Study Guide Chapter 6,7 Pharmacology

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

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

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

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

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. short-acting adrenergic agent
C. long-acting adrenergic agent
D. mucolytic agent

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

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

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

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

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

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

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

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 broken down by COMT
C. more easily it is metabolized
D. greater B₂ specificity

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

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

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

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

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

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

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

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

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

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

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

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. 10-15 mg/hr
D. 5 to 8 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, IV, and V only
B. I, II, III, IV, and IV
C. II and IV only
D. I, II, and V only

All of the following are side effects that should be monitored in you patient when using sympathomimetic aerosol except:
A. muscle tremor
B. tachycardia
C. insomnia
D. 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:
A. alpha adrenergic
B. sympatholytic
C. B₂ adrenergic
D. anticholinergic

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 a weak bronchodilator
B. The (R)-isomer is thought to cause tremors
C. The (R)-isomer is thought to cause tachycardia
D. the (S)-isomer is thought to promote bronchoconstriction

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 has a quicker onset and peak effect than salmeterol
D. formoterol is more B2 specific than salmeterol

What is the indication for use of a short-acing B agonist in asthma?
A. intiinflammatory agent in reversible airlow obstruction
B. rescue therapy in reversible airflow obstruction
C. intiinfective agent in respiratory infections
D. maintenance 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. pre- and postpulmonary function tests
B. pulse oximetry
C. inspection: patient SOB when walking < 25 ft
D. wheezing on auscultation

You receive an order to administer 5 ml of albuterol by SVN. You would:
A. give 0.5 ml of medication because that is probably what the doctor meant to write
B. confirm the order on the char and administer as directed
C. have your supervisor administer the treatment
D. 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:
A. 100
B. 90
C. 110
D. 120

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 abnormal and call the physician
C. that this is normal because of incr perfusion to poorly ventilated areas
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. theophylline
B. albuterol
C. racemic epinephrine
D. ipratropium bromide

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

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

A. I, II, and IV only
B. II, IV, and V only
C. I, III, and IV only
D. II 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. maxair and atrovent
C. albuterol and serevent
D. serevent 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, III, and V only
B. I, II, III, IV, and V
C. II, III, and IV only
D. IV only

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

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

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. blocking adrenergic sites
B. stimulating cholinergic sites
C. stimulating adrenergic sites
D. blocking cholinergic sites

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

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

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

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

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

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

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. combivent MDI
C. foradil DPI
D. ventolin MDI

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

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