NURS 572 Pharm Exam 2 WITH
CORRECT ANSWERS
Definition of asthma and underlying cause - ANSWER-chronic inflammatory
disorder of the airway- cause is immune-mediated airway inflammation
S&S of asthma - ANSWER--Sense of breathlessness & tightness in the chest
-Wheezing
-Dyspnea
-Cough
Definition of COPD and most common cause - ANSWER--Chronic, progressive,
largely irreversible disorder characterized by airflow restrictions and
inflammation
-Common cause is smoking cigarettes
S&S of COPD - ANSWER--chronic cough
-excessive sputum production
-wheezing
-dyspnea
-poor exercise tolerance
What two conditions make up COPD - ANSWER-1. Chronic bronchitis
2. Emphysema
,What are the 3 advantages of administering inhaled antiasthma drugs? -
ANSWER-1. Therapeutic effects enhanced by delivering drugs directly to site
of action
2. Systemic effects minimized
3. Rapid relief of acute attacks
What type of drugs are used for long-term management of asthma and
COPD? - ANSWER-Anti-inflammatory drugs, such as glucocorticoids
What is the prototype drug for glucocorticoids? - ANSWER-Beclomethasone
(QVAR)
MOA of Beclomethasone (QVAR) - ANSWER--Reduce asthma symptoms by
suppressing inflammation:
->Decrease synthesis and release of inflammatory mediators (i.e.
leukotrienes, histamine, prostaglandins)
-> Decreased infiltration and activity of inflammatory cells (e.g. eosinophils,
leukocytes)
-> Decreased edema of airway mucosa
-Suppressing inflammatory reduces bronchial hyperreactiviy and decreases
airway mucosa production
Therapeutic uses of Beclomethasone (QVAR) - ANSWER--Prophylaxis of
chronic asthma
,ADEs of inhaled glucocorticoids - ANSWER--Adrenal insufficiency (SAFETY
ALERT)
-Oropharyngeal candidiasis and dysphonia
-Slowed growth in children
-Bone loss
ADEs of oral glucorticoids - ANSWER--Adrenal suppression
-Osteoporosis
-Hyperglycemia
-Peptic ulcer disease
-Growth suppression
Nursing implications for Beclomethasone (QVAR) - ANSWER--Instruct Pt to
take on a regular schedule, not PRN
Non-prototype drug for Mast Cell Stabilizer - ANSWER-Cromolyn (Intal)
Cromolyn MOA - ANSWER--Suppresses inflammation by stabilizing the
cytoplasmic membrane of mast cells ,preventing release of histamine and
other mediators
Therapeutic uses of Cromolyn - ANSWER--Prophylaxis for mild-moderate
chronic asthma
->NOT for quick relief
->Used when glucocorticoids create problems
Purpose of bronchodilators - ANSWER-Provide symptomatic relief in patients
with asthma and COPD, but do not alter underlying inflammation
, What type of drug is the most effective for relieving acute bronchospasm and
preventing EIB? - ANSWER-inhaled beta2 agonists
Beta2 agonist MOA - ANSWER--Sympathomimetic drugs that activate beta2-
adrenergic receptors in the smooth muscle of the lungs
->Promotes bronchodilation--> relieves bronchospasm
Therapeutic uses of short acting beta2 agonists (SABAs) - ANSWER--Taken
PRN to stop an ongoing attack
-In Pts w/ EIB, SABAs are taken before exercise
SABA safety alert - ANSWER--Taking SABAs in excess can lead to
tachydysrhythmias, angina, seizures, cardiac arrest and death
-If you need your SABA more than 2x/week, asthma therapy needs
modification
Therapeutic uses for LABAs - ANSWER--Long-term control in patients with
frequent asthma attacks or stable COPD
-In Pts with asthma, LABAs are not the first line therapy and must be
combined with a glucocorticoid
-LABA use alone is contraindicated b/c can cause asthma-associated death
Therapeutic uses for oral beta2-agonists - ANSWER-Long term control of
asthma and stable COPD
ADEs for inhaled SABAs - ANSWER--Tachycardia
-Angina
-Tremor
CORRECT ANSWERS
Definition of asthma and underlying cause - ANSWER-chronic inflammatory
disorder of the airway- cause is immune-mediated airway inflammation
S&S of asthma - ANSWER--Sense of breathlessness & tightness in the chest
-Wheezing
-Dyspnea
-Cough
Definition of COPD and most common cause - ANSWER--Chronic, progressive,
largely irreversible disorder characterized by airflow restrictions and
inflammation
-Common cause is smoking cigarettes
S&S of COPD - ANSWER--chronic cough
-excessive sputum production
-wheezing
-dyspnea
-poor exercise tolerance
What two conditions make up COPD - ANSWER-1. Chronic bronchitis
2. Emphysema
,What are the 3 advantages of administering inhaled antiasthma drugs? -
ANSWER-1. Therapeutic effects enhanced by delivering drugs directly to site
of action
2. Systemic effects minimized
3. Rapid relief of acute attacks
What type of drugs are used for long-term management of asthma and
COPD? - ANSWER-Anti-inflammatory drugs, such as glucocorticoids
What is the prototype drug for glucocorticoids? - ANSWER-Beclomethasone
(QVAR)
MOA of Beclomethasone (QVAR) - ANSWER--Reduce asthma symptoms by
suppressing inflammation:
->Decrease synthesis and release of inflammatory mediators (i.e.
leukotrienes, histamine, prostaglandins)
-> Decreased infiltration and activity of inflammatory cells (e.g. eosinophils,
leukocytes)
-> Decreased edema of airway mucosa
-Suppressing inflammatory reduces bronchial hyperreactiviy and decreases
airway mucosa production
Therapeutic uses of Beclomethasone (QVAR) - ANSWER--Prophylaxis of
chronic asthma
,ADEs of inhaled glucocorticoids - ANSWER--Adrenal insufficiency (SAFETY
ALERT)
-Oropharyngeal candidiasis and dysphonia
-Slowed growth in children
-Bone loss
ADEs of oral glucorticoids - ANSWER--Adrenal suppression
-Osteoporosis
-Hyperglycemia
-Peptic ulcer disease
-Growth suppression
Nursing implications for Beclomethasone (QVAR) - ANSWER--Instruct Pt to
take on a regular schedule, not PRN
Non-prototype drug for Mast Cell Stabilizer - ANSWER-Cromolyn (Intal)
Cromolyn MOA - ANSWER--Suppresses inflammation by stabilizing the
cytoplasmic membrane of mast cells ,preventing release of histamine and
other mediators
Therapeutic uses of Cromolyn - ANSWER--Prophylaxis for mild-moderate
chronic asthma
->NOT for quick relief
->Used when glucocorticoids create problems
Purpose of bronchodilators - ANSWER-Provide symptomatic relief in patients
with asthma and COPD, but do not alter underlying inflammation
, What type of drug is the most effective for relieving acute bronchospasm and
preventing EIB? - ANSWER-inhaled beta2 agonists
Beta2 agonist MOA - ANSWER--Sympathomimetic drugs that activate beta2-
adrenergic receptors in the smooth muscle of the lungs
->Promotes bronchodilation--> relieves bronchospasm
Therapeutic uses of short acting beta2 agonists (SABAs) - ANSWER--Taken
PRN to stop an ongoing attack
-In Pts w/ EIB, SABAs are taken before exercise
SABA safety alert - ANSWER--Taking SABAs in excess can lead to
tachydysrhythmias, angina, seizures, cardiac arrest and death
-If you need your SABA more than 2x/week, asthma therapy needs
modification
Therapeutic uses for LABAs - ANSWER--Long-term control in patients with
frequent asthma attacks or stable COPD
-In Pts with asthma, LABAs are not the first line therapy and must be
combined with a glucocorticoid
-LABA use alone is contraindicated b/c can cause asthma-associated death
Therapeutic uses for oral beta2-agonists - ANSWER-Long term control of
asthma and stable COPD
ADEs for inhaled SABAs - ANSWER--Tachycardia
-Angina
-Tremor
