MU NURS 615: Advanced Pharm - Exam 4 Review Questions And Answers With Verified Solutions Graded A+

Atropine - the depression of mucous secretion and the inhibition of mucociliary clearance is an undesirable side effect of ___ in patients with airway disease. Atropine and scopolamine - the inhibition of secretions is esp marked if secretions is excessive and is the basis for the use of which drugs in preanesthetic medication. Bismuth subsalicylate is used to reduce the chance of ulcers from what? - H. pylori Histamine and bradykinin - Atropine also partially antagonizes bronchoconstriction induced by ___ and ___. How are upper respiratory infections treated? - ____ are mostly treated for relief of symptoms. Some people benefit from the use of cough suspressants, expectorants, vit C, and zinc to reduce s/sx or shorten the duration. How do osmotic diuretics work? - they expand extracellular fluid and plasma volume, therefore increasing blood flow to the kidney. This washes out the cortical medullary gradient in the kidney, and stops the loop of Henle from concentrating urine. How does metoclopramide improve GERD - It increases tone and amplitude of gastric contractions and relaxes the pyloric sphincter & duodenal bulb, and increases peristalsis of the duodenum and jejunum resulting in accelerated gastric emptying and increase speed of gastric transit. Works on the dopamine receptors. How will you choose a diuretic in the treatment of HTN? - First check the level of kidney function, thiazide diuretics need GFR > mid 40's. Check BUN and creatinine.How will you treat constipation in children? - Miralax is first line tx. Bulk form laxatives are the safest and produces physiologic effect similar to increasing fiber in the diet. Bulk forming are used for management of chronic diarrhea in adults. How will you treat nausea and vomiting? - First-line therapy is Vit B6 and Unisom, especially in pregnant women. Ginger is helpful. Zofran, especially in children. Loop and thiazide-type diuretics both increase the excretion of what? - potassium Methacholine - Atropine is effective against bronchoconstriction induced by parasympathomimetic drugs like ______. Nasal decongestants can improve breathing. But the treatment may become less effective with repeated use and can cause what? - rebound nasal congestion Neuromuscular junction. - Because muscarinic receptor antagonist cause little blockade of the effects of ACh at nicotinic receptor sites, extremely high doses of atropine or related drugs are required to produce any degree of blockade of the predominantly nicotinic receptors at the ___ ____. Osmotic diuretics can also act at other parts of the body. What are some examples of their other actions? - they can be used to reduce intracranial and intra-ocular pressure. Patients taking long-term proton pump inhibitors are at risk for developing what? - megablastic anemia; hip fractures and osteoporosis Patients taking what medications should consult their doctor before taking antihistamines? - sedatives, sleeping pills, or muscle relaxants. Patients with what disease should consult their doctor before taking antihistamines? - Patients with thyroid disease, HTN, heart disease, kidney disease, liver disease, asthma, chronic bronchitis, emphysema, difficult urination, or glaucoma. Men with BPH.PPIs reduce gastric acids levels by more than 90% and frequently produce this? - hypochlorydria. Singulair can lead to what mood changes? - anxiety, depression, or thoughts of suicide or of hurting yourself Singulair should not be used for exercised- induced - bronchoconstriction Tiotropium - is a muscarinic receptor antagonist, often referred to as an antimuscarinic or anticholingeric agent. Tiotropium - is not used in the treatment for acute exacerbations of COPD and bronchitis What are epithelial sodium channel blockers (ENaC)? - they are sodium channel blockers that are selective for the epithelial sodium channel. They prevent the production of proteins that are normally synthesized in reaction to aldosterone. These mediator proteins are not produced, and so stimulation of sodium-potassium exchange sites in the collection tubule does not occur. This prevents sodium reabsorption and potassium and hydrogen ion secretion.