ATI Pharmacology - Respiratory

A health care professional is talking to a patient who is prescribed albuterol via inhaler and fluticasone (advair) via inhaler for asthma management. The health care professional should tell the patient to use the albuterol inhaler before using fluticasone inhaler for which of the following reasons? a. Albuterol will increase the absorption of fluticasone. b. Albuterol will decrease inflammation. c. Albuterol will reduce nasal secretions. d. Fluticasone will reduce the adverse effects of albuterol.

ALBUTEROL WILL INCREASE THE ABSORPTION OF FLUTICASONE -albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation ,which will increase the absorption of fluticasone, an inhaled glucocorticoid, when the patient uses it before the glucocorticoid. Albuterol relaxes the smooth muscles of the airway

A hcp who is advising a patient about using intranasal glucocorticoid should include which of the following instructions? a. Start at a low dose and gradually increase it. b. ake the drug as needed for nasal congestion. c. Allow at least 2 weeks for the full therapeutic effect. d. Use the drug prior to exercise.

ALLOW AT LEAST 2 WEEKS FOR THE FULL THERAPEUTIC EFFECT -For dry mucous membranes, epistaxis, and sore throat: -Use a humidifier when sleeping. -Increase fluid intake. -Suck on hard candy or lozenges. -Take over-the-counter non-NSAID analgesics as needed for headaches.

When advising a patient about taking prednisone for chronic asthma, a health care professional should include which of the following information a. Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs). b. Rinse your mouth after taking the drug to prevent a yeast infection. c. Stop taking the drug if you become nauseated. d. Change position slowly when standing up.

AVOID TAKING NSAID'S -gastric protective measures are essential for patients who are taking oral glucocorticoid. anti-inflammatory drugs can cause GI bleeding. Inhaled, not oral, glucocorticoids can cause oral candidiasis. Stop taking the drug if you become nauseated. To prevent acute adrenal insufficiency, patients should not stop taking the drug abruptly. Taking the drug with food can help minimize GI effects. Prednisone, an oral glucocorticoid, does not cause postural hypotension. It can, however, cause hyperglycemia.

A health care provider is caring for a patient who is having difficulty in mobilizing thick mucus, which of the following drug should the provider expect to administer? a. Ipratropium (Atrovent) b. Beclomethasone (Beconase AQ) c. Acetylcysteine (Acetadote) d. Azelastine (Astelin)

Acetylcysteine -mucolytics loosens thick respiratory secretions.

Beta2 agonists and methylxanthines

Beta2 agonists and methylxanthines cause bronchodilation by relaxing bronchial smooth muscle.

A health care professional is advising a patinet about the use of cromolyn sodium. which of the following instruction should the health care provider include: a. Report signs of jaundice. b. Anticipate difficulty sleeping. c. Expect a bitter aftertaste. d. Increase calcium and vitamin D intake.

Bitter aftertaste -cromolyn a mast cell stabilizer, leaves a bitter aftertaste. taking sips of water or sucking on hard candy after use of the drug can minimize this effect. is excreted in the urine should increase calcium and vitamin D intake to reduce bone loss.

A health care professional should recognize that using pseudoephedrine (Sudafed) to treat allergic rhinitis requires cautious use with patients who have which of the following a. Peptic ulcer disease b. A seizure disorder c. Anemia d. Coronary artery disease

CORONARY ARTERY DISEASE -because pseudoephedrine is an oral sympathomimetic can cause systeming vasoconstriction, it requires caution with patients who have severe HTN or CAD Other contraindications for sudafed: Patients who have hyperthyroidism or prostatic hypertrophy,

H2 receptor antagonists

Cimetidine Ranitidine Famotidine Nizatidine Block H2 Receptors to treat PUD (peptic ulcer disease)

A health care provider is advising a patient about the use of beclomethasone (beconase AQ) (glucocorticoid) to treat asthma. HCP should explain that the drug treats asthma because it performs which of the following actions a. Thins mucus b. Relaxes bronchial smooth muscle c. Decreases inflammation d. Increases the cough threshold

DECREASE INFLAMMATION -prevents release of inflammation mediators -prevents action of cells responsible for inflammation -decrease edema of airways

Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks a. Respiratory depression b. Drug abuse c. Drug tolerance d. Rebound congestion

DRUG ABUSE -Because it is possible to alter pseudoephedrine and epinephrine, the law restricts the drugs' purchase.

Expectorants

Decrease viscosity of nasal secretions

Fluticasone/Salmeterol

Fluticasone an inhaled glucocorticoid will reduce inflammation.

When advising a patient about using zileuton (zyflo), a health care provider should include which of the following instruction? a. Check the apical pulse before taking the drug. b. Take the drug prior to exercising. c. Rinse the mouth after using the drug. d. Have laboratory tests performed at regular intervals.

Have laboratory tests performed at regular intervals -zileuton, a leukotriene modifier, can cause liver injury. - The health care professional should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment. Can cause chest pain Taken prophylactically to prevent bronchoconstriction Not necessary to rinse mouth after taking drug

When advising a patient who is beginning fluticasone therapy, which of the following instructions should a health care professional include? a. Take the drug as needed for acute asthma. b. Follow a low-sodium diet. c. Use an alternate-day dosing schedule. d. Increase weight-bearing activity.

Increase weight bearing activity -weight bearing acivities can help minimize bone loss, which is a side effect of fluticasone, an inhaled glucocorticoid - take on regular schedule - long acting

Mucolytics

Mucolytics thin mucus to increase expectoration.

A health care professional should tell a patient who is taking albuterol to report which of the following possible indication of a serious adverse effect? a. Fever b. Bruising c. Polyuria d. Palpitations

PALPITATIONS -Tachycardia -Heart palpitations -Tremors -Angina - headache - muscle cramps - chest pain --[Patients with cardiac blood vessels already compromised by vascular disease --Patients who experience significant vasospasm of the cardiac vessels in response to the drug

Before prescribing dextromethorphan (robitussin) to a patient, the primary care provider should know that, when given with an opioid, the drug can result in which of the following? a. Reduced antitussive effect of dextromethorphan b. Potentiation of the analgesic effect of the opioid c. Increased renal reabsorption of the dextromethorphan d. Delayed analgesic effect of the opioid

POTENTIATION OF THE ANALGESIC EFFECT OF THE OPIOID - combining dexotromethorphan (non-opioid antitussive) with an opioid, such as morphine, increases the analgesic effects of the opiod

A health care professional who is advising a patient about the use of antihistamine to treat allergic rhinitis should explain that these drugs are effective because they perform which of the following actions? a. Decreases viscosity of nasal secretions b. Blocks H2 receptors c. Prevents histamine from binding to receptors d. Reduces nasal congestion

PREVENTS HISTAMINE FROM BINDING TO RECEPTORS -antihistamines treats allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.

A health care professional is advising a patient about the use of expectorant to treat cough should explain that this type of drug is effective because it performs? a. Suppresses the cough stimulus b. Reduces surface tension c. Reduces inflammation d. Dries mucous membranes

REDUCE SURFACE TENSION - expectorants act by reducing the surface tension of respiratory secretions. This results in thinning thick mucus, making it easier to . cough out of the lungs. An expectorant does not suppress the cough stimulus. Antitussives, such as dextromethorphan (Robitussin), have this therapeutic effect.

A health care professional is caring for a patient who is taking codeine. Which of the following is the most important assessment following administration of the drug a. Blood pressure b. Apical heart rate c. Respirations d. Level of consciousness

RESPIRATIONS -the greatest risk to patients who are taking codeine, an opioid agonist is severe respiratory depression. Codeine can cause: - Hypotension - Bradycardia - bradypnea - Sedation

A health care provider is advising a patient about the use of cromolyn to prevent bronchospasm. the drug prevents bronchospasm because in performs which of the following? a. Increases leukocyte activity b. Blocks muscarinic receptors c. Causes bronchodilation d. Reduces inflammation

Reduce inflammation -a mast cell stabilizer reduces inflammation by inhibiting inflammatory response.

A health care professional is advising a patient about the adverse effects of pseudoephedrine. which of the following should the health care professional include? select all that apply) a. Restlessness b. Bradycardia c. Insomnia d. Muscle pain e. Anxiety

Restlessness, insomnia, anxiety -CNS stimulation with oral agents (agitation, anxiety, insomnia) -Systemic vasoconstriction, tachycardia, and heart palpitations with oral agents -Rebound nasal congestion with abrupt stoppage of prolonged use of topical agents -Abuse potential (pseudoephedrine, ephedrine)

A health care professional should explain to patient who is prescribed diphenhydramine that the most common side effect associated with the drug is a. sedation. b. anxiety. c. insomnia. d. muscle tremors

SEDATION -it is a first generation antihistamine. most common ADR is sedation

A health care provider is monitoring palsma drug levels in a patient who is taking theophylline. which of the following adverse effect should the health care provider expect to see if the patient level indicated toxicity? a. Seizures b. Constipation c. Vomiting d. Restlessness

Seizures -plasma level of theophylline is >30mcg/ml - indicates toxicity -a methylxanthine, therapeutic level of 5 to 15 mcg/mL May cause: - diarrhea - vomiting - insomnia

A health care professional who is advising a patient about the use of a mucolytics to treat a cough should explain that this type of drug is effective because it performs which of the following actions? a. Suppresses the cough stimulus b. Reduces inflammation c. Thins and loosens mucus d. Dries secretions

THINS AND LOOSENS MUCUS -makes mucus less viscous to increase cough's productivity A mucolytic does not dry secretions. Anticholinergic drugs have this effect.

For which of the following reasons should a patient attach a spacer to a metered-dose inhaler? a. ​To increase the amount of drug delivered to the lungs b. To increase the amount of drug delivered to the oropharynx c. To increase the amount of drug delivered on exhalation d. To increase the speed of drug delivery

TO INCREASE THE AMOUNT OF DRUG DELIVERED TO THE LUNGS -a spacer increases the amount of drug that reaches the lung - A spacer reduces the amount of drug that reaches the mouth and oropharynx. - A spacer ensures that the drug enters the oropharynx at the beginning of inhalation. -A spacer slows the delivery of the drug into the mouth.

Which of the following should a health care professional include when advising a patient about the use of montelukast? a. Use a spacer to improve inhalation. b. Take the drug at the onset of bronchospasm. c. Rinse the mouth to prevent an oral fungal infection. d. Take the drug once a day in the evening.

Take the drug once a day in the evening -most effective when once a day in the evening

A health care provider cautions a patient who is taking guaifenesin (mucinex) about using combination over the counter cold products because? a. they can also contain guaifenesin. b. serious interactions are possible. c. rebound congestion is likely. d. drug tolerance is likely.

They can also contain guaifenesin -patient might be taking excessive amount of drug. Many combination over-the-counter cold products contain guaifenesin; a patient taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, all of which might not be present. Virtually all drugs have potential adverse effects so the patient should use only those drugs required to treat existing symptoms and only in the recommended amounts.

A health care provider is caring for a patient who is taking ipratropium (inhaled anticholinergics). the health care provider should explain which of the following side effect (select all that apply) a. Muscle tremors b. Urinary retention c. Dry mouth d. Insomnia e. Tachycardia

URINARY RETENTION AND DRY MOUTH -Occur secondary to decreased stimulation of the parasympathetic nervous system -Effects include: -Dry mouth -Hoarseness -Increased intraocular pressure -Urinary retention

When explaining how a patient should use ipratropium, a health care professional should include which of the following instructions? a. Do not drink anything for 30 min after using the drug. b. Wait 5 min between using the drug and another inhaled drug. c. This drug is used to thin respiratory secretions. d. Check pulse rate after inhaling the drug.

Wait 5 min before using another inhaled drug - to allow for its bronchodilating effects

Opioid antitussives

relieve cough by increasing the cough threshold in the CNS

Glucocorticoids

therapeutic effect - reduce inflammation