Pharm ch 10 & 11

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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


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