Relaxation of smooth airway muscle in the presence of reversible airflow obstruction is a general indication for the use of:
B. adrenergic bronchodilators
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
C. I, II, II, and IV only
Short-acting B2 agonists are indicated for:
D. relief of acute reversible airflow obstruction
Your patient is diagnosed with persistent asthma. Which type of drug would you recommend for maintenance bronchodilation and control of bronchospasm?
A. long-acting adrenergic agent
Your patient presents with postextubation stridor. You recommend racemic epinephrine for its:
A. 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?
B. racemic epinephrine
In a patient who is receiving large doses of catecholamines, you may expect to see all of the following side effects except:
A. diuresis
Levalbuterol is:
D. the single (R)-isomer of albuterol
Ephinephrine stimulates which sites?
I. Alpha
II. B1
III. B2
IV. Cholinergic
C. I, II, and III only
Epinephrine would be indicated for all of the following except:
A. treatment of infections
Racemic epinephrine comes in what percent solution?
B. 2.25%
The keyhole theory indicates that the larger the side-chain attachment to a catechol base, the:
B. greater B2 specificity
Catecholamines are inactivated by:
C. COMT
Catecholamines should not be given by which of the following routes:
C. oral
Albuterol is available in which of the following forms?
I. syrup
II. nebulizer solution
III. MDI
IV. oral tablets
V. DPI
D. I, II, III, IV and V
Salmeterol is:
c. indicated for acute asthma attacks
B. a long-acting B-adrenergic
Long-acting B2 agonists are indicated for:
A. maintenance therapy for asthmatics
The bronchodilating action of adrenergic drugs is due to stimulation of:
B. B2 receptors
B1 receptor stimulation will:
A. incr heart rate and contractile force
Smooth muscle relaxation most likely occurs as a result of:
C. an incr in intracellular cAMP
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
B. I, II, III, IV, and V
Continuous nebulization of inhaled B agonists has been used for:
A. severe asthma
The dosage recommended by NAEPP EPR 2 for continuous nebulization of adrenergic agents is:
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
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:
C. bracycardia
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:
C. alpha adrenergic
Which is the only B-agonist formulation that is a single isomer and is approved by the FDA for aerosol deliver?
A. levalbuterol
What is the rationale for using the single-isomer agent levalbuterol instead of racemic albuterol?
A. the (S)-isomer is thought to promote bronchoconstriction
What is the main difference between salmeterol and formoterol?
B. formoterol has a quicker onset and peak effect than salmeterol
What is the indication for use of a short-acing B agonist in asthma?
B. rescue therapy in reversible airflow obstruction
Is it appropriate to use formoterol as a rescue B-agonist bronchodilator?
a. yes
b. no
b. no
(because its a controller - up to 12 hours)
Which procedure would tell you that a patient has reversible airway obstruction?
D. pre- and postpulmonary function tests
You receive an order to administer 5 ml of albuterol by SVN. You would:
B. call the physician to confirm the medication dose
You are administering an aerosolized bronchodilator to your patient. Her pretreatment pulse was 85 bpm. You would stop the treatment if her pulse reached:
C. 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:
c. that this is normal because you are giving the treatment with air
C. that this is normal because of incr perfusion to poorly ventilated areas
A patient with glottic edema is in mild distress. Which of the following medications would be of benefit in this situation?
A. racemic epinephrine
The only anticholinergic that is approved by the FDA for aerosolization is:
A. ipratropium bromide
Ipratropium bromide can be delivered by which of the following methods?
I. tablet
II. nebulizer
III. injection
IV. MDI
V. nasal spray
B. II, IV, and V only
Atrovent is approved for:
A. maintenance treatment of airflow obstruction in COPD
Combivent is a combination drug including which agents?
D. albuterol and atrovent
Cholinergic stimulation will produce which of the following effects?
I. bronchoconstrictionn
II. incr mucus secretion
III. miosis
IV. decr heart rate
V. salivation
A. I, II, III, IV, and V
Mucociliary slowing, bronchodilation, and increased heart rate are all a result of:
B. anticholinergic agents
Quaternary ammonium compounds such as ipratropium:
B. do not cross lipid membranes easily
Ipratropium agents may be indicated to treat:
D. all of the above
Quaternary ammonium compounds cause bronchodilation by:
D. blocking cholinergic sites
Patients using ipratropium aerosols should be instructed to avoid allowing the aerosol in contact with their:
A. eye
Activating an atroven inhaler in the eye may cause:
D. pupil dilation
Cardiac effects of aerosolized apratropium bromide include:
A. little or no effect
Drugs that competitively block the action of acetylcholine at parasympathetic postganglionic effector cell receptors are called:
A. antimuscarinic agents
The most common side effect of anticholinergic bronchodilators is:
C. 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
D. I, II, IV, and V 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:
D. combivent MDI
What is the only once-a-day anticholinergic on the market?
A. tiotropium bromide
All of the following are true about piratropium, except:
A. It is a leukotriene modifier used to treat step 3 asthma.
