NURS 615: ADVANCED PHARMACOTHERAPEUTICS Maryville university exam 4 Already Passed!!

What is Tiotropium (SPIRIVA) used to treat? - Used in the management/ maintenance treatment of chronic obstructive pulmonary disease (COPD) which includes chronic bronchitis and emphysema. What is the drug classification of Tiotropium? - >It is a long-acting, 24H anticholinergicbronchodilator. >It is a muscurinic receptor antagonist, often referred to as an antimuscurinic or anticholinergic agent. What is the mechanism of action of Tiotropium (SPIRIVA) - It does not display selectivity for specific muscarinic receptors, when topically applied it acts mainly on M3 muscarinic receptors[8] located on smooth muscle cells and submucosal glands. This leads to a reduction in smooth muscle contraction and mucus secretion and thus produces a bronchodilatory effect. What are the adverse effects with montelukast (Singular) - Anxiety, aggression, depression, suicidal thoughts, What patient teaching should accompany the prescription of montelukast (Singulair)? - Teach pt regarding adverse effect about aggression , depression suicidal thoughts that could occur What patient teaching should be provided when prescribing inhaled corticosteroids? - They should be taken 2x a day every day for the use of prevention of asthma. Rinse mouth after use to prevent oral thrush. What ethnic background should not be prescribed long-acting beta agonists? - African Americans, increased incidence of death in this population What medication would you prescribe for bronchospasm for a patient taking propranolol? - IpratropiumWhat is the mechanism of action of albuterol? - Activation of beta adrenergic receptors lead to relaxation of the muscle of the lung and opening and dilation of the airway Beta adrenergic receptor are coupled with stimulatory g-protein of the the d-anelyl cyclase> This enzyme produces the second messennger cyclic AMP (in the lungs it cAMP decreases calcium concentration w/in cells and and activates protein kinase A. Both of these inactivates myosin activase kinase and myosin like phosphatase They open large conductants of hyperpolarize airway smooth muscle cells What is the mechanism of action of inhaled corticosteroids? - Extremely potent vasoconstrictive and anti-inflammatory activity.