking no other medication, except her albuterol MDI. What other medication would you suggest be prescribed for her?
beclomethasone MDI
A patient has been taking oral prednisone for 1 week following a severe episode of asthma. The physician decides to switch the patient to aerosolized beclomethasone (QVAR). What is the best way to accomplish this?
begin the aerosol and begin to gradually taper off the oral dose
You are in the room of a 26-week gestational baby that has just been born. The newborn wieghs 1200 g. On assessment you find the baby has poor color, substernal retractions, nasal flaring, RR of 45, HR of 140. You note that the baby is difficult to bag. Which of the following agents wyould you recommend?
beractant
The rise and fall of levels of glucocorticoids in the body follows what kind of rhythm?
circadian
All of the following are types of corticosteroids produced in the adrenal cortex except
corticotropin-releasing factor
Corticosteroids normally produced by the body are known as
endogenous
The term used to describe surfactant produced outside of the patient's body is:
exogenous
Lack of pulmonary surfactant in respiratory distress syndrome of the newborn results in:
high surface tensi
Natural surfactant is obtained by all of the following methods except:
in vitro preparation
Use of systemic corticosteroids can cause all of the following, except:
incr endogenous steroid production
Surfactant is stored in
lamellar bodies
In COPD, the primary inflammatory cells are:
neutrophils
You are in the room of a 36-week gestationa baby that has just been born. The newborn weighs 2200 g. On assessment you find the baby has good color, no retractions, no nasal flaring, a RR of 25, a HR of 110, and a pulse-ox of 96% on room air. Which of the following would you choose?
no indication for therapy at this time
Which of the following is a common side effect of inhaled corticosteroids?
oral candidiasis
Side effects of aerosolized steroid use include all of the following except:
osteoporosis
Surfactant is composed primarily of :
phospholipids
A newborn baby weighing 1000 g exhibits symptoms of RDS, including poor color, suprasternal retractions, nasal flaring, and desaturations. The therapist should recommend:
poractant alfa
For an alveolus, LaPlace's Law is written as:
pressure = (2 x surface tension)/radius
All the following are hazards or complications of exogenous surfactants except:
tachycardia