Study Guide Chapter 6,7 Pharmacology

Adrenergic bronchodilators mimic the actions of:
A. Acetylcholine
B. Penicillin
C. norepinephrine
D. Epinephrine

Relaxation of smooth airway muscle in the presence of reversible airflow obstruction is a general indication for the use of:
A. antiinfective agents
B. steroids
C. adrenergic bronchodilators
D. mucolytics

Disease states that could benefit from the use of adrenergic bronchodilators include which of the following?
I. asthma
II. bronchitis
III. emphysema
IV. bronchiectasis
V. pleural effusion

A. II, IV, and V only
B. I and III only
C. I, II, III, IV, and V
D. I, II, II, and IV only

Short-acting B₂ agonists are indicated for:
A. reduction of airway edema
B. thinning of secretions
C. relief of acute reversible airflow obstruction
D. maintenance of bronchodilation

Your patient is diagnosed with persistent asthma. Which type of drug would you recommend for maintenance bronchodilation and control of bronchospasm?
A. alpha-adrenergic agent
B. long-acting adrenergic agent
C. mucolytic agent
D. short-acting adrenergic agent

Your patient presents with postextubation stridor. You recommend racemic epinephrine for its:
A. B₁-adrenergic effect
B. short-acting B₂-adrenergic effect
C. long-acting B₂-adrenergic effect
D. alpha-adrenergic vasoconstricting effect

You enter the room of a 2-year-old patient who presents with the characteristic "barking cough" found with croup. Once the diagnosis is confirmed, you may recommend which of the following medications to help provide relief from subglottic swelling?
A. salmeterol
B. racemic epinephrine
C. albuterol
D. terbutaline

In a patient who is receiving large doses of catecholamines, you may expect to see all of the following side effects except:
A. incr blood pressure
B. diuresis
C. relaxation of brochial smooth muscle
D. tachycardia

Levalbuterol is:
A. the same as racemic epinephrine
B. an equal mixture of (R)- and (S)-isomers
C. the single (R)-isomer of albuterol
D. the same as albuterol.

Ephinephrine stimulates which sites?
I. Alpha
II. B₁
III. B₂
IV. Cholinergic

A. II only
B. II, III, and IV only
C. IV only
D. I, II, and III only

Epinephrine would be indicated for all of the following except:
A. treatment of infections
B. cardiac stimulation
C. acute asthma episodes
D. systemic hypersensitivity reactions

Racemic epinephrine comes in what percent solution?
A. 5.0%
B. 0.05%
C. 2.25%
D. 1.25%

The keyhole theory indicates that the larger the side-chain attachment to a catechol base, the:
A. shorter the duration of action
B. more easily it is metabolized
C. more easily it is broken down by COMT
D. greater B₂ specificity

Catecholamines are inactivated by:
A. COMT
B. ephinephrine
C. ACTH
D. ATP

Catecholamines should not be given by which of the following routes:
A. inhalation
B. subcutaneous
C. injection
D. oral

Albuterol is available in which of the following forms?
I. syrup
II. nebulizer solution
III. MDI
IV. oral tablets
V. DPI

A. III, IV, and V only
B. II and III only
C. I, II, and V only
D. I, II, III, IV and V

Salmeterol is:
A. available in nebulizer solution only
B. a long-acting B-adrenergic
C. another name for albuterol
c. indicated for acute asthma attacks

Long-acting B2 agonists are indicated for:
A. maintenance therapy for asthmatics
B. treating infections
C. mucus reduction
D. acute asthma attacks

The bronchodilating action of adrenergic drugs is due to stimulation of:
A. B₁ receptors
B. B₂ receptors
C. cholinergic receptors
D. alpha receptors

B₁ receptor stimulation will:
A. provide upper airway decongestion
B. cause vasoconstriction
C. incr heart rate and contractile force
D. relax bronchiole smooth muscles

Smooth muscle relaxation most likely occurs as a result of:
A. an incr in intracellular cAMP
B. a decr in intracellular cAMP
C. a decr in ATP
D. an incr in ATP

Inhalation is the preferred route of administering catecholamines for which of the following reasons?
I. rapid onset of action
II. smaller dosage used
III. reduced side effects
IV. drug is delivered to target organ
V. safe and painless route

A. I, III, and V only
B. III and IV only
C. I and II only
D. I, II, III, IV, and V

Continuous nebulization of inhaled B agonists has been used for:
A. pneumonia
B. cystic fibrosis
C. emphysema
D. severe asthma

The dosage recommended by NAEPP EPR 2 for continuous nebulization of adrenergic agents is:
A. 20-30 mg/hr
B. 8 to 12 mg/hr
C. 5 to 8 mg/hr
D. 10-15 mg/hr

Your patient is receiving her third continuous nebulizer of albuterol (15 mg/hr). Which potential complications should you be on the look out for?
I. hypokalemia
II. cardiac arrhythmias
III. hyperglycemia
IV. PVCs
V. tremor

A. I, II, and V only
B. I, II, IV, and V only
C. II and IV only
D. I, II, III, IV, and IV

All of the following are side effects that should be monitored in you patient when using sympathomimetic aerosol except:
A. insomnia
B. bracycardia
C. muscle tremor
D. tachycardia

You are ordered to extubate a mechanically ventilated patient who has recently undergone open heart surgery. On postextubation assessment you note that the patient has stridor with mild retractions. Pharmacologically, you would recommend:
A. alpha adrenergic
B. B₂ adrenergic
C. anticholinergic
D. sympatholytic

Which is the only B-agonist formulation that is a single isomer and is approved by the FDA for aerosol deliver?
A. levalbuterol
B. albuterol
C. tiotropium
D. epinephrine

What is the rationale for using the single-isomer agent levalbuterol instead of racemic albuterol?
A. the (S)-isomer is thought to promote bronchoconstriction
B. the (S)-isomer is a weak bronchodilator
C. The (R)-isomer is thought to cause tremors
D. The (R)-isomer is thought to cause tachycardia

What is the main difference between salmeterol and formoterol?
A. formoterol is a short-acting; salmeterol is long-acting
B. formoterol has slower onset and peak effect compared with salmeterol
C. formoterol is more B2 specific than salmeterol
D. formoterol has a quicker onset and peak effect than salmeterol

What is the indication for use of a short-acing B agonist in asthma?
A. intiinflammatory agent in reversible airlow obstruction
B. intiinfective agent in respiratory infections
C. maintenance therapy in reversible airflow obstruction
D. rescue therapy in reversible airflow obstruction

Is it appropriate to use formoterol as a rescue B-agonist bronchodilator?
a. yes
b. no

Which procedure would tell you that a patient has reversible airway obstruction?
A. wheezing on auscultation
B. inspection: patient SOB when walking < 25 ft
C. pre- and postpulmonary function tests
D. pulse oximetry

You receive an order to administer 5 ml of albuterol by SVN. You would:
A. confirm the order on the char and administer as directed
B. call the physician to confirm the medication dose
C. have your supervisor administer the treatment
D. give 0.5 ml of medication because that is probably what the doctor meant to write

You are administering an aerosolized bronchodilator to your patient. Her pretreatment pulse was 85 bpm. You would stop the treatment if her pulse reached:
A. 120
B. 90
C. 100
D. 110

A 7-yr-old boy has been given multiple aerosolized albuterol treatments over the last several days. You enter the room and his father tells you that every time a therapist administers a treatment, a few minutes later the saturation falls. You explain to the father:
A. that this is abnormal and you will try to changle the med to levalbuterol
B. that this is normal because of incr perfusion to poorly ventilated areas
C. that this is abnormal and call the physician
c. that this is normal because you are giving the treatment with air

A patient with glottic edema is in mild distress. Which of the following medications would be of benefit in this situation?
A. ipratropium bromide
B. theophylline
C. albuterol
D. racemic epinephrine

The only anticholinergic that is approved by the FDA for aerosolization is:
A. atropine
B. albuterol sulfate
C. ipratropium bromide
D. glycopyrrolate

Ipratropium bromide can be delivered by which of the following methods?
I. tablet
II. nebulizer
III. injection
IV. MDI
V. nasal spray

A. I, III, and IV only
B. II only
C. II, IV, and V only
D. I, II, and IV only

Atrovent is approved for:
A. exacerbation of COPD
B. thinning of dried secretions
C. maintenance treatment of airflow obstruction in COPD
D. acute bronchoconstriction

Combivent is a combination drug including which agents?
A. albuterol and atrovent
B. serevent and atrovent
C. maxair and atrovent
D. albuterol and serevent

Cholinergic stimulation will produce which of the following effects?
I. bronchoconstrictionn
II. incr mucus secretion
III. miosis
IV. decr heart rate
V. salivation

A. II, III, and IV only
B. I, III, and V only
C. I, II, III, IV, and V
D. IV only

Mucociliary slowing, bronchodilation, and increased heart rate are all a result of:
A. parasympathetic agents
B. anticholinergic agents
C. cholinergic agents
D. adrenergic agents

Quaternary ammonium compounds such as ipratropium:
A. do not cross lipid membranes easily
B. are not effective as inhaled agents
C. are distributed quickly throught the body when inhaled
D. have no role in respiratory care

Ipratropium agents may be indicated to treat:
a. allergic rhinitis
b. common cold
c. nonallergic rhinitis
d. all of the above

Quaternary ammonium compounds cause bronchodilation by:
A. stimulating cholinergic sites
B. blocking cholinergic sites
C. stimulating adrenergic sites
D. blocking adrenergic sites

Patients using ipratropium aerosols should be instructed to avoid allowing the aerosol in contact with their:
A. ear
B. hair
C. eye
D. nose

Activating an atroven inhaler in the eye may cause:
A. pupil constriction
B. scarring of the cornea
C. pupil dilation
D. blindness

Cardiac effects of aerosolized apratropium bromide include:
A. incr heart rate
B. incr blood pressure
C. little or no effect
D. incr heart muscle contractility

Drugs that competitively block the action of acetylcholine at parasympathetic postganglionic effector cell receptors are called:
A. cholinergic agents
B. antimuscarinic agents
C. adrenergic agents
D. musarinic agents

The most common side effect of anticholinergic bronchodilators is:
A. delirium
B. wheezing
C. incr heart rate
D. dry mouth

Possible side effects of aerosolized atrovent include which of the following?
I. flulike symptoms
II. pharyngitits
III. cardiac arrest
IV. dry mouth
V. dyspnea

A. I, II, IV, and V only
B. I, II, III, IV, and V
C. I, II, and III only
D. I, II, and IV only

Results of your patient's PFT show that the peak flow rate increased the most when she inhaled an aerosolized sympathomimetic agent and an aerosolized parasympatholytic agent. You would recommend that she be given:
A. serevent DPI
B. foradil DPI
C. combivent MDI
D. ventolin MDI

What is the only once-a-day anticholinergic on the market?
A. ipratropium bromide
B. tiotropium bromide
C. atropine
D. glycopyrrolate

All of the following are true about piratropium, except:
A. It is a leukotriene modifier used to treat step 3 asthma.
B. It is a first-line choice of bronchodilator for COPD.
C. It can be combined with a B-agonist for maintenance bronchodilation in COPD.
D. It is added to B-agonist in severe asthma episodes that do not respond to B-agonists alone.