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Questions and Answers
What is Chronic Obstructive Pulmonary Disease?
What is Chronic Obstructive Pulmonary Disease?
What causes the airways of the lungs to become narrow in COPD?
What causes the airways of the lungs to become narrow in COPD?
What type of inhaler is used as a rescue inhaler for acute episodes of COPD?
What type of inhaler is used as a rescue inhaler for acute episodes of COPD?
What is the most commonly used short-acting beta-2 specific bronchodilating beta agonist?
What is the most commonly used short-acting beta-2 specific bronchodilating beta agonist?
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Why should SABAs not be used too frequently?
Why should SABAs not be used too frequently?
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What is the purpose of LABAs in COPD treatment?
What is the purpose of LABAs in COPD treatment?
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Which of the following LABAs should never be given more than twice daily or exceeded the maximum daily dose?
Which of the following LABAs should never be given more than twice daily or exceeded the maximum daily dose?
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What is the main difference between SABAs and LABAs?
What is the main difference between SABAs and LABAs?
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Why are SABAs used in patient education for rapid/onset of respiratory episode?
Why are SABAs used in patient education for rapid/onset of respiratory episode?
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Which of the following is NOT a characteristic of COPD?
Which of the following is NOT a characteristic of COPD?
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What is the combination of vilanterol and fluticasone known as?
What is the combination of vilanterol and fluticasone known as?
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What type of receptors do non-selective adrenergics stimulate?
What type of receptors do non-selective adrenergics stimulate?
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What is the indication for using beta-2 agonists?
What is the indication for using beta-2 agonists?
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What is a contraindication for using beta-2 agonists?
What is a contraindication for using beta-2 agonists?
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What is a common adverse effect of albuterol?
What is a common adverse effect of albuterol?
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How often should salmeterol be taken?
How often should salmeterol be taken?
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What is the mechanism of action of anticholinergics?
What is the mechanism of action of anticholinergics?
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What is the indication for using ipratropium?
What is the indication for using ipratropium?
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What is a common adverse effect of ipratropium?
What is a common adverse effect of ipratropium?
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What is the only xanthine derivative used as a bronchodilator?
What is the only xanthine derivative used as a bronchodilator?
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What is the therapeutic blood level range for the medication Aminophylline?
What is the therapeutic blood level range for the medication Aminophylline?
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Which of the following is a contraindication for Leukotriene Receptor Antagonist (LRTAs)?
Which of the following is a contraindication for Leukotriene Receptor Antagonist (LRTAs)?
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What is the primary effect of Aminophylline on the cardiovascular system?
What is the primary effect of Aminophylline on the cardiovascular system?
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Which of the following is an indication for Aminophylline?
Which of the following is an indication for Aminophylline?
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What is the primary mechanism of action of Leukotriene Receptor Antagonist (LRTAs)?
What is the primary mechanism of action of Leukotriene Receptor Antagonist (LRTAs)?
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Which of the following is a side effect of Aminophylline?
Which of the following is a side effect of Aminophylline?
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Why is it recommended to avoid caffeine when taking Aminophylline?
Why is it recommended to avoid caffeine when taking Aminophylline?
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Which of the following is an approved indication for Montelukast?
Which of the following is an approved indication for Montelukast?
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What is the effect of Aminophylline on the kidneys?
What is the effect of Aminophylline on the kidneys?
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When can improvement be seen with the use of Leukotriene Receptor Antagonist (LRTAs)?
When can improvement be seen with the use of Leukotriene Receptor Antagonist (LRTAs)?
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What is the primary use of inhaled corticosteroids in the treatment of asthma?
What is the primary use of inhaled corticosteroids in the treatment of asthma?
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What is a common side effect of inhaled corticosteroids?
What is a common side effect of inhaled corticosteroids?
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Why are systemic corticosteroids generally used to treat acute exacerbations or severe asthma?
Why are systemic corticosteroids generally used to treat acute exacerbations or severe asthma?
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What is a nursing implication for patients taking beta-adrenergic agonist therapy?
What is a nursing implication for patients taking beta-adrenergic agonist therapy?
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What is a contraindication for the use of inhaled corticosteroids?
What is a contraindication for the use of inhaled corticosteroids?
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What is a nursing implication for patients taking xanthine derivatives?
What is a nursing implication for patients taking xanthine derivatives?
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What is the mechanism of action of inhaled corticosteroids?
What is the mechanism of action of inhaled corticosteroids?
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What is a nursing implication for patients taking LRTAs?
What is a nursing implication for patients taking LRTAs?
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What is a common combination therapy for asthma treatment?
What is a common combination therapy for asthma treatment?
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What is a nursing implication for patients taking inhaled corticosteroids?
What is a nursing implication for patients taking inhaled corticosteroids?
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Study Notes
Chronic Obstructive Pulmonary Disease (COPD)
- COPD occurs when the airways of the lungs become narrow, leading to recurrent and reversible shortness of breath
- Narrowing of airways is caused by bronchospasms, inflammation of the bronchial mucosa, edema of the bronchial mucosa, and production of viscous mucus
Beta-Adrenergic Agonists
- Used to treat bronchospasm related to asthma, bronchitis, and other pulmonary diseases
- Three types: nonselective adrenergics, nonselective beta-adrenergics, and selective beta-2 drugs
- Examples: epinephrine, metproterenol, and albuterol
- Indications: relief of bronchospasm, treatment and prevention of acute attacks
- Contraindications: known drug allergy, uncontrolled hypertension, cardiac dysrhythmias, and high risk of stroke
- Adverse effects: insomnia, restlessness, anorexia, vascular headache, hyperglycemia, tremor, and cardiac stimulation
Short-Acting Beta-2 Agonists (SABAs)
- Used as rescue inhalers for acute episodes
- Examples: albuterol (Ventolin, ProAir), levalbuterol (Xopenex), and terbutaline (Brethine)
- Patient education: used for rapid onset of respiratory episode, must not be used too frequently
Long-Acting Beta-2 Agonists (LABAs)
- Used as maintenance medications
- Examples: arformoterol (Brovana), formoterol (Foradil, Perforomist), and salmeterol (Serevent)
- Patient education: used for chronic management of asthma, not for acute asthma treatment
Anticholinergics
- MOA: bind to ACh receptors, preventing ACh binding, resulting in prevention of bronchoconstriction and airway dilation
- Examples: ipratropium (Atrovent), tiotropium (Spiriva), and aclidinium (Tudorza)
- Indications: prevention of bronchospasms associated with chronic bronchitis or emphysema
- Adverse effects: dry mouth or throat, nasal congestion, heart palpitations, gastrointestinal distress, headache, coughing, and anxiety
Xanthine Derivatives
- Only theophylline is used as a bronchodilator
- Decreases cAMP levels, causes smooth muscle relaxation, bronchodilation, and increased airflow
- Also known as Aminophylline, given IV for treatment of patients with status asthmaticus
- Therapeutic blood level range: 10-20mcg/ml, now most clinicians advise levels between 5 and 15 mcg/ml
- Drug effects: cardiac stimulation, increased force of contraction, and increased heart rate
- Patient education: avoid caffeine, teach patients to take medications exactly as prescribed, and report adverse effects
Leukotriene Receptor Antagonists (LRTAs)
- Nonbronchodilating
- Newer class of asthma medications
- Examples: montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo)
- Indications: prophylaxis and long-term treatment and prevention of asthma in adults and children 12 years of age and older
- Contraindications: known drug allergy, previous adverse drug reaction, and allergy to inactive ingredients
- Patient education: approved for treatment of allergic rhinitis, improvement seen in about 1 week, and report adverse effects
Corticosteroids
- Naturally occurring or synthetic drugs used for their anti-inflammatory effects
- MOA: stabilize membranes of cells that release harmful bronchoconstricting substances, increase responsiveness of bronchial smooth muscle to beta-adrenergic stimulation
- Indications: primarily used to treat bronchospastic disorders, persistent asthma, and often used concurrently with beta-adrenergic agonist
- Adverse effects: pharyngeal irritation, coughing, dry mouth, oral fungal infections, and systemic effects
- Patient education: teach patients to take medications exactly as prescribed, report adverse effects, and monitor for therapeutic effects
Nursing Implications
- Encourage patients to take measures to prevent, relieve, or decrease symptoms of COPD
- Perform a thorough assessment before beginning therapy, including skin color, baseline vitals, respirations, respiratory assessment, and pulse oximetry
- Teach patients to take bronchodilators exactly as prescribed, report adverse effects, and monitor for therapeutic effects
- Ensure patients know how to use inhalers and MDIs, and provide a demonstration to ensure successful administration
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Description
This quiz covers the definition, symptoms, and treatment of Chronic Obstructive Pulmonary Disease (COPD), a lung condition characterized by recurring and reversible shortness of breath. Learn about the causes, such as bronchospasms, inflammation, and mucus production, and the role of rescue inhalers like albuterol.