Chapter 37: Respiratory Drugs
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Questions and Answers

What is the primary characteristic of Chronic Obstructive Pulmonary Disease (COPD)?

  • Irreversible airflow obstruction (correct)
  • Complete absence of symptoms
  • Intermittent airflow obstruction
  • Reversible lung damage

    • Which of the following is a factor that can trigger asthma symptoms?

  • Exposure to cold air (correct)
  • Genetic predisposition
  • Changes in altitude
  • Nutritional deficiencies

    • Chronic bronchitis is primarily defined by which of the following symptoms?

  • Difficulty breathing during exercise
  • Persistent cough and excessive mucus production (correct)
  • Recurrent wheezing without cough
  • Frequent lung infections

    • How is asthma categorized when there are no known triggers or allergies involved?

    <p>Intrinsic asthma</p> Signup and view all the answers

    What type of asthma is specifically caused by exposure to certain medications?

    <p>Drug-induced asthma</p> Signup and view all the answers

    Which cells are involved in the inflammatory response seen in asthma?

    <p>Mast cells, eosinophils, and lymphocytes</p> Signup and view all the answers

    What distinguishes emphysema from other lung conditions like chronic bronchitis?

    <p>Destruction of alveolar elasticity</p> Signup and view all the answers

    What is a major feature of COPD compared to asthma?

    <p>Progressive lung disease with chronic obstruction</p> Signup and view all the answers

    What effect can beta2 agonists have on blood pressure?

    <p>They can either decrease or increase blood pressure.</p> Signup and view all the answers

    Which of the following is a common central nervous system effect of beta-adrenergic agonists?

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

    What is a major risk when combining beta-adrenergic agonists with nonselective beta blockers?

    <p>Decreased efficacy of beta agonists.</p> Signup and view all the answers

    Which xanthine derivative is commonly used for bronchodilation?

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

    What is an adverse effect commonly associated with anticholinergic medications?

    <p>Dry mouth</p> Signup and view all the answers

    Salmeterol is indicated for which role in asthma management?

    <p>Long-term maintenance therapy</p> Signup and view all the answers

    What is an important consideration when using albuterol?

    <p>Overuse can lead to systemic side effects.</p> Signup and view all the answers

    Which of the following effects is NOT associated with xanthine derivatives?

    <p>Decreased heart rate</p> Signup and view all the answers

    What effect do anticholinergics primarily have on airway secretions?

    <p>Reduce airway secretions</p> Signup and view all the answers

    What is one potential cardiovascular side effect of using xanthine derivatives?

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

    What is an indicator for carefully monitoring patients on beta-adrenergic agonists if they have diabetes?

    <p>Potential for high blood glucose levels</p> Signup and view all the answers

    Which anticholinergic is often described as the oldest and most commonly used?

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

    Which of the following is a potential adverse effect of both anticholinergics and xanthines?

    <p>Dry mouth</p> Signup and view all the answers

    Which inhaled corticosteroid is indicated for treating asthma in both adults and children?

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

    What is a primary role of inhaled corticosteroids in asthma management?

    <p>To control inflammation in the airways</p> Signup and view all the answers

    Inhaled corticosteroids are NOT suitable for patients with which condition?

    <p>Fungal infections</p> Signup and view all the answers

    What common side effect may occur when starting treatment with inhaled corticosteroids?

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

    Which corticosteroid is available in both inhaled and intranasal forms?

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

    Inhaled corticosteroids may increase the risk of which oral condition?

    <p>Oral fungal infections</p> Signup and view all the answers

    Which medication is classified as an inhaled corticosteroid specifically for asthma management?

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

    Which of the following medication interactions may decrease the effectiveness of inhaled corticosteroids?

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

    What is an important aspect of patient education regarding inhaler use?

    <p>Check for remaining doses regularly</p> Signup and view all the answers

    Which inhaled corticosteroid is known for having a longer duration of action compared to others?

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

    What is the therapeutic range for theophylline blood levels ideally recommended by most clinicians?

    <p>5 to 15 mcg/mL</p> Signup and view all the answers

    Which drug is indicated for use in infants with bradycardia?

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

    What is the primary action of leukotriene receptor antagonists (LTRAs)?

    <p>They prevent leukotrienes from binding to their receptors.</p> Signup and view all the answers

    What severe side effects should be monitored in patients taking Montelukast?

    <p>Serious mood changes and behaviors</p> Signup and view all the answers

    Which of the following is NOT a characteristic of corticosteroids?

    <p>They are used for immediate relief of asthma attacks.</p> Signup and view all the answers

    In which form is aminophylline administered?

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

    Which class of drugs is primarily used to prevent asthma attacks rather than treating acute symptoms?

    <p>Leukotriene Receptor Antagonists</p> Signup and view all the answers

    What is an adverse effect commonly associated with leukotriene receptor antagonists?

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

    Which LTRA is specifically indicated for treating allergic rhinitis symptoms?

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

    How do corticosteroids primarily improve asthma treatment?

    <p>By stabilizing leukocytes' membranes</p> Signup and view all the answers

    What is the main benefit of inhaled corticosteroids compared to oral corticosteroids?

    <p>They have localized effects minimizing systemic side effects.</p> Signup and view all the answers

    Which of the following is a potential complication of long-term corticosteroid use?

    <p>Adrenal gland suppression</p> Signup and view all the answers

    What symptom can bronchoconstriction cause?

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

    What effect do leukotriene receptor antagonists have on mucus secretion in the lungs?

    <p>Block mucus production.</p> Signup and view all the answers

    What is a primary characteristic of chronic bronchitis?

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

    Which of the following is a common cause of chronic bronchitis?

    <p>Prolonged exposure to bronchial irritants</p> Signup and view all the answers

    What is the effect of emphysema on the alveoli?

    <p>They are destroyed and enlarged.</p> Signup and view all the answers

    How do short-acting beta-agonists (SABAs) primarily function?

    <p>They relax bronchial smooth muscle.</p> Signup and view all the answers

    What is a notable characteristic of long-acting beta-agonists (LABAs)?

    <p>They offer relief lasting 12 hours or more.</p> Signup and view all the answers

    In which situation are LABAs not recommended for use?

    <p>Acute asthma attacks</p> Signup and view all the answers

    Which medication type is indicated for rapid relief during acute asthma attacks?

    <p>Short-acting beta-agonists</p> Signup and view all the answers

    What mechanism is triggered by beta-adrenergic agonists after binding to the beta2 receptor?

    <p>Increased production of cAMP</p> Signup and view all the answers

    Which condition can beta-adrenergic agonists be used to treat besides respiratory issues?

    <p>Hypotension and shock</p> Signup and view all the answers

    What is a contraindication for the use of beta-adrenergic agonists?

    <p>Uncontrolled hypertension</p> Signup and view all the answers

    What role do anticholinergics play in bronchial treatment?

    <p>They block the action of acetylcholine.</p> Signup and view all the answers

    What is a primary function of bronchodilators?

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

    Which type of adrenergics only stimulate beta2 receptors?

    <p>Selective beta2 drugs</p> Signup and view all the answers

    Study Notes

    Chronic Obstructive Pulmonary Disease (COPD)

    • COPD is a group of lung diseases that cause airflow obstruction.
    • It includes chronic bronchitis and emphysema.
    • Lung damage is generally irreversible.
    • COPD is characterized by an irreversible airflow obstruction in the lungs.

    Bronchial Asthma

    • Bronchial asthma is a chronic inflammatory disease that causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing.
    • Airway inflammation, bronchospasm, and mucus hypersecretion lead to airway obstruction.
    • Asthma can be intrinsic, extrinsic, exercise-induced, or drug-induced.

    Chronic Bronchitis

    • Chronic bronchitis is characterized by persistent inflammation and low-grade infection of the bronchi.
    • Inflammation leads to excessive mucus secretion and changes in the bronchial structure, causing breathing difficulties.
    • It often results from exposure to bronchial irritants like cigarette smoke or air pollution.

    Emphysema

    • Emphysema damages the alveoli, the tiny air sacs in the lungs.
    • It leads to reduced gas exchange and makes it difficult to get enough oxygen.
    • Symptoms include shortness of breath, wheezing, and chronic cough.

    Pharmacologic Overview: Bronchodilators

    • Bronchodilators relax bronchial smooth muscle, widening the bronchi and bronchioles.
    • They include beta-adrenergic agonists, anticholinergics, and xanthine derivatives.

    Bronchodilators: Beta-Adrenergic Agonists

    • Short-acting Beta-Agonists (SABAs) provide quick relief from bronchospasm.
      • Examples include albuterol.
      • They're often used as rescue inhalers.
    • Long-acting Beta-Agonists (LABAs) provide long-lasting relief from asthma symptoms, lasting for 12 hours or more.
      • Examples include salmeterol and formoterol.
      • They are for long-term management of asthma symptoms.
    • Newest LABAs include indacaterol and vilanterol, often available in combination with other medications.
      • "Ellipta" refers to a dry powder inhaler delivery system.

    Beta-Adrenergic Agonists: Mechanism of Action

    • Beta-adrenergic agonists stimulate beta2 receptors, leading to bronchodilation.
    • Stimulation of beta2 receptors triggers the production of cyclic adenosine monophosphate (cAMP).
    • cAMP relaxes smooth muscle in the airways, improving airflow.

    Anticholinergics

    • Anticholinergics block the action of acetylcholine, a neurotransmitter that constricts bronchioles.
    • Examples include ipratropium, tiotropium, and aclidinium.
    • They prevent bronchoconstriction by blocking acetylcholine from binding to muscarinic receptors in the airway, promoting airway relaxation and dilation.

    Xanthine Derivatives

    • Xanthines, such as theophylline, inhibit phosphodiesterase, increasing cAMP levels, leading to bronchodilation.
    • They stimulate the central nervous system and cardiovascular system.

    Nonbronchodilating Respiratory Drugs

    • Leukotriene Receptor Antagonists (LTRAs) block the action of leukotrienes, substances that cause inflammation, bronchoconstriction, and mucus production.
      • Examples include montelukast, zafirlukast, and zileuton.
    • Corticosteroids reduce inflammation in the airways.
    • Mast Cell Stabilizers prevent the release of histamine, a substance that causes inflammation and airway constriction in the lungs.

    Leukotriene Receptor Antagonists (LTRAs)

    • They are used to prevent asthma attacks, not to treat acute attacks.
    • They offer an alternative to traditional asthma medications.

    Corticosteroids

    • They have potent anti-inflammatory effects, reducing inflammation in the airways.
    • They are crucial for managing chronic asthma, preventing exacerbations.
    • Oral corticosteroids have systemic effects, while inhaled forms are more localized.

    Inhaled Corticosteroids

    • Examples include beclomethasone dipropionate.
    • Used for long-term control of asthma.

    Inhaled Corticosteroids: Overview

    • Purpose: Primarily used for long-term asthma control, reducing exacerbations, and treating persistent asthma.
    • Commonly Used: Budesonide, Ciclesonide, Flunisolide, Fluticasone, Mometasone, Triamcinolone acetonide.
    • Mechanism: Control inflammation in the airways by suppressing inflammatory cells and mediators.
    • Administration: Inhaled corticosteroids are delivered directly to the lungs, minimizing systemic effects.

    Inhaled Corticosteroids: Contraindications

    • Drug Allergy: Avoid in patients with known allergy to inhaled corticosteroids.
    • Acute Asthma Attacks: Not a primary treatment for acute attacks; bronchodilators are used instead.
    • Hypersensitivity: Contraindicated in those with hypersensitivity to glucocorticoids.
    • Fungal Infection: Avoid in patients with systemic fungal infections or positive sputum tests for Candida.

    ​Inhaled Corticosteroids: Adverse Effects

    • Common: Pharyngeal irritation, coughing, dry mouth, oral fungal infections.
    • Systemic Effects (Rare): Adrenal suppression, osteoporosis, cataracts (with high doses or prolonged use).

    Inhaled Corticosteroids: Drug Interactions

    • Systemic vs. Inhaled: Drug interactions are more likely with systemic corticosteroids; inhaled corticosteroids are generally safe and well-tolerated.
    • Common Interactions:
      • Antidiabetic Drugs: May increase serum glucose levels; dosage adjustments may be needed.
      • Cyclosporine & Tacrolimus: Increased risk of infections, especially in renal impairment.
      • Itraconazole, Ketoconazole, Strong CYP3A4 inhibitors: Potential increase in adverse effects of inhaled corticosteroids.
      • Phenytoin, Phenobarbital, Rifampin: Reduced effectiveness of inhaled corticosteroids.

    Inhaler: Patient Education

    • Inhaler Technique:
      • Teach proper technique for effective medication delivery.
      • Demonstrate and practice inhaler use.
      • Emphasize correct timing of inhalation and activation.
      • Provide a spacer for patients with coordination difficulties.
    • Dose Tracking:
      • Ensure patients can monitor their medication use.
      • Educate on how to count remaining doses.
      • Encourage refilling before running out.
      • Advise patients to keep inhalers in a safe, accessible location.

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    Description

    This quiz covers various chronic lung diseases, including Chronic Obstructive Pulmonary Disease (COPD), bronchial asthma, chronic bronchitis, and emphysema. Learn about their characteristics, causes, and effects on lung function. Test your knowledge on the differences and similarities between these respiratory conditions.

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