Pharmacology - Exam 4 Blueprint
Lower Airflow Disorders ANS: 1. Asthma - chronic inflammatory disorder of the airway. Characterized by
bronchospasms (tightening of airway in the lungs)
2. Chronic Obstructive Pulmonary Disease (COPD) - occurs w time, lungs start retaining too much CO2
making it difficult to breathe
Airflow Disorder Medications ANS: - Beta-2 Adrenergic Agonists (Albuterol, Formoterol, Salmeterol)
- Inhaled Anticholinergics (Ipratropium)
- Glucocorticoids Prednisone, Beclomethasone, Budesonide, Fluticasone, Methylprednisolone
- Leukotriene Modifiers (Montelukast/Zafirlukast)
- Methylxanthines (Theophylline)
Mechanism of Action for Beta-2 Adrenergic Agonists ANS: Includes: Albuterol/Salmeterol/Formoterol
- promote bronchodilation (relaxes the muscle and widens airway) by activating beta-2-receptors in the
bronchial smooth muscle
- Sympathetic: Fight or flight (react really quick to a frightening event)
- concurrent use with beta blockers will negate the effects of the med
Results of Beta-2 Adrenergic Agonists ANS: bronchospasm is relieved, histamine release is inhibited, and
ciliary motility is increased
- can cause tachycardia (check pulse and report an increase of greater than 20/30min)
Two types of bronchodilator medications ANS: Short Acting Beta-2 Adrenergic Agonists (SABAs)
Long Acting Beta-2 Adrenergic Agonists (LABAs)
Short Acting Beta-2 Adrenergic Agonists (SABAs) ANS: Includes: Albuterol (THINK RESCUE INHALER!!!!)
,- inhaled
- treats bronchospasm by opening up the airway and prevents exercise induced bronchospasms
- used for acute episodes of bronchospasms
Immediate relief, gives fast results!!!!
Long Acting Beta-2 Adrenergic Agonists (SABAs) ANS: Includes: Salmeterol, Formoterol
both inhaled and used for long term control of asthma
Complications of Albuterol/Salmeterol/Formoterol ANS: 1. tachycardia which can lead to angina(chest
pain)
- mild tachycardia is normal but once it gets too high --> check pulse and report if there is an increase of
greater than 20 to 30 bpm
2. tremors (usually resolved w continued med use)
Effectiveness of Albuterol/Salmeterol/Formoterol ANS: - Clear and equal breath sounds
- Absence of wheezing/shortness of breath
- Return of respiratory rate to baseline
- Control of asthma(Salmeterol/Formoterol) and prevention of exercise induced asthma(albuterol)
Teaching about SABAs & LABAs ANS: - Avoid caffeine
- Report chest pain
- Do not exceed prescribed doses
- If pt is taking for asthma, log frequency and intensity of asthma exacerbations
Metered Dose Inhaler Steps ANS: 1. Remove the mouthpiece cap
2. Shake container vigorously 5 to 6 times (or as instructed)
, 3. Hold inhaler w mouthpiece at bottom and thumb near the mouthpiece and index and middle finger at
the top
4. Close your mouth around the mouthpiece with the opening pointing towards the back of your throat
5.. Take a deep breath and then exhale
6. Tilt head back and while slowly breathing in, press down on the inhaler to activate and release the
medication; continue breathing in slowly for 3-5 more seconds
7. Hold your breath for 10 seconds to allow the medication to enter into your airways
- Wait at least one minute between inhalations
- Rinse mouth out with water or brush teeth if using a corticosteroid inhaler to reduce the risk of fungal
infections
Inhaled Anticholinergics ANS: Ipratropium
Maintenance asthma medication (works by taking everyday to maintain and control asthma) resulting in
bronchodilation; long term; Parasympathetic: rest and digest
- blocks action of acetylcholine
- Adverse effects: Can't see(blurred vision), Can't pee(urinary retention), Can't spit(Dry
mouth/hoarsness), Can't Poop(constpiated), & Tachycardia
- Give fluids and sugar free candy to control dry mouth/rinse mouth after
- Don't give to patients allergic to soy or peanuts
Glucocorticoids ANS: Includes: Prednisone(oral), Methylprednisolone, Beclomethasone, Fluticasone,
Budesonide
end in -sone
MOA: prevent and treat inflammation and reduce airway mucosa edema
- do not provide immediate relief, but reduce frequency and severity of exacerbations (used to help
treat many disorders)
- NO NSAIDs, YES food
Lower Airflow Disorders ANS: 1. Asthma - chronic inflammatory disorder of the airway. Characterized by
bronchospasms (tightening of airway in the lungs)
2. Chronic Obstructive Pulmonary Disease (COPD) - occurs w time, lungs start retaining too much CO2
making it difficult to breathe
Airflow Disorder Medications ANS: - Beta-2 Adrenergic Agonists (Albuterol, Formoterol, Salmeterol)
- Inhaled Anticholinergics (Ipratropium)
- Glucocorticoids Prednisone, Beclomethasone, Budesonide, Fluticasone, Methylprednisolone
- Leukotriene Modifiers (Montelukast/Zafirlukast)
- Methylxanthines (Theophylline)
Mechanism of Action for Beta-2 Adrenergic Agonists ANS: Includes: Albuterol/Salmeterol/Formoterol
- promote bronchodilation (relaxes the muscle and widens airway) by activating beta-2-receptors in the
bronchial smooth muscle
- Sympathetic: Fight or flight (react really quick to a frightening event)
- concurrent use with beta blockers will negate the effects of the med
Results of Beta-2 Adrenergic Agonists ANS: bronchospasm is relieved, histamine release is inhibited, and
ciliary motility is increased
- can cause tachycardia (check pulse and report an increase of greater than 20/30min)
Two types of bronchodilator medications ANS: Short Acting Beta-2 Adrenergic Agonists (SABAs)
Long Acting Beta-2 Adrenergic Agonists (LABAs)
Short Acting Beta-2 Adrenergic Agonists (SABAs) ANS: Includes: Albuterol (THINK RESCUE INHALER!!!!)
,- inhaled
- treats bronchospasm by opening up the airway and prevents exercise induced bronchospasms
- used for acute episodes of bronchospasms
Immediate relief, gives fast results!!!!
Long Acting Beta-2 Adrenergic Agonists (SABAs) ANS: Includes: Salmeterol, Formoterol
both inhaled and used for long term control of asthma
Complications of Albuterol/Salmeterol/Formoterol ANS: 1. tachycardia which can lead to angina(chest
pain)
- mild tachycardia is normal but once it gets too high --> check pulse and report if there is an increase of
greater than 20 to 30 bpm
2. tremors (usually resolved w continued med use)
Effectiveness of Albuterol/Salmeterol/Formoterol ANS: - Clear and equal breath sounds
- Absence of wheezing/shortness of breath
- Return of respiratory rate to baseline
- Control of asthma(Salmeterol/Formoterol) and prevention of exercise induced asthma(albuterol)
Teaching about SABAs & LABAs ANS: - Avoid caffeine
- Report chest pain
- Do not exceed prescribed doses
- If pt is taking for asthma, log frequency and intensity of asthma exacerbations
Metered Dose Inhaler Steps ANS: 1. Remove the mouthpiece cap
2. Shake container vigorously 5 to 6 times (or as instructed)
, 3. Hold inhaler w mouthpiece at bottom and thumb near the mouthpiece and index and middle finger at
the top
4. Close your mouth around the mouthpiece with the opening pointing towards the back of your throat
5.. Take a deep breath and then exhale
6. Tilt head back and while slowly breathing in, press down on the inhaler to activate and release the
medication; continue breathing in slowly for 3-5 more seconds
7. Hold your breath for 10 seconds to allow the medication to enter into your airways
- Wait at least one minute between inhalations
- Rinse mouth out with water or brush teeth if using a corticosteroid inhaler to reduce the risk of fungal
infections
Inhaled Anticholinergics ANS: Ipratropium
Maintenance asthma medication (works by taking everyday to maintain and control asthma) resulting in
bronchodilation; long term; Parasympathetic: rest and digest
- blocks action of acetylcholine
- Adverse effects: Can't see(blurred vision), Can't pee(urinary retention), Can't spit(Dry
mouth/hoarsness), Can't Poop(constpiated), & Tachycardia
- Give fluids and sugar free candy to control dry mouth/rinse mouth after
- Don't give to patients allergic to soy or peanuts
Glucocorticoids ANS: Includes: Prednisone(oral), Methylprednisolone, Beclomethasone, Fluticasone,
Budesonide
end in -sone
MOA: prevent and treat inflammation and reduce airway mucosa edema
- do not provide immediate relief, but reduce frequency and severity of exacerbations (used to help
treat many disorders)
- NO NSAIDs, YES food
