Antihistamines for Respiratory Disorders Quiz
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Questions and Answers

What effect does histamine have on small blood vessels in the vascular system?

  • Stimulates acid secretion
  • Increases capillary permeability
  • Dilates small blood vessels (correct)
  • Constricts small blood vessels
  • Where is histamine stored in the periphery?

  • Gallbladder
  • Mucus membranes
  • Mucosal lining of the stomach
  • Mast cells and basophils (correct)
  • Which type of cells are responsible for the synthesis and storage of histamine in the periphery?

  • Neurons
  • Lymphocytes
  • Erythrocytes
  • Mast cells and basophils (correct)
  • What is histamine's role in the bronchi?

    <p>Constricts smooth muscle</p> Signup and view all the answers

    Where are mast cells predominantly present?

    <p>Skin and soft tissues</p> Signup and view all the answers

    What is the main clinical use of histamine?

    <p>Diagnostic procedures</p> Signup and view all the answers

    Where is histamine produced in the central nervous system (CNS)?

    <p>Posterior hypothalamus</p> Signup and view all the answers

    What stimulates the allergic release of histamine?

    <p>Production of antibodies of the immunoglobulin E class</p> Signup and view all the answers

    What are the two common pathologic states where histamine is involved?

    <p>Allergic disorders and peptic ulcer disease</p> Signup and view all the answers

    What are two areas of high histamine content in the body?

    <p>Lungs and gastrointestinal tract (GI)</p> Signup and view all the answers

    What is the main effect of H1 stimulation?

    <p>Vasodilation of the skin, face, and upper body</p> Signup and view all the answers

    How does histamine act directly on parietal cells of the stomach?

    <p>To promote acid release</p> Signup and view all the answers

    Why are antihistamines not effective in treating asthma?

    <p>Histamine is not involved in asthma attacks</p> Signup and view all the answers

    What is the principal use of H2 blockers?

    <p>Treatment of gastric and duodenal ulcers</p> Signup and view all the answers

    Which mediator is primarily responsible for mild allergic conditions like hay fever?

    <p>Histamine acting at H1 receptors</p> Signup and view all the answers

    What triggers allergic release of histamine?

    <p>Prior sensitization to allergens</p> Signup and view all the answers

    Which agents can trigger histamine release from mast cells without prior sensitization?

    <p>Certain drugs, radiocontrast media, plasma expanders</p> Signup and view all the answers

    'The intensity of an allergic reaction is determined by which mediator?' - Which of the following best completes this statement?

    <p>(H1) receptors</p> Signup and view all the answers

    'Other effects of histamine include itching, pain, and secretion of mucous.' - Which receptor plays a significant role in these effects?

    <p>(H1) receptors in the central nervous system</p> Signup and view all the answers

    Which group of H1 antagonists is known for causing significant sedation?

    <p>First-generation H1 antagonists</p> Signup and view all the answers

    What is the primary therapeutic effect of H1 antagonists at arterioles and venules?

    <p>Inhibit histamine-induced dilation</p> Signup and view all the answers

    Which effect is a direct result of blocking histamine at sensory nerves using H1 antagonists?

    <p>Reduced itching and pain</p> Signup and view all the answers

    What effect do H1 antagonists have on histamine-induced increases in capillary permeability?

    <p>Reduce edema</p> Signup and view all the answers

    Which symptom is likely to be reduced by blocking H1 receptors in mucous membranes with antihistamines?

    <p>Suppressed mucus secretion</p> Signup and view all the answers

    What is the primary CNS effect of most second-generation antihistamines?

    <p>CNS depression</p> Signup and view all the answers

    What is a potential consequence of antihistamine overdose in terms of CNS function?

    <p>Seizures</p> Signup and view all the answers

    Why are very young children particularly sensitive to CNS stimulation by antihistamines?

    <p>They have less developed CNS</p> Signup and view all the answers

    Why do most second-generation antihistamines have reduced CNS depression compared to first-generation antihistamines?

    <p>Higher receptor selectivity in second-generation antihistamines</p> Signup and view all the answers

    What is a common therapeutic use of dimenhydrinate among antihistamines?

    <p>Motion sickness</p> Signup and view all the answers

    Which generation of antihistamines is associated with the least amount of sedation?

    <p>Both second and third generations</p> Signup and view all the answers

    What is the primary reason for the reduced sedative effects of second-generation antihistamines?

    <p>Low affinity for H1 receptors of the CNS</p> Signup and view all the answers

    Which category of first-generation antihistamines causes the most prominent CNS depression?

    <p>Ethanolamines</p> Signup and view all the answers

    What advice should be given to patients regarding alcohol consumption when taking H1 blockers?

    <p>Avoid alcoholic beverages</p> Signup and view all the answers

    Why is it recommended to use antihistamines in pregnancy only when clearly necessary?

    <p>To avoid any potential risks to the fetus</p> Signup and view all the answers

    Which antihistamine group is largely devoid of anticholinergic actions?

    <p>Second-generation agents</p> Signup and view all the answers

    What characteristic makes alkylamines like chlorpheniramine different from other first-generation antihistamines?

    <p>Less prominent CNS depression</p> Signup and view all the answers

    Why are second-generation antihistamines less likely to cause sedation than first-generation agents?

    <p>Low affinity for H1 receptors of CNS</p> Signup and view all the answers

    Which adverse effect is primarily associated with older patients taking antihistamines?

    <p>Sedation and fatigue</p> Signup and view all the answers

    What should be done if sedation remains excessive with an alkylamine antihistamine?

    <p>Switch to a second-generation antihistamine</p> Signup and view all the answers

    What is the half-life of fexofenadine?

    <p>14.4 hours</p> Signup and view all the answers

    Which formulation of fexofenadine should be used for patients with renal impairment?

    <p>All are safe</p> Signup and view all the answers

    What is the marketed name for the fexofenadine suspension?

    <p>Allegra Children's Liquid</p> Signup and view all the answers

    Which fruit juice can reduce fexofenadine absorption?

    <p>Grapefruit juice</p> Signup and view all the answers

    What is the primary symptom of allergic rhinitis?

    <p>Pruritus</p> Signup and view all the answers

    What is the mechanism behind nasal congestion in allergic rhinitis?

    <p>Increased blood vessel permeability</p> Signup and view all the answers

    How should patients time fruit juice consumption to avoid affecting fexofenadine absorption?

    <p>1 to 2 hours after dosing</p> Signup and view all the answers

    Which antihistamine is approved for oral therapy of chronic idiopathic urticaria?

    <p>Fexofenadine</p> Signup and view all the answers

    What is the primary route of excretion for fexofenadine?

    <p>Unchanged in urine</p> Signup and view all the answers

    What dosage adjustment is recommended for fexofenadine in patients with renal impairment?

    <p>Reduce the dosage</p> Signup and view all the answers

    Which inflammatory mediators are released from mast cells upon binding of airborne allergens to IgE antibodies?

    <p>Histamine, leukotrienes, and prostaglandins</p> Signup and view all the answers

    What is the primary difference between seasonal and perennial allergic rhinitis?

    <p>Seasonal rhinitis occurs in the spring and fall due to outdoor allergens, while perennial rhinitis is triggered by indoor allergens.</p> Signup and view all the answers

    Which class of drugs is considered the most effective for both prevention and treatment of seasonal and perennial allergic rhinitis?

    <p>Glucocorticoids (intranasal)</p> Signup and view all the answers

    Which of the following adverse effects is rare but can occur with the use of intranasal glucocorticoids?

    <p>Adrenal suppression and slowed growth in children</p> Signup and view all the answers

    What makes oral antihistamines most effective for mild to moderate allergic rhinitis?

    <p>Taking them prophylactically before symptoms appear</p> Signup and view all the answers

    Which route of administration is used for azelastine and olopatadine for the treatment of allergic rhinitis?

    <p>Intranasal spray</p> Signup and view all the answers

    What common side effect can occur due to systemic absorption when using azelastine or olopatadine for allergic rhinitis?

    <p>Somnolence</p> Signup and view all the answers

    What is the primary mechanism of action of intranasal cromolyn (Nasalcrom) for treating allergic rhinitis?

    <p>Suppressing the release of histamine from mast cells</p> Signup and view all the answers

    Why is intranasal cromolyn (Nasalcrom) considered best suited for prophylaxis in allergic rhinitis?

    <p>It should be administered before symptoms start</p> Signup and view all the answers

    What is a characteristic adverse reaction associated with sympathomimetics when used for allergic rhinitis treatment?

    <p>Rebound congestion after prolonged use</p> Signup and view all the answers

    How do sympathomimetics reduce nasal congestion in patients with allergic rhinitis?

    <p>By activating α1-adrenergic receptors on nasal blood vessels</p> Signup and view all the answers

    Which symptom of allergic rhinitis can sympathomimetics help relieve?

    <p>Nasal congestion</p> Signup and view all the answers

    What is the primary reason for informing patients about the delayed response to intranasal cromolyn (Nasalcrom) therapy?

    <p>To set appropriate expectations for symptom relief</p> Signup and view all the answers

    Which adverse reaction is most likely associated with oral sympathomimetic drugs used for allergic rhinitis?

    <p>Generalized vasoconstriction</p> Signup and view all the answers

    What distinguishes the primary therapeutic effect of intranasal glucocorticoids from intranasal cromolyn in treating allergic rhinitis?

    <p>Greater benefits in symptom relief</p> Signup and view all the answers

    What distinguishes sympathomimetics from intranasal cromolyn in their mechanism of action for treating allergic rhinitis?

    <p>Causing shrinkage of swollen membranes via vasoconstriction</p> Signup and view all the answers

    What distinguishes topical sympathomimetics from oral agents in terms of onset of action?

    <p>Topical agents act faster than oral agents</p> Signup and view all the answers

    Which side effect is commonly associated with ipratropium bromide when used for allergic rhinitis?

    <p>Nasal drying and irritation</p> Signup and view all the answers

    How do systemic effects primarily manifest in relation to oral and topical sympathomimetics?

    <p>Systemic effects occur only with oral agents</p> Signup and view all the answers

    What differentiates the administration of phenylephrine as a nasal decongestant compared to its use in combination preparations?

    <p>Phenylephrine is fast and effective when administered topically</p> Signup and view all the answers

    What makes pseudoephedrine preferable to oral phenylephrine according to the text?

    <p>Pseudoephedrine is better absorbed and more effective</p> Signup and view all the answers

    Which drug is indicated for allergic rhinitis, asthma, and the common cold as an anticholinergic agent?

    <p>Ipratropium bromide (Atrovent)</p> Signup and view all the answers

    What distinguishes the effect of oral phenylephrine from its topical administration?

    <p>Oral phenylephrine has a slower onset of action compared to topical administration</p> Signup and view all the answers

    'Even though absorption is poor, why is increasing the dosage of phenylephrine not advisable?'

    <p>Higher doses can cause adverse cardiovascular and CNS effects despite poor absorption</p> Signup and view all the answers

    'What is a notable difference between the duration of action of topical and oral sympathomimetics?'

    <p>'Oral agents act longer than topical preparations'</p> Signup and view all the answers

    How does montelukast relieve nasal congestion in allergic rhinitis?

    <p>By blocking leukotriene receptors</p> Signup and view all the answers

    What is the primary reason for reserving montelukast for patients who do not respond to intranasal glucocorticoids or antihistamines?

    <p>Limited beneficial effects</p> Signup and view all the answers

    Which of the following is a rare but serious neuropsychiatric effect associated with montelukast?

    <p>Depression and insomnia</p> Signup and view all the answers

    What type of allergic rhinitis symptom does montelukast have little effect on?

    <p>Sneezing</p> Signup and view all the answers

    In comparison to intranasal glucocorticoids, how effective is montelukast when used alone or in combination with an antihistamine for allergic rhinitis?

    <p>Less effective</p> Signup and view all the answers

    What is the primary mechanism of action of omalizumab in treating allergy-mediated asthma?

    <p>Inhibiting IgE synthesis</p> Signup and view all the answers

    Why is omalizumab approved only for allergy-mediated asthma?

    <p>'On-label' use restricted to asthma</p> Signup and view all the answers

    Which of the following symptoms are improved by omalizumab according to several studies?

    <p>'Allergy-like' symptoms</p> Signup and view all the answers

    What distinguishes the approved indications between montelukast and omalizumab in terms of allergic conditions they treat?

    <p>Montelukast is approved for seasonal and perennial allergic rhinitis, while omalizumab is approved only for allergy-mediated asthma.</p> Signup and view all the answers

    What is the primary reason for the off-label prescription of omalizumab for patients with ragweed-induced seasonal allergic rhinitis?

    <p>To manage symptoms when other drugs have been ineffective</p> Signup and view all the answers

    Which opioid analgesic is noted for being somewhat more potent than codeine for cough suppression?

    <p>Hydrocodone</p> Signup and view all the answers

    What is the primary distinguishing factor between codeine and hydrocodone in terms of their classification under the Controlled Substances Act?

    <p>Codeine is classified under Schedule II, while hydrocodone is not scheduled.</p> Signup and view all the answers

    What sets dextromethorphan apart from traditional opioids like codeine in terms of its side effects?

    <p>Dextromethorphan does not produce typical opioid-like euphoria or physical dependence.</p> Signup and view all the answers

    Which antitussive acts by decreasing the sensitivity of respiratory tract stretch receptors to suppress cough?

    <p>Benzonatate</p> Signup and view all the answers

    What is the primary action of an expectorant in relation to cough?

    <p>Makes cough more productive by stimulating respiratory tract secretions</p> Signup and view all the answers

    Which compound is noted for its mucolytic action by reacting directly with mucus to make it more watery?

    <p>Acetylcysteine</p> Signup and view all the answers

    What sets guaifenesin apart from other expectorants in terms of its efficacy?

    <p>It requires doses higher than normal to be effective.</p> Signup and view all the answers

    What adverse effect is specifically noted for benzonatate use in children and adults?

    <p>Severe effects</p> Signup and view all the answers

    What distinguishes hypertonic saline and acetylcysteine from other expectorants in terms of administration?

    <p>They are administered by inhalation.</p> Signup and view all the answers

    Which of the following is a characteristic symptom of the common cold?

    <p>Headache</p> Signup and view all the answers

    Why are antibiotics not justified for treating colds?

    <p>Colds are caused by viruses</p> Signup and view all the answers

    What is the purpose of including antihistamines in some cold remedies?

    <p>To suppress mucus secretion</p> Signup and view all the answers

    Why is caffeine added to some combination cold remedies?

    <p>To counteract the sedative effects of antihistamines</p> Signup and view all the answers

    What is a disadvantage associated with combination cold remedies?

    <p>The dosage may lead to excessive or subtherapeutic levels of ingredients</p> Signup and view all the answers

    Which group of patients are advised to use single-drug preparations for cold relief?

    <p>Patients with just a single symptom (e.g., rhinitis, cough, or headache)</p> Signup and view all the answers

    Why are antibiotics not a recommended treatment for the common cold?

    <p>They have no effect on viruses.</p> Signup and view all the answers

    What is the purpose of including antihistamines in some combination cold remedies?

    <p>To suppress mucus secretion</p> Signup and view all the answers

    Why is caffeine added to some combination cold remedies?

    <p>To offset the sedative effects of antihistamines</p> Signup and view all the answers

    What is a disadvantage associated with combination cold remedies?

    <p>They may contain unnecessary ingredients.</p> Signup and view all the answers

    Why was the use of OTC cold remedies restricted for children below the age of 2 years?

    <p>Because they cause life-threatening events</p> Signup and view all the answers

    What is the primary reason for informing patients about the delayed response to intranasal cromolyn therapy?

    <p>To ensure compliance with the treatment regimen</p> Signup and view all the answers

    What distinguishes sympathomimetics from intranasal cromolyn in their mechanism of action for treating allergic rhinitis?

    <p>Sympathomimetics stimulate alpha-adrenergic receptors.</p> Signup and view all the answers

    What effect does histamine have on small blood vessels in the vascular system?

    <ul> <li>It dilates them.</li> </ul> Signup and view all the answers

    What makes oral antihistamines most effective for mild to moderate allergic rhinitis?

    <p>They have longer duration of action.</p> Signup and view all the answers

    Which drug is classified under Schedule II of the Controlled Substances Act due to its potential for abuse?

    <p>Codeine</p> Signup and view all the answers

    What is the main mechanism of action of benzonatate (Tessalon and Zonatuss) in suppressing cough?

    <p>Decreasing sensitivity of respiratory tract stretch receptors</p> Signup and view all the answers

    Which drug is a derivative of opioids but does not produce typical opioid-like euphoria or physical dependence?

    <p>Dextromethorphan</p> Signup and view all the answers

    What makes guaifenesin different from other compounds promoted as expectorants?

    <p>Questionable efficacy</p> Signup and view all the answers

    Which drug acts as a mucolytic by reacting directly with mucus to make it more watery?

    <p>Acetylcysteine</p> Signup and view all the answers

    What is the primary disadvantage associated with the mucolytic acetylcysteine?

    <p>'Rotten egg' smell</p> Signup and view all the answers

    What is the main distinguishing factor between codeine and hydrocodone in terms of their action on cough suppression?

    <p>'Potency' and 'liability for abuse'</p> Signup and view all the answers

    'Which agent acts within the CNS to suppress cough?'

    <p>'Dextromethorphan'</p> Signup and view all the answers

    Which neurotransmitter is primarily involved in causing nasal congestion in people with allergic rhinitis?

    <p>Leukotrienes</p> Signup and view all the answers

    What is the primary mechanism of action of montelukast (Singulair) in relieving nasal congestion?

    <p>Blocking leukotriene receptors</p> Signup and view all the answers

    Which symptom of allergic rhinitis is least affected by the use of montelukast?

    <p>Sneezing</p> Signup and view all the answers

    What is the primary reason for reserving montelukast for patients who do not respond to intranasal glucocorticoids or antihistamines?

    <p>Limited beneficial effects of montelukast</p> Signup and view all the answers

    Which drug is a monoclonal antibody directed against IgE, specifically approved for allergy-mediated asthma?

    <p>Omalizumab (Xolair)</p> Signup and view all the answers

    What is the main role of IgE in allergic reactions?

    <p>Stimulating mast cells to release inflammatory mediators</p> Signup and view all the answers

    What common neuropsychiatric side effect can occur with the use of montelukast?

    <p>Insomnia</p> Signup and view all the answers

    How do the benefits of montelukast in allergic rhinitis compare to those of intranasal glucocorticoids?

    <p>'Montelukast is less effective than intranasal glucocorticoids'</p> Signup and view all the answers

    'What are the main adverse neuropsychiatric effects associated with montelukast?'

    <p>'Depression and insomnia'</p> Signup and view all the answers

    Why is montelukast generally reserved for patients who do not respond well to intranasal glucocorticoids or antihistamines?

    <p>Its benefits are limited, and it can cause rare but serious neuropsychiatric effects.</p> Signup and view all the answers

    Which type of COPD is genetically determined and often associated with an alpha one antitrypsin deficiency?

    <p>Genetically determined COPD</p> Signup and view all the answers

    What environmental factor can cause COPD due to abnormal lung development?

    <p>Premature birth</p> Signup and view all the answers

    Which type of COPD is associated with exposure to cigarette smoke, pollution, and factory fumes?

    <p>Environmental COPD</p> Signup and view all the answers

    Which type of COPD is linked with childhood infections such as tuberculosis and HIV?

    <p>COPD due to infections</p> Signup and view all the answers

    When patients exhibit signs and symptoms of both COPD and asthma, what category of COPD does this fall under?

    <p>COPD and asthma combo</p> Signup and view all the answers

    In which publication did the lecturer's article on the clinical indicators for diagnosing COPD appear?

    <p>The Nurse Practitioner</p> Signup and view all the answers

    When should inhaled corticosteroids be used in stable COPD patients?

    <p>When a patient has two or more exacerbations per year</p> Signup and view all the answers

    What is the main reason for avoiding long-term use of oral glucocorticoids in COPD?

    <p>They lead to hearing test impairments</p> Signup and view all the answers

    What factors are important when initiating inhaled corticosteroids in patients with COPD?

    <p>Blood eosinophils of 100 to 300</p> Signup and view all the answers

    In which patients are E for inhibitors used in COPD?

    <p>Patients with chronic bronchitis</p> Signup and view all the answers

    What effect does treatment with ISIS renascent have on patients?

    <p>Increased risk for bacterial resistance</p> Signup and view all the answers

    Which pharmacologic treatment shows evidence supporting a reduction in mortality and COPD?

    <p>Pulmonary rehab</p> Signup and view all the answers

    What is a key goal for treating stable COPD patients?

    <p>Enhancing exercise tolerance</p> Signup and view all the answers

    Which factor is emphasized in the importance of providing education on inhaler device technique?

    <p>Patient preference and ability</p> Signup and view all the answers

    What is the key spirometry ratio that needs to be met for a diagnosis of COPD?

    <p>0.70</p> Signup and view all the answers

    What is a critical component in preventing disease progression in COPD patients?

    <p>Avoiding irritant exposures</p> Signup and view all the answers

    In the modified Medical Research Council (MRC) Dyspnea Scale, what does Grade 2 indicate?

    <p>Breathless when hurrying on a walk</p> Signup and view all the answers

    Which category of patients, based on exacerbation history and MRC scores, would fall under Category B for initial COPD treatment?

    <p>Zero exacerbations, MRC score 2</p> Signup and view all the answers

    What is the recommended GOLD grade classification for a patient with FEV1 between 30% and 50% predicted?

    <p>GOLD 3</p> Signup and view all the answers

    What is the purpose of using the COPD Assessment Test (CAT) in the assessment of COPD patients?

    <p>To assess symptoms and health status</p> Signup and view all the answers

    Which of the following conditions is NOT included as a potential cause of chronic cough mentioned in the text?

    <p>Pneumonia</p> Signup and view all the answers

    What is a recommended therapeutic option for patients with stable COPD demonstrating post bronchodilator FGB1 between 15 to 40 percent and evidence of hyperinflation and lung volume reduction?

    <p>Lung volume reduction surgery</p> Signup and view all the answers

    Which vaccine is recommended by the CDC to protect against pertussis for patients with COPD who were not vaccinated in adolescence?

    <p>Tdap vaccine</p> Signup and view all the answers

    What is the main treatment approach for COPD with long-acting muscarinic antagonist and long-acting beta-agonist combinations?

    <p>Inhaled corticosteroids</p> Signup and view all the answers

    Which of the following medications has been shown to reduce the incidence of community-acquired pneumonia and exacerbations in patients with COPD?

    <p>Pneumococcal vaccine</p> Signup and view all the answers

    What is recommended for lung cancer screening in patients with COPD due to smoking?

    <p>Low dose CT scan</p> Signup and view all the answers

    Which medication exerts a small bronchodilator effect in stable COPD and is associated with modest symptomatic benefits?

    <p>Theophylline</p> Signup and view all the answers

    What is the recommended strategy for choosing an inhalation device for patients?

    <p>Use only one device type, minimize the number of different device types, and avoid switching devices without proper information or follow-up.</p> Signup and view all the answers

    Why is it essential to assess a patient's ability to perform the correct inhalation maneuver for the inhalation device?

    <p>To assess if they can make a forceful and deep inhalation for specific types of inhalation devices.</p> Signup and view all the answers

    Which type of inhalers require coordination between device triggering and inhalation?

    <p>Soft mist inhalers</p> Signup and view all the answers

    Why should physicians only prescribe inhalation devices that they know how to use?

    <p>To maintain patient trust in the physician's expertise.</p> Signup and view all the answers

    What is the preferred choice when initiating treatment with long-acting bronchodilators?

    <p>Combination of a long-acting muscarinic antagonist and long-acting beta-agonist</p> Signup and view all the answers

    Which type of bronchodilator treatment should be considered for patients with persistent symptoms on a single long-acting bronchodilator treatment?

    <p>Escalation to two single inhalers</p> Signup and view all the answers

    What are the indications for non-invasive mechanical ventilation?

    <p>Respiratory acidosis with CO2 levels greater than or equal to 6 and arterial pH less than or equal to 7.3</p> Signup and view all the answers

    What is a criterion for initiating invasive mechanical ventilation?

    <p>Severe hemodynamic instability responsive to fluids and bioactive drugs</p> Signup and view all the answers

    Which factor is NOT considered a risk factor for developing lung cancer?

    <p>Low BMI below 25 kg/m^2</p> Signup and view all the answers

    What is a key point for managing COPD during the COVID-19 pandemic?

    <p>Maintain physical activity and ensure an adequate supply of medications</p> Signup and view all the answers

    What should be evaluated during the 12 to 16-week follow-up for COPD patients?

    <p>Spirometry results and symptom documentation</p> Signup and view all the answers

    What is a discharge criteria recommendation for COPD patients?

    <p>Ensure early follow-up within 12 weeks</p> Signup and view all the answers

    'What is a key intervention to reduce the frequency of exacerbations in COPD patients?' - Which option addresses this best?

    <p>'Smoking cessation' as part of interventions</p> Signup and view all the answers

    'What patient assessment should be done during the one to four-week follow-up?' - Which choice is most relevant?

    <p>'Review the understanding of treatment'</p> Signup and view all the answers

    'Which factor should be reassessed during the one to four-week follow-up?' - Which option is most appropriate?

    <p>'Capacity to do physical activity'</p> Signup and view all the answers

    'What should be maintained in patients with COPD during the COVID-19 pandemic?' - Which choice aligns with this recommendation?

    <p>'Continue regular regimens unchanged'</p> Signup and view all the answers

    What is the main difference in exacerbation criteria between group A and group B in the twenty twenty to twenty twenty two slide?

    <p>Severity of exacerbations</p> Signup and view all the answers

    In the management cycle suggested in the text, what step comes after 'assess'?

    <p>Review</p> Signup and view all the answers

    Which group receives lobal lama based on the twenty twenty to twenty twenty two slide information?

    <p>Group E</p> Signup and view all the answers

    What distinguishes the new twenty twenty three guidelines from the previous ones mentioned in the text?

    <p>Combination therapy requirement</p> Signup and view all the answers

    What should be considered for patients whose blood eosinophils are greater than three hundred according to the text?

    <p>Including an AC</p> Signup and view all the answers

    Which step is crucial at every visit during pharmacologic treatment follow up according to the text?

    <p>Check inhaler technique</p> Signup and view all the answers

    What is the critical factor determining which group a patient falls into based on exacerbations?

    <p>Blood eosinophil count</p> Signup and view all the answers

    In the management cycle provided in the text, what is suggested to be considered at every visit regarding treatment?

    <p>'Check' inhaler technique</p> Signup and view all the answers

    'Group E gets Loblaw and you consider adding an AC if the blood eosinophils are greater than three hundred.' - What does AC stand for in this context?

    <p>'Add-on Corticosteroid'</p> Signup and view all the answers

    What is the distinguishing factor between group A and group B regarding exacerbation requirements in the twenty twenty to twenty twenty two slide?

    <p>Hospital admission rate</p> Signup and view all the answers

    What is the primary consideration when prescribing supplemental oxygen in COPD patients?

    <p>Maintaining SATs above 90</p> Signup and view all the answers

    How can you differentiate a COPD exacerbation related to heart failure from one related to pulmonary issues?

    <p>By checking the BNP levels</p> Signup and view all the answers

    What is a key contributor to consider when treating patients with COPD, pneumonia, and heart failure?

    <p>Technip near tachycardia</p> Signup and view all the answers

    What should be monitored when managing severe exacerbations of COPD that are not life-threatening?

    <p>Fluid balance</p> Signup and view all the answers

    Which pharmacological treatment is indicated for patients with COPD showing evidence of hyperinflation and lung volume reduction?

    <p>Bronchodilators</p> Signup and view all the answers

    What should be evaluated to determine the cause of an exacerbation in COPD patients?

    <p>Pulse ox lab assessment</p> Signup and view all the answers

    What is a potential indication for hospitalization in COPD patients?

    <p>Worsening or resting hypoxemia</p> Signup and view all the answers

    What is a key consideration for patients with COPD that exacerbations do not respond to initial medical management?

    <p>Identifying associated conditions</p> Signup and view all the answers

    What is the appropriate strategy for choosing an inhalation device for patients with COPD?

    <p>'Trial and error' method</p> Signup and view all the answers

    What is the maximum recommended daily dose of promotora according to the text?

    <p>48 micrograms</p> Signup and view all the answers

    How does adding a law to an inhaled corticosteroid regimen affect asthma patients?

    <p>Improves symptoms and reduces exacerbations</p> Signup and view all the answers

    What is a common side effect of using iciest for asthma control?

    <p>Dryness of the mouth</p> Signup and view all the answers

    Which leukotriene modifier targets part of the inflammatory pathways in asthma?

    <p>Montelukast</p> Signup and view all the answers

    What is the main purpose of using muscarinic antagonists or sama's in asthma treatment?

    <p>As reliever medication in severe acute asthma</p> Signup and view all the answers

    How are controller medications like inhaled corticosteroids supplied?

    <p>In multiclass or deep inhalers</p> Signup and view all the answers

    What is the recommended duration of short-term treatment with corticosteroids for asthma exacerbations in adults?

    <p>5-7 days</p> Signup and view all the answers

    For which patients may long-term treatment with corticosteroids be necessary?

    <p>Patients with persistent airflow limitation</p> Signup and view all the answers

    What are some of the side effects associated with short-term use of corticosteroids?

    <p>Mood changes</p> Signup and view all the answers

    What is the main reason for confirming evidence documented in medical records before starting controlled therapy in asthma patients?

    <p>To prevent making the diagnosis more difficult</p> Signup and view all the answers

    What is the primary goal of short-term treatment in asthma management?

    <p>Achieve symptom control and minimize risks</p> Signup and view all the answers

    Why is a partnership between the asthma patient and healthcare provider crucial for effective asthma management?

    <p>To improve health outcomes</p> Signup and view all the answers

    What is a common side effect of combining Lopa with volatile zeffirelli medications?

    <p>Elevated liver function test</p> Signup and view all the answers

    Which statement accurately describes the role of chromoglycate and Hendropriyono sodium as controller medications?

    <p>They require meticulous inhaler maintenance</p> Signup and view all the answers

    What distinguishes Taiyo tropism among long-acting muscarinic antagonists?

    <p>Included in combo medications with inhaled corticosteroids</p> Signup and view all the answers

    For which patients is Anomalously Mad suitable as a treatment option?

    <p>Patients with controlled severe eosinophilic asthma</p> Signup and view all the answers

    What differentiates Eosinophilic Granulomatosis with Polyangiitis treatment with Emam compared to other options?

    <p>Subcutaneous injection</p> Signup and view all the answers

    In what patient group is New Program (anti interleukin four) most recommended?

    <p>Patients requiring maintenance oral corticosteroids</p> Signup and view all the answers

    What is the primary purpose of short-acting beta agonists in asthma treatment?

    <p>To provide quick relief during asthma symptoms</p> Signup and view all the answers

    What is a common side effect associated with regular and excessive use of short-acting beta agonists?

    <p>Tremor and tachycardia</p> Signup and view all the answers

    When should short-acting beta agonists (SABAs) be used in asthma treatment?

    <p>Only as needed at the lowest dose required</p> Signup and view all the answers

    What is the primary function of low-dose inhaled corticosteroids in asthma treatment?

    <p>To provide maintenance therapy for asthma control</p> Signup and view all the answers

    Which medications are referred to as reliever medications for asthma maintenance therapy?

    <p>SABAs and MARKT</p> Signup and view all the answers

    What distinguishes the use of inhaled corticosteroids like budesonide from oral corticosteroids in asthma management?

    <p>Inhaled corticosteroids have reduced risk of systemic side effects</p> Signup and view all the answers

    Why is regular Sahba no longer recommended in asthma treatment?

    <p>Due to its association with severe adverse effects</p> Signup and view all the answers

    What is the risk associated with higher Sobhi use in asthma treatment?

    <p>Adverse clinical outcomes</p> Signup and view all the answers

    When should step two of the stepwise approach for adults and adolescents be initiated?

    <p>If symptoms are twice a month or more, but less than daily</p> Signup and view all the answers

    In the stepwise approach for children ages six to 11, what is the alternative dosing for step one?

    <p>Low dose inhaled corticosteroid taken whenever Saba is taken</p> Signup and view all the answers

    What symptom frequency indicates the need to initiate step four in the stepwise approach for adults and adolescents?

    <p>Symptoms on most days or waking with asthma once a week or more</p> Signup and view all the answers

    What distinguishes track two from track one in the stepwise approach for adults and adolescents?

    <p>Track two involves an as-needed low dose inhaled corticosteroid</p> Signup and view all the answers

    What is the recommended treatment for patients with asthma who are experiencing symptoms most days or waking at night more than once a week?

    <p>High dose inhaled corticosteroids or add-on Taiyo tropism</p> Signup and view all the answers

    When should step-up asthma treatment be considered according to the text?

    <p>When symptoms are not controlled after two to three months of sustained treatment</p> Signup and view all the answers

    What is the alternative suggested in the text for patients with asthma being treated with Sombat as reliever medication?

    <p>Low dose inhaled corticosteroid plus leukotriene receptor antagonists with short-acting beta agonist as reliever medication</p> Signup and view all the answers

    What is the initial step recommended by the text to confirm the diagnosis and assess symptom control in children with asthma?

    <p>Assess modifiable risk factors</p> Signup and view all the answers

    In what scenario should patients with asthma consider moving up to step three in treatment according to the text?

    <p>Experiencing symptoms most days or waking at night more than once a week</p> Signup and view all the answers

    Which option represents the correct treatment for patients with asthma who do not have symptoms twice a month or more?

    <p>Step one treatment</p> Signup and view all the answers

    Why is it important to assess inhaler technique, adherence, and other factors before considering stepping up asthma treatment?

    <p>To identify comorbidities like allergic rhinitis</p> Signup and view all the answers

    Which factor should prompt consideration of step-up asthma treatment according to the text?

    <p>Persistent symptoms despite correct inhaler technique</p> Signup and view all the answers

    What does the text recommend for patients with asthma who are having symptoms most days or waking at night more than once a week and have poor lung function?

    <p>High dose inhaled corticosteroids or add-on Taiyo tropism</p> Signup and view all the answers

    What should be done if patients with asthma experience persistent symptoms despite two to three months of sustained control?

    <p>Consider evaluating their use of correct inhaler technique and adherence.</p> Signup and view all the answers

    What is the recommended stepwise approach for children five and under with asthma?

    <p>Double low dose of inhaled corticosteroid plus SABA as needed</p> Signup and view all the answers

    What is the primary reason for avoiding Lamai as an add-on treatment before ensuring sufficient inhaled corticosteroid?

    <p>To reduce exacerbations</p> Signup and view all the answers

    What additional checks are recommended before considering Lamai as an add-on?

    <p>Sputum and EKG</p> Signup and view all the answers

    What is the main purpose of checking a patient's sputum according to the text?

    <p>To evaluate eosinophilic levels</p> Signup and view all the answers

    Why are exacerbations often viewed as failures in chronic asthma care?

    <p>As they represent opportunities to improve patient care plans</p> Signup and view all the answers

    What is the significance of following up with patients until their symptoms and lung function return to normal?

    <p>To monitor treatment effectiveness</p> Signup and view all the answers

    What distinguishes the stepwise approach for children five and under from older patients with asthma?

    <p>Requirement of pediatric nurse practitioners for treatment</p> Signup and view all the answers

    What is the main consideration before deciding on Lamai as an add-on treatment?

    <p>Ensuring sufficient inhaled corticosteroid</p> Signup and view all the answers

    How do exacerbations provide opportunities for improving patient care plans?

    <p>By relieving the patient's current plan</p> Signup and view all the answers

    Why is it emphasized that only pediatric nurse practitioners should treat children five and under for asthma?

    <p>To ensure correct stepwise approach application</p> Signup and view all the answers

    What is the recommended approach for stepping down treatment in asthma patients?

    <p>Gradually reduce treatment once asthma is under control</p> Signup and view all the answers

    How much prednisone should be given to adults for severe asthma exacerbations?

    <p>40-50 milligrams for 5-7 days</p> Signup and view all the answers

    What is the purpose of documenting the baseline status of lung function in asthma patients?

    <p>To track progress and assess response to treatment</p> Signup and view all the answers

    What should be considered before stepping down treatment in asthma patients?

    <p>Recent E.R. visits</p> Signup and view all the answers

    What is the role of corticosteroids during asthma exacerbations?

    <p>To reduce the need for oral corticosteroids</p> Signup and view all the answers

    What is the typical dose range of prednisone given to adults during severe asthma exacerbations?

    <p>40-60 milligrams for 7 days</p> Signup and view all the answers

    What is the purpose of providing an asthma action plan to patients?

    <p>To provide guidance on managing symptoms and exacerbations</p> Signup and view all the answers

    Why is it important not to take asthma patients off corticosteroids during treatment?

    <p>To prevent exacerbations and worsening symptoms</p> Signup and view all the answers

    What is the significance of assessing risk factors before making treatment decisions in asthma patients?

    <p>It assists in identifying potential triggers or exacerbating factors.</p> Signup and view all the answers

    How do exacerbations differ from the usual symptoms in asthma patients?

    <p>They represent a flare-up or worsening of symptoms beyond the usual.</p> Signup and view all the answers

    Which pathogen is most commonly associated with Legionella pneumonia in middle-aged male smokers and alcohol abusers?

    <p>Legionella pneumophila</p> Signup and view all the answers

    What is a characteristic symptom of mycoplasma pneumonia in patients under thirty-five years old?

    <p>Immaculate skin rash</p> Signup and view all the answers

    Which bacterial pathogen commonly causes pneumonia in neonates due to exposure to maternal strep?

    <p>Streptococcus pneumoniae</p> Signup and view all the answers

    In which group of patients is Haemophilus influenza most commonly observed?

    <p>Older adults with COPD</p> Signup and view all the answers

    What defines severe pneumonia according to the 2007 Infectious Disease Society and American Thoracic Society criteria?

    <p>One major criterion or three minor criteria</p> Signup and view all the answers

    What is a characteristic feature of pneumococcal pneumonia presentation?

    <p>Rust-colored sputum</p> Signup and view all the answers

    What is indicated by a degenerative left shift in a blood count?

    <p>Depletion of neutrophils and an increase in bands</p> Signup and view all the answers

    Which type of patients are hospitalized based on the CURB-65 criteria if they score 4 or greater?

    <p>Patients with confusion, high respiratory rate, and age over 65 years</p> Signup and view all the answers

    When should a chest X-ray be obtained for patients suspected of pneumonia?

    <p>To confirm or establish the diagnosis</p> Signup and view all the answers

    Why might a chest X-ray show a false negative in pneumonia patients?

    <p>Dehydration</p> Signup and view all the answers

    What is recommended for outpatient treatment of healthy adults without comorbidities according to the Infectious Disease Society and American Thoracic Society?

    <p>Amoxicillin one gram three times daily</p> Signup and view all the answers

    Why should outpatient adults with comorbidities receive combination therapy for pneumonia treatment?

    <p>To cover a broader spectrum of pathogens</p> Signup and view all the answers

    Which bacterial cause of community-acquired pneumonia is most common in smokers?

    <p>Haemophilus influenzae</p> Signup and view all the answers

    Which organism is most likely responsible for pneumonia in patients recovering from the flu?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    Which bacterium is commonly found in college students living in dormitories and is a cause of community-acquired pneumonia?

    <p>Mycoplasma pneumoniae</p> Signup and view all the answers

    Which bacterium is considered an 'atypical' cause of community-acquired pneumonia but is common in older buildings and air conditioning systems?

    <p>Legionella pneumophila</p> Signup and view all the answers

    What is the most common bacterial cause of community-acquired pneumonia overall?

    <p>Streptococcus pneumoniae</p> Signup and view all the answers

    Why is it recommended to avoid using fluoroquinolones for community-acquired pneumonia unless it is the very last option?

    <p>To avoid developing resistance to fluoroquinolones</p> Signup and view all the answers

    Which bacterium causing community-acquired pneumonia is commonly associated with patients recovering from the flu?

    <p>Legionella pneumophila</p> Signup and view all the answers

    Which factor would necessitate the use of combination therapy instead of monotherapy in patients with a recent history of antibiotic use?

    <p>Repeated courses of therapy with similar antibiotics</p> Signup and view all the answers

    What is the main reason corticosteroids are not recommended for outpatient use in pneumonia?

    <p>Limited evidence of corticosteroid benefits in outpatient settings</p> Signup and view all the answers

    Why should patients with community-acquired pneumonia ideally be febrile and stable for 48 to 72 hours before discontinuing antimicrobial treatment?

    <p>To ensure complete eradication of the infection</p> Signup and view all the answers

    Why do younger children often acquire RSV from their older siblings?

    <p>Higher RSV transmission rates among siblings</p> Signup and view all the answers

    What is a key characteristic that limits the immunologic response in RSV-infected individuals?

    <p>Limited replicative activity of the virus in the airways</p> Signup and view all the answers

    What is a significant risk factor for acquiring RSV in younger children?

    <p>Having older siblings in preschool</p> Signup and view all the answers

    Which infants are at the greatest risk for severe RSV disease requiring hospitalization?

    <p>Infants born at 28 weeks gestation</p> Signup and view all the answers

    What is a common symptom of RSV infection in infants over three months of age?

    <p>Significant coughing and sneezing</p> Signup and view all the answers

    Which condition is NOT a risk factor for severe RSV disease requiring hospitalization?

    <p>Attention deficit hyperactivity disorder</p> Signup and view all the answers

    What is the purpose of RSV testing according to the text?

    <p>To avoid unneeded antibiotic therapy</p> Signup and view all the answers

    Why is palivizumab recommended for prophylaxis in high-risk infants?

    <p>It reduces RSV hospitalization rate by up to 55%</p> Signup and view all the answers

    Which group of patients are recommended for RSV vaccination during pregnancy?

    <p>Patients with hemodynamically significant congenital heart disease</p> Signup and view all the answers

    What is the purpose of immunizing patients during pregnancy against RSV?

    <p>To protect the infant through passive immunity</p> Signup and view all the answers

    What is one condition that makes a patient eligible for RSV vaccination according to the text?

    <p>Chronic lung disease</p> Signup and view all the answers

    For which age group is RSV vaccination during pregnancy especially emphasized?

    <p>Second year of life</p> Signup and view all the answers

    What factor associated with severe illness in patients 65 and older is mentioned in the text?

    <p>Immunosuppressive disease</p> Signup and view all the answers

    What is a common misconception about RSV vaccination during pregnancy according to the text?

    <p>It protects against bacterial superinfection</p> Signup and view all the answers

    Which patient group should be considered for RSV vaccination during pregnancy based on their need for medical intervention?

    <p>Patients with chronic heart disease</p> Signup and view all the answers

    What is a crucial eligibility criterion for RSV vaccination according to the text?

    <p>Less than 24 months of age with heart failure medications</p> Signup and view all the answers

    What is a telltale sign of influenza in adults?

    <p>Allergies</p> Signup and view all the answers

    Which complication can occur as a result of a secondary infection from the flu virus?

    <p>Myositis pericarditis syndrome</p> Signup and view all the answers

    Which statement about pneumonia caused by a secondary flu infection is true?

    <p>It is commonly caused by bacteria (staff)</p> Signup and view all the answers

    Which group of patients may experience prolonged recovery from influenza due to preexisting conditions?

    <p>Patients with heart disease</p> Signup and view all the answers

    Which symptom is highlighted as being uncommon in adults but possible in children with influenza?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the recommended age for giving peramivir to children?

    <p>2 and older</p> Signup and view all the answers

    When should antiviral therapy be initiated for patients with complications or progressive disease related to influenza?

    <p>As soon as possible</p> Signup and view all the answers

    Which antiviral medication is given once orally for flu treatment in children 12 and older?

    <p>Belloc severe</p> Signup and view all the answers

    What is the full name of the virus that causes COVID-19?

    <p>SARS-CoV-2</p> Signup and view all the answers

    Why are antiviral therapy and booster vaccines important in reducing COVID-19 deaths?

    <p>They provide additional protection against existing variants.</p> Signup and view all the answers

    What is the primary concern with the timing of COVID-19 immunizations and the emergence of new variants?

    <p>Need for updated boosters for new variants</p> Signup and view all the answers

    'Why should acetaminophen and ibuprofen be used for chest pain, dyspnea, and wheezing in patients?'

    <p>'They manage respiratory symptoms.'</p> Signup and view all the answers

    'What is the main reason behind a reduction in masking and social distancing related to COVID-19?'

    <p>'Increased vaccination rates'</p> Signup and view all the answers

    When is it recommended to start antiviral therapy for flu?

    <p>Any time, even up to 10 days after symptoms start</p> Signup and view all the answers

    Who should NOT receive live attenuated (nasal spray) flu vaccines according to the text?

    <p>Pregnant patients</p> Signup and view all the answers

    What is a key factor in determining candidates for antiviral therapy for flu based on the text?

    <p>Chronic aspirin therapy</p> Signup and view all the answers

    Why might sensitivity testing be done on patients with egg allergies before flu vaccination?

    <p>To check if they are suitable for live attenuated vaccines</p> Signup and view all the answers

    Based on the text, who are considered candidates for antiviral therapy for flu?

    <p>Those with anemia</p> Signup and view all the answers

    Why are live attenuated (nasal spray) flu vaccines contraindicated in pregnant patients according to the text?

    <p>They can compromise fetal health</p> Signup and view all the answers

    What is a significant consideration for starting antiviral therapy for flu as outlined in the text?

    <p>The patient's high-risk status</p> Signup and view all the answers

    Why should flu immunization be considered even for patients with egg allergies based on the text?

    <p>Some patients with anaphylaxis can still be vaccinated</p> Signup and view all the answers

    What is the most common chronic health problem that can result in more severe COVID-19?

    <p>Obesity</p> Signup and view all the answers

    What is the primary antiviral therapy goal for COVID-19 recommended by the CDC?

    <p>Reduce hospitalizations</p> Signup and view all the answers

    What is the recommended timing to initiate antiviral therapy for most outpatients with COVID-19 symptoms?

    <p>Within 5 days of symptom onset</p> Signup and view all the answers

    Which drug is known for its inhibition of CYP3A4 metabolism and is often given in combination with another antiviral?

    <p>Ritonavir</p> Signup and view all the answers

    What drug interaction effect can be anticipated when using a strong CYP3A4 inhibitor with a CYP3A4 substrate?

    <p>$5$-fold increase in the substrate</p> Signup and view all the answers

    What action is recommended regarding statin medications when initiating antiviral therapy?

    <p>Hold for 8 days</p> Signup and view all the answers

    What drug should be avoided or doses reduced when using antivirals due to potential interactions?

    <p>Calcium channel blockers</p> Signup and view all the answers

    $50%$ of all prescription medications are substrates for which enzyme pathway?

    <p>$CYP3A4$</p> Signup and view all the answers

    What is the recommended management strategy for patients who experience rebound symptoms after taking Paxil?

    <p>Continue to use Paxil as recommended</p> Signup and view all the answers

    What is the suggested approach for patients who cannot take the preferred antiviral therapies?

    <p>Reserve alternative treatments for when preferred options are not feasible</p> Signup and view all the answers

    What is the CDC's guidance on patient isolation in the context of rebound symptoms after taking antiviral medications?

    <p>Total isolation period of 7 days after symptom onset</p> Signup and view all the answers

    What is the anticipated future trend regarding antiviral therapy for COVID-19 based on current research findings?

    <p>Shift towards combination therapy due to potential drug resistance</p> Signup and view all the answers

    What distinguishes the use of alternative antiviral therapies from the preferred options in the context of severe COVID-19?

    <p>Limited evidence in placebo-controlled trials</p> Signup and view all the answers

    What does the lecture suggest about the potential development of resistance to antivirals used for COVID-19?

    <p>Resistance will be similar to other antivirals in the past</p> Signup and view all the answers

    Why is it suggested that future antiviral therapies for COVID-19 may involve combination treatments?

    <p>Due to concerns about developing resistance</p> Signup and view all the answers

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