CMN 568 Unit 3 Study Guide with Complete Solutions

CMN 568 Unit 3 Study Guide with Complete Solutions What are the 3 characteristics of Asthma - Answer-Bronchoconstriction Airway Inflammation Reversible airflow limitation Which inhaled anticholinergic is best used for asthma pt. w/an intolerance to beta agonist or w/ bronchospasms due to beta blocker meds? - Answer-Ipratropium Bromide What is the primary tx for pt. w/moderate to severe asthma exacerbations who do not respond promptly and completely to SABA? - Answer-Systemic Corticosteroids Which bacterial infections predispose exacerbations of asthma - Answer-M. Pneumoniae and C. Pneumoniae Is routine use of antimicrobials recommended for acute exacerbations of asthma - Answer- No, only use when likelihood of acute bacterial respiratory tract infection Name short acting beta agonist - Answer-albuterol, levalbuterol, bitolerol, pirbuterol, terbutaline What does a SABA do? - Answer-acts directly by relaxing bronchial smooth muscles. EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 2/28 What do long-term pharmacologic agents accomplish for asthma pt. - Answer-act primarily to attenuate airway inflammation. Why take long-term pharmacologic agents for asthma daily? - Answer-to achieve and maintain control of persistent asthma independent of symptoms. What does the NAEPP recommend as the cornerstone of daily treatment of persistent asthma? - Answer-daily anti-inflammatory therapy with inhaled corticosteroids Role of corticosteroids with asthma - Answer-Reduce inflammation (acute and chronic) = improved airflow, decreased airway hyper-responsiveness and fewer asthma exacerbations, and potentiate the action of beta-adrenergic agonist. 1st. line treatment agent for all pt w/persistent asthma (long term controller) - Answer- Inhaled Corticosteroids How often to most patient use inhaled corticosteroids? - Answer-Twice daily to provide adequate control. How long can it take to see maximum response of inhaled corticosterioids? - Answer- Months What can a patient do to reduce side effects of inhaled corticosteroids? - Answer-Rinse mouth after each use A patient has an exacerbation of asthma, what is the most effective treatment to achieve prompt control? - Answer-Systemic (oral) corticosteroids EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 3/28 Dose of oral corticosteroids for children during exacerbation of asthma - Answer-1-2 mg/kg/day. Can be either a single dose or divided BID. MAX 60 mg/day Dose of oral corticosteroids for adults during exacerbation of asthma - Answer-40-60 mg/day either as a single dose of divided BID Duration of treatment of oral corticosteroids for asthma exacerbation - Answer-3-10 days or until symptoms resolve (no evidence that tapering dose of PO steroids prevents relapse) When treating exacerbation of asthma, what is the preferred treatment plan? - Answer- Alternate days rather than daily treatment. What additional medications are required to be given concurrent with systemic corticosteroids to prevent corticosteroid induced bone mineral loss? - Answer-Vitamin D and Calcium Should systemic corticosteroids be rapidly discontinued? - Answer-No, to prevent adrenal insufficiency Name some mediator inhibitors to treat asthma - Answer-Cromolyn sodium and nedocromil EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 4/28 What is the mechanism of action of mediator inhibitors? - Answer-prevent asthma symptoms, improve airway function in pt w/mild persistent of exercise induce asthma When are mediator inhibitors effective? - Answer-Before allergen exposure or exercise Do not relieve asthmatic symptoms once present. Name the Long acting beta 2 agonist (LABA) for asthma - Answer-Salmeterol and Formoteol How are LABA's delivered? - Answer-dry powder What are LABA's used for - Answer-Long term prevention of asthma symptoms Nocturnal symptoms Prevention of exercise induced bronchospasm Should LABA be used as monotherapy - Answer-NO linked to fatal asthma when used alone has no anti-inflammatory effects- so use w/a cortic