Test Bank for NURSING PROCESS AND
Pharmacology 10th Edition By Linda
Lilley, Shelly Collins, Julie Snyder
Chapter 1-58
• Bronchodilators overview Bronchodilators are an important part of the
pharmacotherapy for all respiratory diseases. These drugs relax bronchial smooth
muscle, which causes dilation of the bronchi and bronchioles that are narrowed as
a result of the disease process. There are three classes of such drugs: beta
adrenergic agonists, anticholinergics, and xanthine derivatives.
• Beta andregenic drug overview The beta-adrenergic agonists are a group of
drugs that are commonly used during the acute phase of an asthmatic attack to
quickly reduce airway constriction and restore airflow to normal. They are agonists
of the adrenergic receptors in the sympathetic nervous system. The beta and alpha
adrenergic receptors are discussed in Chapters 18 and 19. The beta agonists
imitate the effects of norepinephrine on beta receptors. For this reason, they are
also called sympathomimetic bronchodilators. The beta agonists are categorized by
their onset of action. Short-acting beta agonist (SABA) inhalers include albuterol
(Ventolin), levalbuterol (Xopenex), pirbuterol (Maxair), terbutaline (Brethine), and
metaproterenol (Alupent). Long-acting beta agonist (LABA) inhalers include
arformoterol (Brovana), formoterol (Foradil, Perforomist), and salmeterol
(Serevent). The newest long-acting beta agonists are indacterol (Arcapta Neohaler);
vilanterol in conjunction with fluticasone (Breo Ellipta); and vilanterol in conjunction
, with the anticholinergic umeclidinium (Anoro Ellipta). The term Ellipta refers to a
new delivery system. Because the long-acting beta agonists (LABAs) have a longer
onset of action, they must never be used for acute treatment. Patients must be
taught to use the short-acting beta agonist (SABA) as rescue treatment.
• short acting beta agonist albuterol (Ventolin), levalbuterol (Xopenex), pirbuterol
(Maxair), terbutaline (Brethine), and metaproterenol (Alupent).
• Albuterol Class : beta 2 agonist (short acting)
• Indications and mechanisms of action: is a short-acting beta2-specific
bronchodilating beta agonist. Other similar drugs include bitolterol (Tornalate),
levalbuterol (Xopenex), pirbuterol (Maxair), and terbutaline (Brethine). Albuterol is
the most commonly used drug in this class. If albuterol is used too frequently, dose-
related adverse effects may be seen, because albuterol loses its beta2-specific
actions, especially at larger dosages
• Contraindications :. As a consequence, the beta1 receptors are stimulated, which
causes nausea, increased anxiety, palpitations, tremors, and an increased heart
rate.
• Route: po and inhalation
,• Other facts: levorotatory isomeric form of albuterol, levalbuterol, is sometimes
prescribed as an albuterol alternative for patients with certain risk factors (e.g.,
tachycardia, including tachycardia associated with albuterol treatment). (Lilley 583)
• Lilley, Linda, Shelly Collins, Julie Snyder. Pharmacology and the Nursing Process,
8th Edition. Mosby, 022016. VitalBook file.
• long acting beta agonist arformoterol (Brovana), formoterol (Foradil,
Perforomist), and salmeterol (Serevent). The newest long-acting beta agonists are
indacterol (Arcapta Neohaler); vilanterol in conjunction with fluticasone (Breo
Ellipta); and vilanterol in conjunction with the anticholinergic umeclidinium (Anoro
Ellipta)
• beta andregenic mechanism of action and drug effect The beta agonists relax and
dilate airways by stimulating the beta2-adrenergic receptors located throughout the
lungs.
• 582
• There are three subtypes of these drugs, based on their selectivity for beta2
receptors:
• Nonselective adrenergic drugs, which stimulate the beta, beta1 (cardiac), and
beta2 (respiratory) receptors. Example: epinephrine. (NOTE: Epinephrine inhalers
, were taken off the market in 2012 because they did not comply with FDA
requirements). Epinephrine is available as a prefilled syringe for self-administration
by patients with severe allergic reactions and is called EpiPen (Figure 37-2).
• Nonselective beta-adrenergic drugs, which stimulate both beta1 and beta2
receptors. Example: metaproterenol.
• Selective beta2 drugs, which primarily stimulate the beta2 receptors. Example:
albuterol.
• These drugs can also be categorized according to their routes of administration as
oral, injectable, or inhaled. The various beta agonist bronchodilators are listed in
Table 37-3. The bronchioles are surrounded by smooth muscle. When the smooth
muscle contracts, the airways are narrowed and the amount of oxygen and carbon
dioxide exchanged is reduced. The action of beta agonist bronchodilators begins at
the specific receptor stimulated and ends with the relaxation and dilation of the
airways. However, many reactions must take place at the cellular level for
bronchodilation to occur. When a beta2-adrenergic receptor is stimulated by a beta
agonist, adenylate cyclase is activated and produces cyclic adenosine
monophosphate (cAMP). Adenylate cyclase is an enzyme needed to make cAMP.
The increased levels of cAMP cause bronchial smooth muscles to relax, which
results in bronchial dilation and increased airflow into and out of the lungs.
Pharmacology 10th Edition By Linda
Lilley, Shelly Collins, Julie Snyder
Chapter 1-58
• Bronchodilators overview Bronchodilators are an important part of the
pharmacotherapy for all respiratory diseases. These drugs relax bronchial smooth
muscle, which causes dilation of the bronchi and bronchioles that are narrowed as
a result of the disease process. There are three classes of such drugs: beta
adrenergic agonists, anticholinergics, and xanthine derivatives.
• Beta andregenic drug overview The beta-adrenergic agonists are a group of
drugs that are commonly used during the acute phase of an asthmatic attack to
quickly reduce airway constriction and restore airflow to normal. They are agonists
of the adrenergic receptors in the sympathetic nervous system. The beta and alpha
adrenergic receptors are discussed in Chapters 18 and 19. The beta agonists
imitate the effects of norepinephrine on beta receptors. For this reason, they are
also called sympathomimetic bronchodilators. The beta agonists are categorized by
their onset of action. Short-acting beta agonist (SABA) inhalers include albuterol
(Ventolin), levalbuterol (Xopenex), pirbuterol (Maxair), terbutaline (Brethine), and
metaproterenol (Alupent). Long-acting beta agonist (LABA) inhalers include
arformoterol (Brovana), formoterol (Foradil, Perforomist), and salmeterol
(Serevent). The newest long-acting beta agonists are indacterol (Arcapta Neohaler);
vilanterol in conjunction with fluticasone (Breo Ellipta); and vilanterol in conjunction
, with the anticholinergic umeclidinium (Anoro Ellipta). The term Ellipta refers to a
new delivery system. Because the long-acting beta agonists (LABAs) have a longer
onset of action, they must never be used for acute treatment. Patients must be
taught to use the short-acting beta agonist (SABA) as rescue treatment.
• short acting beta agonist albuterol (Ventolin), levalbuterol (Xopenex), pirbuterol
(Maxair), terbutaline (Brethine), and metaproterenol (Alupent).
• Albuterol Class : beta 2 agonist (short acting)
• Indications and mechanisms of action: is a short-acting beta2-specific
bronchodilating beta agonist. Other similar drugs include bitolterol (Tornalate),
levalbuterol (Xopenex), pirbuterol (Maxair), and terbutaline (Brethine). Albuterol is
the most commonly used drug in this class. If albuterol is used too frequently, dose-
related adverse effects may be seen, because albuterol loses its beta2-specific
actions, especially at larger dosages
• Contraindications :. As a consequence, the beta1 receptors are stimulated, which
causes nausea, increased anxiety, palpitations, tremors, and an increased heart
rate.
• Route: po and inhalation
,• Other facts: levorotatory isomeric form of albuterol, levalbuterol, is sometimes
prescribed as an albuterol alternative for patients with certain risk factors (e.g.,
tachycardia, including tachycardia associated with albuterol treatment). (Lilley 583)
• Lilley, Linda, Shelly Collins, Julie Snyder. Pharmacology and the Nursing Process,
8th Edition. Mosby, 022016. VitalBook file.
• long acting beta agonist arformoterol (Brovana), formoterol (Foradil,
Perforomist), and salmeterol (Serevent). The newest long-acting beta agonists are
indacterol (Arcapta Neohaler); vilanterol in conjunction with fluticasone (Breo
Ellipta); and vilanterol in conjunction with the anticholinergic umeclidinium (Anoro
Ellipta)
• beta andregenic mechanism of action and drug effect The beta agonists relax and
dilate airways by stimulating the beta2-adrenergic receptors located throughout the
lungs.
• 582
• There are three subtypes of these drugs, based on their selectivity for beta2
receptors:
• Nonselective adrenergic drugs, which stimulate the beta, beta1 (cardiac), and
beta2 (respiratory) receptors. Example: epinephrine. (NOTE: Epinephrine inhalers
, were taken off the market in 2012 because they did not comply with FDA
requirements). Epinephrine is available as a prefilled syringe for self-administration
by patients with severe allergic reactions and is called EpiPen (Figure 37-2).
• Nonselective beta-adrenergic drugs, which stimulate both beta1 and beta2
receptors. Example: metaproterenol.
• Selective beta2 drugs, which primarily stimulate the beta2 receptors. Example:
albuterol.
• These drugs can also be categorized according to their routes of administration as
oral, injectable, or inhaled. The various beta agonist bronchodilators are listed in
Table 37-3. The bronchioles are surrounded by smooth muscle. When the smooth
muscle contracts, the airways are narrowed and the amount of oxygen and carbon
dioxide exchanged is reduced. The action of beta agonist bronchodilators begins at
the specific receptor stimulated and ends with the relaxation and dilation of the
airways. However, many reactions must take place at the cellular level for
bronchodilation to occur. When a beta2-adrenergic receptor is stimulated by a beta
agonist, adenylate cyclase is activated and produces cyclic adenosine
monophosphate (cAMP). Adenylate cyclase is an enzyme needed to make cAMP.
The increased levels of cAMP cause bronchial smooth muscles to relax, which
results in bronchial dilation and increased airflow into and out of the lungs.
