NURS 6521 Advanced Pharmacology Final Exam Best Reviewed A+ Questions and Answers _ 100% Updated

NURS 6521 Advanced Pharmacology Final Exam Best Reviewed A+ Questions and Answers _ 100% Updated Albuterol - CORRECT ANSWER-Class: Short acting B2 agonist with minor B1 Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS excitation effects (tremors, dizziness), HA, tachycardia, palpitations Comments: Safe for children and pregnancy; may combine with ipratropium; least expensive Terbutaline - CORRECT ANSWER-Class: Short acting B2 agonist with minor B1 Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS excitation effects (tremors, dizziness), HA, tachycardia, palpitations X: Pregnancy category B or C Salmeterol - CORRECT ANSWER-Class: Long acting B2 agonist, more selective Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS excitation effects (tremors, dizziness), HA, tachycardia, palpitations Comments: Do not use alone for persistent asthma, combine with an inhaled corticosteroid; don't wash it, powder can get clogged What are some things you can educate your patients on regarding beta agonist inhalers? - CORRECT ANSWER-1. Demonstrate and have patient do return demonstration 2. Check correct inhaler use if patient says it's not working 3. Encourage use of spacer Fluticasone - CORRECT ANSWER-Class: Inhaled corticosteroid Used for: 1st line treatment for persistent asthma MOA: Anti-inflammatory, minimal systemic exposure Budesonide - CORRECT ANSWER-Class: Inhaled corticosteroid Used for: 1st line treatment for persistent asthma MOA: Anti-inflammatory, minimal systemic exposure Zafirlukast - CORRECT ANSWER-Class: Leukotriene modifier/antagonist Used for: 2nd line to decrease bronchoconstriction, edema MOA: Works similar to prostaglandins in r/t to inflammation, blocks lipoxygenase Theophylline - CORRECT ANSWER-Class: Xanthine; stimulant Used for: Asthma MOA: Bronchial smooth muscle relaxation ADR: cardiovascular effects, increased gastric acid production, CNS effects (irritability, restlessness, seizures, insomnia), GI effects (reflux, worsens heartburn), cardiac effects (palpitations, tachycardia, hypotension, life-threatening arrhythmias) X: GERD, HTN, ischemic heart dx, coronary insufficiency, CHF, history of stroke, cardiac arrhythmias; smoking increases clearance Comments: Stay away from charcoal-broiled foods (accelerates the hepatic metabolism), avoid large amounts of caffeine containing beverages; elimination is influenced by diet What are the signs of Theophylline toxicity? - CORRECT ANSWER-Vomiting, insomnia, jitteriness, HA, severe GI pain, irregular heartbeat Ipratropium Bromide - CORRECT ANSWER-Class: Inhaled anticholinergic Used for: NOT 1st line, supplemental use in acute bronchospasm MOA: Blocks the muscarinic cholinergic receptors, causes bronchial smooth muscle relaxation; uses alternate pathway, effects additive with beta receptors What is asthma? - CORRECT ANSWER-Chronic inflammatory disorder of the airways, recurrent episodes of wheezing, breathlessness and chest tightness, airflow obstruction is reversible - recommendations by Expert Panel III is to take an aggressive approach to gain quick control What would you treat mild intermittent asthma with? - CORRECT ANSWER-Step 1 therapy: 1. Use short acting B2 agonists PRN for symptoms - patients may have symptoms when exposed to triggers (URI, allergens, chemical inhalents, exercise) 2. Educate on annual flu shot What would you treat mild persistent asthma with? - CORRECT ANSWER-Step 2 therapy: 1. Long-term/low dose inhaled corticosteroids such as Fluticasone or Budesonide 2. Use short acting B2 agonist PRN, if using more than 2 days/week, then step up therapy What would you treat moderate persistent asthma with? - CORRECT ANSWER-Step 3 therapy: 1. Treat with medium dose inhaled corticosteroids (Fluticasone or Budesonide) OR 1. Low dose inhaled steroid (Fluticasone or Budesonide) plus long acting B2 agonist (Advair or Salmeterol) OR 1. Medium dose inhaled steroid (Fluticasone or Budesonide) plus leukotriene receptor antagonist (Zafirlukast) 2. May use short acting B2 agonists (Albuterol or Terbutaline) What would you treat severe persistent asthma with? - CORRECT ANSWER-Step 4 therapy: 1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND long-acting B2 agonist (Salmeterol) OR 1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND a leukotriene modifier (Zafirlukast) OR Theophylline Step 5 therapy: 1. High dose inhaled corticosteroid AND long acting B2 agonist Step 6 therapy: 1. High dose inhaled corticosteroid AND long acting B2 agonist AND oral corticosteroid