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Questions and Answers
A patient presents with urticaria, angioedema, and difficulty breathing shortly after exposure to peanuts. Which type of hypersensitivity reaction is most likely occurring?
A patient presents with urticaria, angioedema, and difficulty breathing shortly after exposure to peanuts. Which type of hypersensitivity reaction is most likely occurring?
- Type II Cytotoxic
- Type IV Delayed
- Type III Immune Complex
- Type I Immediate (correct)
Which of the following is a key difference between diphenhydramine and cetirizine regarding their side effect profiles?
Which of the following is a key difference between diphenhydramine and cetirizine regarding their side effect profiles?
- Diphenhydramine is less likely to cause dry mouth compared to cetirizine.
- Cetirizine is more likely to cause significant drowsiness compared to diphenhydramine.
- Cetirizine is more likely to cause anticholinergic effects compared to diphenhydramine.
- Diphenhydramine is more likely to cause significant drowsiness compared to cetirizine. (correct)
Nasal decongestants are often combined with antihistamines to target multiple symptoms of allergic rhinitis. What is the primary rationale for this combination therapy?
Nasal decongestants are often combined with antihistamines to target multiple symptoms of allergic rhinitis. What is the primary rationale for this combination therapy?
- Antihistamines and decongestants have synergistic effects on reducing histamine release.
- Antihistamines counteract the cardiovascular side effects of decongestants.
- Decongestants enhance the absorption of antihistamines in the nasal mucosa.
- Antihistamines address inflammation, while decongestants relieve nasal congestion. (correct)
Mometasone is prescribed as an intranasal corticosteroid for allergic rhinitis. Which of the following is the primary mechanism of action of mometasone?
Mometasone is prescribed as an intranasal corticosteroid for allergic rhinitis. Which of the following is the primary mechanism of action of mometasone?
Cromolyn is used as a mast cell stabilizer for allergic rhinitis and asthma. What is a key limitation of cromolyn that affects its clinical use?
Cromolyn is used as a mast cell stabilizer for allergic rhinitis and asthma. What is a key limitation of cromolyn that affects its clinical use?
Pseudoephedrine is contraindicated in certain patient populations due to its mechanism of action. Which of the following conditions would be a significant contraindication for pseudoephedrine use?
Pseudoephedrine is contraindicated in certain patient populations due to its mechanism of action. Which of the following conditions would be a significant contraindication for pseudoephedrine use?
A patient experiencing anaphylaxis is treated with epinephrine. If the patient is at home, what is the most critical next step after administering the epinephrine?
A patient experiencing anaphylaxis is treated with epinephrine. If the patient is at home, what is the most critical next step after administering the epinephrine?
In managing a patient with asthma and concurrent allergic rhinitis, which of the following inhaled medications is considered a controller medication, used to reduce airway inflammation and prevent symptoms?
In managing a patient with asthma and concurrent allergic rhinitis, which of the following inhaled medications is considered a controller medication, used to reduce airway inflammation and prevent symptoms?
A patient with COPD is prescribed theophylline. Which of the following factors is most important to consider when managing theophylline therapy?
A patient with COPD is prescribed theophylline. Which of the following factors is most important to consider when managing theophylline therapy?
A patient with latent tuberculosis (TB) is started on isoniazid (INH) for treatment. What is the primary goal of treating latent TB?
A patient with latent tuberculosis (TB) is started on isoniazid (INH) for treatment. What is the primary goal of treating latent TB?
Flashcards
Anaphylaxis
Anaphylaxis
A rapid, severe allergic reaction that can be life-threatening, involving symptoms like difficulty breathing, hives, and swelling.
Type 1 Hypersensitivity Reaction
Type 1 Hypersensitivity Reaction
A type of allergic reaction mediated by IgE antibodies, leading to rapid release of histamine and other mediators from mast cells and basophils.
Diphenhydramine vs. Cetirizine
Diphenhydramine vs. Cetirizine
Diphenhydramine is a first-generation antihistamine that crosses the blood-brain barrier, causing sedation. Cetirizine is a second-generation antihistamine with less sedation.
Antihistamines MOA
Antihistamines MOA
Block histamine receptors, reducing allergy symptoms. Often combined with decongestants to counteract histamine-induced nasal congestion.
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Intranasal Corticosteroids
Intranasal Corticosteroids
Reduce inflammation in the nasal passages, alleviating allergic symptoms like congestion, sneezing, and runny nose.
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Mast Cell Stabilizers
Mast Cell Stabilizers
Medications that prevent the release of inflammatory substances from mast cells, reducing allergic symptoms. Often used prophylactically.
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Nasal Decongestants
Nasal Decongestants
Medications that constrict blood vessels in the nasal passages, reducing congestion. Pseudoephedrine is oral and systemic; oxymetazoline is topical.
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COPD vs. Asthma Pathophysiology
COPD vs. Asthma Pathophysiology
Characterized by airflow limitation. COPD is less reversible, progressive, and related to smoking, while asthma varies and can be triggered by allergens.
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Albuterol vs. Salmeterol
Albuterol vs. Salmeterol
Albuterol - short-acting beta-agonist (SABA) for quick relief, whilst Salmeterol - long-acting beta-agonist (LABA), used as a controller, always with an inhaled corticosteroid.
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Cystic Fibrosis
Cystic Fibrosis
A genetic disorder caused by a mutation in the CFTR gene, leading to thick mucus buildup in the lungs and other organs.
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- Type 1 hypersensitivity reaction should be described
- Determine the three disease states that share this pathophysiology
- List the differences for preventers and relievers in the treatment of allergies
- Outline the differences between diphenhydramine and cetirizine
Antihistamines: Diphenhydramine and Cetirizine
- Diphenhydramine and cetirizine's MOA, adverse effects, and drug interactions
- Explanation of why these are often combined with nasal decongestants
Intranasal Corticosteroid: Mometasone
- Mometasone's MOA and adverse effects
- Allergic symptoms which it helps with
Mast Cell Stabilizer: Cromolyn
- Cromolyn's MOA
- Document the adverse effects with intranasal and nebulizer
- Allergic symptoms for which it works
- Issues with cromolyn use and administration
Nasal Decongestants: Pseudoephedrine and Oxymetazoline
- MOA of pseudoephedrine and oxymetazoline
- Differences in administration and adverse effects of pseudoephedrine and oxymetazoline
- Which patients should not receive pseudoephedrine?
- Clinical considerations for pseudoephedrine and oxymetazoline
Anaphylaxis
- Identify the general signs and symptoms of anaphylaxis
- Nurses should always clarify the type of allergy and response
- All patients with anaphylaxis should wear and carry
- Epinephrine MOA, administration, and adverse effects
- Steps to take if epinephrine is administered to a person outside the hospital
Common Cold
- List shared symptoms of allergies and the common cold
- General treatments for the common cold
Antitussives
- Examine dextromethorphan's MOA and adverse effects
- Clinical considerations for dextromethorphan
Expectorant
- Guaifenesin MOA and adverse effects
- Clinical considerations
Mucolytic
- Acetylcysteine MOA and adverse effect
- Precautions in patients that have
- Clinical considerations
Lung Cells & Autonomic Control
- Type I and type II epithelial cells role in the lung
- Autonomic Nervous System control of lungs
- Bronchodilation
- Bronchoconstriction
Asthma and COPD
- Asthma and COPD are characterized by restriction of airflow
- Comparing Asthma and COPD:
| Feature | Asthma | COPD |
|---|---|---|
| Age at onset | < 20 years | > 40 years |
| Pattern of symptoms | Variation over minutes, hours, days | Persistent despite treatment, daily symptoms, exertional dyspnea |
| Lung function | Record of variable airflow | Record of persistent airflow limitation |
| Lung function (between) | Normal | Abnormal |
| Patient or family history | Family history of asthma or eczema | Heavy exposure to risk factor |
| Time course | No worsening; improves spontaneously | Slowly worsening over time; Rapid-acting bronchodilator treatment provides only limited relief |
| Radiography | Normal | Severe hyperinflation |
Asthma, COPD:
- Signs and symptoms based on pathophysiology
- Bronchial constriction
- Excessive mucus production
- Hypoxemia
- Tools used when evaluating a person with asthma
COPD
- Changes that can happen in the lung for someone with COPD
- Most common cause and common symptoms
- Common characteristics and drug therapy considerations
- Treatment and similarities/differences to asthma
- Pathophysiology differences between asthma and COPD
- Advantages and disadvantages of MDIs and DPIs and administration differences
- Pharmacotherapy for asthma and COPD divided into bronchodilators and anti-inflammatory medications
Bronchodilators
- Albuterol- rescue: MOA, adverse effects, contraindications, and drug interactions
- Salmeterol- controller: MOA, adverse effects, black boxed warning, use with asthma treatment, and clinical considerations for SABAs and LABAs
- Ipratropium (rescue), tiotropium (controller): MOA, adverse effects, drug interactions, and clinical considerations
- Methylxanthine- theophylline (controller): MOA, adverse effects, route, drug interactions, and clinical considerations
Anti-inflammatory Medications
- Inhaled corticosteroid - Budesonide (controller): MOA, adverse effects, 1st line treatment of, and clinical considerations
- Montelukast (controller) - ASTHMA ONLY: MOA, adverse effects, and monitoring
- Omalizumab (controller- add on) - ASTHMA ONLY: MOA, black boxed warning, adverse effects, route, and clinical considerations
Inhaler Administration
- The order of administration if there are separate inhalers for a patient
Cystic Fibrosis
- Is an inherited autosomal trait caused by a mutation in the gene/protein
- Causes the obstruction to organs in patients with CF and respiratory changes
- Dornase alfa and treatment
- Other treatments
- Ivacaftor
- MOA
- Adverse effects
- Drug interactions
- Clinical considerations
Pneumonia & Tuberculosis
- Pneumonia: Presentation of signs/symptoms and general bacterial pneumonia treatment
- Tuberculosis
- Difference between latent and active tuberculosis
- % of patients with latent TB with develop active TB in one year if untreated
- Patient presentation of signs and symptoms of Tuberculosis
- Diagnostic Tests
- Usual treatment of patients with latent TB
- Treatment of patients with active TB for months
- Identify the "RIPE" drugs and the major adverse effect associated with their use
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