Pharmacology of Upper Respiratory Drugs
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Questions and Answers

When should the nurse expect to administer medications for upper respiratory tract disorders to a patient across the lifespan?

  • Only when the patient complains of symptoms
  • Only when there is a diagnosis from doctors
  • Based on the patient's age, health status, and individual needs (correct)
  • Proactively to prevent future health complications

    • What is a crucial aspect of nursing considerations for patients receiving drugs acting on the upper respiratory tract?

  • Ensuring the patient has a balanced diet
  • Providing education to the patient regarding their medication (correct)
  • Administering medications only when the patient is asleep
  • Monitoring the patient's vital signs every hour

    • Which of the following is NOT a therapeutic action of drugs acting on the upper respiratory tract?

  • Treating bacterial infections (correct)
  • Reducing inflammation
  • Improving breathing
  • Relieving congestion
  • Suppressing cough

    • What is a key aspect to consider when comparing and contrasting drugs acting on the upper respiratory tract?

    <p>The drug's mechanism of action (E)</p> Signup and view all the answers

    What is a crucial consideration when outlining the pharmacokinetics of drugs acting on the upper respiratory tract?

    <p>The drug's absorption, distribution, metabolism, and excretion (D)</p> Signup and view all the answers

    Which of the following antitussive drugs is NOT a narcotic?

    <p>benzonatate (A)</p> Signup and view all the answers

    Which of the following drugs decrease blood flow to the upper respiratory tract?

    <p>decongestants (C)</p> Signup and view all the answers

    What is the main purpose of expectorants?

    <p>To thin and loosen respiratory secretions (D)</p> Signup and view all the answers

    Which of the following drugs is a mucolytic?

    <p>acetylcysteine (D)</p> Signup and view all the answers

    What is the mechanism of action of antihistamines?

    <p>Block the release or action of histamine (B)</p> Signup and view all the answers

    Which of the following is a common adverse effect of traditional antitussives?

    <p>Respiratory depression (C)</p> Signup and view all the answers

    What is a major concern with using codeine and hydrocodone for an extended period?

    <p>Potential for addiction and dependence (C)</p> Signup and view all the answers

    Which of the following drug interactions should be avoided?

    <p>Combining dextromethorphan with MAO inhibitors (A)</p> Signup and view all the answers

    What is 'rebound congestion'?

    <p>Congestion that worsens after the effects of a nasal decongestant wear off (B)</p> Signup and view all the answers

    Which of the following decongestants is available both topically and orally?

    <p>phenylephrine (B)</p> Signup and view all the answers

    Which of the following is a first-generation antihistamine?

    <p>diphenhydramine (C)</p> Signup and view all the answers

    What is the main difference between first-generation and second-generation antihistamines?

    <p>Second-generation antihistamines are less likely to cause sedation (D)</p> Signup and view all the answers

    Why are cough and cold medications generally not recommended for children under 4 years of age?

    <p>They can cause serious side effects such as sedation and confusion (A)</p> Signup and view all the answers

    How long should a nasal decongestant be used?

    <p>For a maximum of 3 to 5 days (A)</p> Signup and view all the answers

    Which of these medications is NOT typically used to treat upper respiratory tract symptoms?

    <p>Dornase alfa (B)</p> Signup and view all the answers

    What is the primary action of an antitussive drug like dextromethorphan?

    <p>To suppress the cough reflex (C)</p> Signup and view all the answers

    What are the potential adverse effects of frequent or prolonged use of topical nasal decongestants?

    <p>Rebound congestion (A)</p> Signup and view all the answers

    Which of the following is NOT a typical adverse effect of drugs affecting the upper respiratory tract?

    <p>Diarrhea (A)</p> Signup and view all the answers

    Why is it important to ask parents specifically about the use of OTC or herbal remedies before administering drugs to children?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the mechanism of action of decongestants in relieving nasal congestion?

    <p>Constricting blood vessels to reduce swelling (B)</p> Signup and view all the answers

    Why is it essential to monitor older adults closely when administering drugs affecting the upper respiratory tract?

    <p>All of the above (D)</p> Signup and view all the answers

    What is a potential concern regarding the use of drugs affecting the upper respiratory tract during pregnancy?

    <p>All of the above are potential concerns. (D)</p> Signup and view all the answers

    Which of the following drugs is NOT typically considered a topical nasal decongestant?

    <p>Dextromethorphan (B)</p> Signup and view all the answers

    What is the primary reason why adults may inadvertently overdose on OTC medications for cold or flu?

    <p>They are taking multiple OTC preparations simultaneously (D)</p> Signup and view all the answers

    What is rhinitis medicamentosa?

    <p>Rebound congestion caused by prolonged use of decongestants (D)</p> Signup and view all the answers

    Which of the following is a nondrug measure that can help relieve symptoms of an upper respiratory problem?

    <p>Drinking plenty of fluids (B)</p> Signup and view all the answers

    Why is it important to advise patients to check with their healthcare provider before starting an OTC drug regimen for an upper respiratory problem?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the typical onset of action for an oral antitussive like dextromethorphan?

    <p>Within 25-30 minutes (C)</p> Signup and view all the answers

    What is the primary route of excretion for the antitussive drug dextromethorphan?

    <p>Through the urine (D)</p> Signup and view all the answers

    Which of the following statements is TRUE about topical nasal decongestants?

    <p>They are frequently available over-the-counter (A)</p> Signup and view all the answers

    Why is it important to avoid smoke-filled areas and contact with known allergens or irritants during a cold?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following medications is an expectorant?

    <p>Guaifenesin (B)</p> Signup and view all the answers

    What is the primary action of expectorants on respiratory secretions?

    <p>Decrease viscosity (C)</p> Signup and view all the answers

    What is the recommended duration of use for expectorants?

    <p>Up to 1 week (B)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of expectorants?

    <p>Nausea (D)</p> Signup and view all the answers

    Which of the following medications is indicated for the treatment of allergic rhinitis?

    <p>Both B and C (A)</p> Signup and view all the answers

    Which medication is indicated for the treatment of chronic idiopathic urticaria?

    <p>Loratadine (B)</p> Signup and view all the answers

    What is the recommended dosage for adults and children over 12 years old taking levocetirizine?

    <p>5 mg daily (B)</p> Signup and view all the answers

    What is the recommended dosage for children 6-11 years old taking loratadine?

    <p>5 mg daily (B)</p> Signup and view all the answers

    Which of the following is a contraindication for the use of expectorants?

    <p>History of allergy to the drug (A)</p> Signup and view all the answers

    What is the onset of action for guaifenesin?

    <p>30 minutes (D)</p> Signup and view all the answers

    What is the recommended dosage for adults and children over 12 years old taking olopatadine nasal spray?

    <p>2 sprays per nostril twice daily (A)</p> Signup and view all the answers

    Which of the following medications is a nasal corticosteroid?

    <p>Olopatadine (C)</p> Signup and view all the answers

    Which of the following medications is indicated for the relief of symptoms associated with dermographism?

    <p>Loratadine (D)</p> Signup and view all the answers

    Which of the following is a potential caution for the use of expectorants?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following medications is indicated for the treatment of angioedema?

    <p>Loratadine (A)</p> Signup and view all the answers

    What is the primary mechanism of action of acetylcysteine as a mucolytic?

    <p>It breaks down disulfide bonds in mucus, making it less viscous. (A)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of acetylcysteine?

    <p>Bronchospasm. (A)</p> Signup and view all the answers

    A patient is prescribed dornase alfa (Pulmozyme) for cystic fibrosis. What is the primary reason for using this medication?

    <p>To thin and loosen thick mucus in the lungs. (D)</p> Signup and view all the answers

    A patient taking acetylcysteine for acetaminophen toxicity also has asthma. What is the primary nursing concern for this patient?

    <p>Risk of bronchospasm due to the medication. (D)</p> Signup and view all the answers

    What is the primary difference between acetylcysteine and dornase alfa?

    <p>Acetylcysteine is used for acetaminophen toxicity, while dornase alfa is used for cystic fibrosis. (D)</p> Signup and view all the answers

    A patient asks about the safety of using over-the-counter cough medications containing guaifenesin while taking acetylcysteine. What is the nurse's best response?

    <p>It's best to talk to the doctor about using both medications together, as the dosage may need to be adjusted. (C)</p> Signup and view all the answers

    A patient with a history of hypersensitivity to acetylcysteine needs a medication for their cough. Which of the following alternatives might be appropriate?

    <p>Dornase alfa. (B), Guaifenesin. (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the administration of dornase alfa?

    <p>It is administered via nebulizer for direct delivery to the lungs. (B)</p> Signup and view all the answers

    A patient is taking acetylcysteine for acetaminophen toxicity. Which of the following is NOT a reason for monitoring this patient closely?

    <p>To assess for the effectiveness of the drug in reducing mucus viscosity. (B)</p> Signup and view all the answers

    A patient is receiving dornase alfa for cystic fibrosis. Prior to administering the medication, the nurse should assess which of the following?

    <p>Patient's respiratory rate and lung sounds. (A)</p> Signup and view all the answers

    What is the primary benefit of using ivacaftor for cystic fibrosis patients with certain gene mutations?

    <p>It improves chloride transport in the cells, leading to thinner mucus. (A)</p> Signup and view all the answers

    Why is it important to assess a patient receiving acetylcysteine for acetaminophen toxicity for signs of gastrointestinal distress?

    <p>Acetylcysteine can cause nausea and vomiting, which could impact the medication's effectiveness. (D)</p> Signup and view all the answers

    What is the primary rationale for monitoring a patient's lung function throughout therapy with dornase alfa?

    <p>To ensure the medication is effectively thinning the mucus. (D)</p> Signup and view all the answers

    A patient is receiving acetylcysteine via nebulizer. Which of the following nursing actions is most important?

    <p>Monitor the patient for signs of respiratory distress. (C)</p> Signup and view all the answers

    A patient taking dornase alfa asks about potential long-term effects of the medication. What is the nurse's best response?

    <p>The long-term effects of dornase alfa are not fully understood but are thought to be minimal. (C)</p> Signup and view all the answers

    Which of the following adverse effects is NOT typically associated with acetylcysteine?

    <p>Diarrhea (D)</p> Signup and view all the answers

    What is the primary function of acetylcysteine in the treatment of acetaminophen toxicity?

    <p>To protect liver cells from the toxic effects of acetaminophen (C)</p> Signup and view all the answers

    Which of the following is a contraindication to the use of mucolytics?

    <p>Presence of acute bronchospasm (C)</p> Signup and view all the answers

    What is a crucial nursing intervention when administering acetylcysteine by face mask?

    <p>Wiping the residue off the face mask and face with plain water (C)</p> Signup and view all the answers

    Which of the following is NOT a typical nursing conclusion related to drug therapy for patients receiving mucolytics?

    <p>Increased risk of developing a pulmonary embolism (A)</p> Signup and view all the answers

    What is a key nursing intervention to enhance the effectiveness of dornase alfa in patients with cystic fibrosis?

    <p>Administering the drug with a nebulizer (A)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of dornase alfa?

    <p>It is known for its rapid onset of action (D)</p> Signup and view all the answers

    What is the primary action of an antitussive medication?

    <p>To suppress the cough reflex (C)</p> Signup and view all the answers

    Why should antitussive medications generally not be used for longer than 1 week?

    <p>They can mask the symptoms of a serious underlying condition (B)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of frequent or prolonged use of topical nasal decongestants?

    <p>Rebound vasodilation, causing rhinitis medicamentosa (D)</p> Signup and view all the answers

    Which type of decongestant is preferred for patients who need to avoid systemic adrenergic effects?

    <p>Topical nasal decongestants (B)</p> Signup and view all the answers

    Which of the following is NOT an indication for the use of dornase alfa?

    <p>Chronic bronchitis (C)</p> Signup and view all the answers

    Which statement BEST describes the mechanism of action of nasal steroid decongestants?

    <p>They block the inflammatory response from occurring (C)</p> Signup and view all the answers

    What is a crucial consideration for nursing staff when providing patient teaching regarding acetylcysteine?

    <p>Providing adequate information regarding the drug therapy, potential adverse effects and safety measures (A)</p> Signup and view all the answers

    What is a key nursing assessment when evaluating the effectiveness of dornase alfa therapy?

    <p>Evaluating the patient's respiratory symptoms and mucus consistency (B)</p> Signup and view all the answers

    Which of the following drugs is a long-acting beta-agonist (LABA) that is indicated for treatment of airflow obstruction in patients with COPD?

    <p>olodaterol (D)</p> Signup and view all the answers

    Which of the following drugs is used for treatment and prevention of bronchospasm in patients ≥6 years of age who have reversible obstructive pulmonary disease?

    <p>levalbuterol (D)</p> Signup and view all the answers

    Which of the following inhaled steroids is available as both an inhaler and a nasal spray?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following drugs can be used for both bronchodilation and inflammation in the airways?

    <p>cromolyn sodium (D)</p> Signup and view all the answers

    Which drug is the preferred treatment for acute bronchospasm?

    <p>epinephrine (A)</p> Signup and view all the answers

    Which of the following drugs is NOT typically used to treat bronchospasm?

    <p>beclomethasone (B)</p> Signup and view all the answers

    Which of the following medications is indicated for the treatment of chronic idiopathic urticaria?

    <p>Cromolyn sodium (A)</p> Signup and view all the answers

    What is the maximum dose of budesonide for adults and children ≥12 years old?

    <p>720 mcg inhalation b.i.d. (C)</p> Signup and view all the answers

    Which of the following inhaled steroids is available in a metered-dose inhaler (MDI) version?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the usual dosage for formoterol in adults and pediatric patients ≥5 years old for asthma maintenance?

    <p>12 mcg capsule inhaled using the Aerolizer inhaler q12h (D)</p> Signup and view all the answers

    Which of the following statements about the use of inhaled steroids is TRUE?

    <p>Inhaled steroids can be used to prevent exercise-induced bronchospasm. (C)</p> Signup and view all the answers

    Which of the following drugs is a leukotriene receptor antagonist?

    <p>Montelukast (B)</p> Signup and view all the answers

    Which of the following drugs are approved for treatment of chronic steroid-dependent bronchial asthma?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the first-line treatment for children with asthma?

    <p>Daily inhaled corticosteroids (C)</p> Signup and view all the answers

    Which factor may necessitate reevaluation and adjustment of asthma treatment in children during puberty?

    <p>Changes in hormone levels (C)</p> Signup and view all the answers

    What should healthcare providers advise patients who can become pregnant regarding their asthma medications?

    <p>Discuss medication optimization with their provider (D)</p> Signup and view all the answers

    Which of the following considerations is particularly important for older adults when using respiratory medications?

    <p>They may have renal or hepatic impairments that affect metabolism (D)</p> Signup and view all the answers

    Why is theophylline rarely used in children for asthma management?

    <p>It has numerous adverse effects relative to newer agents (B)</p> Signup and view all the answers

    For what reason should older adults be cautious when using over-the-counter respiratory medications?

    <p>They may interact with prescription medications (B)</p> Signup and view all the answers

    What is a recommended measure for parents to help prevent acute asthma attacks in their children?

    <p>Avoid smoke-filled rooms and known allergens (B)</p> Signup and view all the answers

    What is the usual purpose of leukotriene receptor antagonists in asthma treatment for children?

    <p>They are used for maintenance therapy (A)</p> Signup and view all the answers

    What should be part of routine evaluation for adults managing asthma?

    <p>Periodic spirometry readings and inhaler technique review (A)</p> Signup and view all the answers

    What is the primary effect of short-acting inhaled beta2-agonists in COPD management?

    <p>Facilitate bronchodilation (B)</p> Signup and view all the answers

    Which intervention is considered the best way to slow the progression of COPD?

    <p>Smoking cessation (B)</p> Signup and view all the answers

    What is a contraindication for using Roflumilast in COPD treatment?

    <p>Liver impairment (B)</p> Signup and view all the answers

    Which nonpharmacological strategy is effective in decreasing asthma exacerbations?

    <p>Using a written action plan for symptoms (A)</p> Signup and view all the answers

    What is the mechanism by which xanthines are thought to promote bronchodilation?

    <p>Increased calcium mobilization within cells (C)</p> Signup and view all the answers

    Which medication combination is preferred for reliever therapy in asthma management according to current guidelines?

    <p>Low-dose inhaled corticosteroid–formoterol combination (D)</p> Signup and view all the answers

    What effect does noninvasive mechanical ventilation have on patients with COPD in acute distress?

    <p>Shortens hospital stay and improves survival rate (B)</p> Signup and view all the answers

    What is the primary action of systemic corticosteroids in COPD management?

    <p>Decrease recovery time and hospital stay (B)</p> Signup and view all the answers

    Which statement about bronchodilators is TRUE?

    <p>They provide symptomatic relief by dilating the airways. (C)</p> Signup and view all the answers

    In patients with asthma, what should be monitored to prevent exacerbations?

    <p>Respiratory symptoms and medication use (C)</p> Signup and view all the answers

    What adverse effect has been associated with Roflumilast?

    <p>CNS changes including suicidality (D)</p> Signup and view all the answers

    Which aspect of xanthines contributes to their potential adverse effects?

    <p>Narrow therapeutic index (B)</p> Signup and view all the answers

    What is an important consideration regarding the use of antibiotics in COPD exacerbations?

    <p>They are indicated when there is suspicion of bacterial infection. (C)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of topical nasal decongestants?

    <p>Rebound congestion (A)</p> Signup and view all the answers

    What is the primary mechanism of action for topical nasal decongestants?

    <p>Stimulating the sympathetic nervous system (B)</p> Signup and view all the answers

    Which of the following conditions would be a contraindication for the use of topical nasal decongestants?

    <p>Glaucoma (D)</p> Signup and view all the answers

    What is the primary way in which antihistamines relieve respiratory symptoms?

    <p>Blocking histamine receptors (B)</p> Signup and view all the answers

    Which of the following statements is true regarding first-generation antihistamines?

    <p>They are often preferred for patients who need to remain alert. (C)</p> Signup and view all the answers

    Which of the following antihistamines is considered a second-generation, non-sedating option?

    <p>Cetirizine (C)</p> Signup and view all the answers

    What is a potential nursing consideration when administering topical nasal decongestants?

    <p>Assessing for skin color and temperature changes (D)</p> Signup and view all the answers

    In which scenario would the use of topical nasal decongestants be particularly concerning?

    <p>A patient with diabetes and hypertension (A)</p> Signup and view all the answers

    Which of the following is a common reason for the misuse of antihistamines?

    <p>Managing symptoms of the common cold and influenza (B)</p> Signup and view all the answers

    What is a significant factor to consider when choosing an antihistamine for a patient?

    <p>The patient's individual reaction to the drug (A)</p> Signup and view all the answers

    Which of the following antihistamines is typically used to treat motion sickness?

    <p>Dimenhydrinate (D)</p> Signup and view all the answers

    What is a primary characteristic of second-generation antihistamines compared to first-generation antihistamines?

    <p>Lower risk of sedation (C)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of antihistamines?

    <p>Drowsiness (A)</p> Signup and view all the answers

    Which of the following statements is true regarding the use of antihistamines in children?

    <p>Antihistamines are generally considered safe and effective for children. (D)</p> Signup and view all the answers

    What is the main reason why topical nasal decongestants should not be used for extended periods?

    <p>They can lead to rebound congestion and worsening symptoms. (C)</p> Signup and view all the answers

    Which of the following is NOT a type of antihistamine discussed in the text?

    <p>Third-generation (B)</p> Signup and view all the answers

    What is a primary adverse effect associated with inhaled steroids?

    <p>Sore throat (C)</p> Signup and view all the answers

    What potential risk is associated with long-term use of steroids in pediatric patients?

    <p>Growth impairment (A), Cataracts (C)</p> Signup and view all the answers

    What action do lung surfactants perform in neonates with respiratory distress syndrome (RDS)?

    <p>Replace missing surfactant (D)</p> Signup and view all the answers

    Which statement best describes the pharmacokinetics of budesonide when inhaled?

    <p>Slow absorption, clinical response may be delayed (B)</p> Signup and view all the answers

    Which of the following is a contraindication for the use of inhaled steroids?

    <p>Acute asthmatic attacks (B)</p> Signup and view all the answers

    What monitoring should be done for patients receiving inhaled steroids?

    <p>Assess growth patterns in pediatric patients (A)</p> Signup and view all the answers

    What is a common adverse effect associated with lung surfactants?

    <p>Patent ductus arteriosus (A)</p> Signup and view all the answers

    What is a key consideration when administering fluticasone with ritonavir?

    <p>Increased fluticasone plasma levels (C)</p> Signup and view all the answers

    What is the recommended route for administering lung surfactants?

    <p>Intratracheal (C)</p> Signup and view all the answers

    What is a common effect of budesonide in treating asthma?

    <p>Decreases airway inflammation (A)</p> Signup and view all the answers

    What is a primary effect of long-term steroid use in adults?

    <p>Increased risk of glaucoma (D)</p> Signup and view all the answers

    Which lung surfactant is recommended for rescue treatment of infants with RDS?

    <p>Poractant (C)</p> Signup and view all the answers

    What potential risk is associated with the use of lung surfactants?

    <p>Risk of sepsis (A)</p> Signup and view all the answers

    What is the maximum daily dosage of ciclesonide for pediatric patients aged 5 to 11 years?

    <p>360 mcg (C)</p> Signup and view all the answers

    Which of the following medications is primarily indicated for prophylaxis and treatment of asthma in children aged 6 months to 14 years?

    <p>Montelukast (C)</p> Signup and view all the answers

    For which condition is mepolizumab primarily indicated in pediatric patients aged 6 to 11 years?

    <p>Severe asthma with an eosinophilic phenotype (B)</p> Signup and view all the answers

    What is the primary route of administration for dupilumab in adults and pediatrics?

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

    What is the starting dosage of fluticasone for children aged 4 to 11 years?

    <p>One inhalation b.i.d. (C)</p> Signup and view all the answers

    Which combination medication includes a corticosteroid and a long-acting beta2-adrenergic agonist (LABA)?

    <p>Advair Diskus (C)</p> Signup and view all the answers

    Zafirlukast is indicated for the treatment of chronic bronchial asthma in which age group?

    <p>Children aged 5-11 years (B)</p> Signup and view all the answers

    What is a key restriction associated with the use of inhaled steroids?

    <p>Not for emergency use (A)</p> Signup and view all the answers

    What is the recommended method of administration for zileuton?

    <p>Oral 1 hour after meals (D)</p> Signup and view all the answers

    How often is benralizumab administered for patients with severe asthma?

    <p>Every 4 weeks (B)</p> Signup and view all the answers

    Which medication is used as an add-on therapy for nasal polyps in adult patients with inadequate response to nasal corticosteroids?

    <p>Mepolizumab (D)</p> Signup and view all the answers

    What dosage of montelukast is indicated for pediatric patients aged 2-5 years?

    <p>4 mg PO daily (C)</p> Signup and view all the answers

    What is a key reason for continuous monitoring of the patient during drug administration?

    <p>To provide life support measures as needed (B)</p> Signup and view all the answers

    What is a common route of excretion for most respiratory drugs mentioned?

    <p>Urinary (B)</p> Signup and view all the answers

    Which of the following is a consequence of improper placement of the endotracheal tube?

    <p>Ineffective airway clearance (D)</p> Signup and view all the answers

    Which of the following drugs is specifically indicated for treatment of adult patients with chronic idiopathic urticaria?

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

    What should be done immediately before administration of lung surfactants?

    <p>Suction the infant (D)</p> Signup and view all the answers

    What is one of the main adverse effects to monitor for during drug therapy in premature infants?

    <p>Pneumothorax (B)</p> Signup and view all the answers

    What is a common teaching point related to the administration of lung surfactants for parent education?

    <p>Improvement in breathing should be monitored (B)</p> Signup and view all the answers

    Which two drugs are indicated for the treatment of idiopathic pulmonary fibrosis (IPF)?

    <p>Pirfenidone and Nintedanib (A)</p> Signup and view all the answers

    What is a major concern when administering Nintedanib to patients?

    <p>Liver toxicity (B)</p> Signup and view all the answers

    Which assessment is essential to evaluate effectiveness of drug therapy in infants receiving lung surfactants?

    <p>Alveolar expansion and breathing improvement (A)</p> Signup and view all the answers

    What is a potential adverse effect of Pirfenidone that healthcare professionals should monitor?

    <p>Severe GI issues (A)</p> Signup and view all the answers

    Which factor increases the risk of infection in the lower respiratory tract?

    <p>Young age and concurrent respiratory dysfunction (C)</p> Signup and view all the answers

    What is a fundamental goal of drug therapy in premature infants receiving respiratory treatments?

    <p>Achieve the best therapeutic effect (A)</p> Signup and view all the answers

    What instructional material should staff review before the regular use of lung surfactants?

    <p>Manufacturer’s teaching video (C)</p> Signup and view all the answers

    What is the primary mechanism of action for lung surfactants?

    <p>Reduce surface tension in the alveoli (A)</p> Signup and view all the answers

    Which of the following is NOT a class of drugs used to treat lower respiratory tract disorders?

    <p>Anticonvulsants (A)</p> Signup and view all the answers

    What is the primary mechanism of action for sympathomimetics in treating lower respiratory tract disorders?

    <p>Relaxing smooth muscle in the airways (D)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of inhaled corticosteroids in the treatment of lower respiratory tract disorders?

    <p>Bronchospasm (A)</p> Signup and view all the answers

    Which of the following is NOT a common cause of adult respiratory distress syndrome (ARDS)?

    <p>Severe anemia (D)</p> Signup and view all the answers

    What is the primary role of surfactant in the treatment of respiratory distress syndrome (RDS) in neonates?

    <p>Decreasing surface tension in the alveoli (B)</p> Signup and view all the answers

    Which of the following is a common adverse effect associated with xanthine bronchodilators like theophylline?

    <p>Gastrointestinal upset (D)</p> Signup and view all the answers

    Which of the following drug classes is NOT typically used to treat obstructive pulmonary disorders?

    <p>Diuretics (D)</p> Signup and view all the answers

    Which of the following is a major contraindication for the use of beta-adrenergic bronchodilators?

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

    Which of the following is NOT a common symptom associated with COPD exacerbations?

    <p>Decreased blood pressure (D)</p> Signup and view all the answers

    What is the primary route of administration for leukotriene receptor antagonists?

    <p>Oral (B)</p> Signup and view all the answers

    Which of the following is a key nursing consideration when teaching a patient about inhaled corticosteroids?

    <p>Teach the patient about the importance of rinsing their mouth after use (B)</p> Signup and view all the answers

    Which of the following drug classes is NOT typically used to treat lower respiratory tract disorders?

    <p>Antihistamines (C)</p> Signup and view all the answers

    What is the primary difference between a short-acting beta-agonist (SABA) and a long-acting beta-agonist (LABA) in treating asthma?

    <p>SABAs have a rapid onset of action, while LABAs have a slower onset but a longer duration of action (D)</p> Signup and view all the answers

    Which of the following is NOT a recommended non-pharmacological intervention for managing COPD?

    <p>Use of over-the-counter decongestants (C)</p> Signup and view all the answers

    Which of the following is a potential drug interaction to be aware of when administering theophylline?

    <p>Theophylline can increase the effects of caffeine (B)</p> Signup and view all the answers

    What is the primary role of bile in the gastrointestinal system?

    <p>To aid in the absorption of fats (A)</p> Signup and view all the answers

    Which structure is responsible for the production of digestive enzymes that assist in the breakdown of food?

    <p>Pancreas (C)</p> Signup and view all the answers

    What type of GI movement is characterized by a progressive wave of muscle contraction that moves a food bolus forward?

    <p>Peristalsis (D)</p> Signup and view all the answers

    What does gastrin stimulate in the gastrointestinal system?

    <p>Release of hydrochloric acid and pepsin (D)</p> Signup and view all the answers

    Which layer of the gastrointestinal tract is responsible for providing the inner lining?

    <p>Mucosal layer (D)</p> Signup and view all the answers

    Which of the following best describes segmentation in the GI tract?

    <p>Contraction and relaxation of intestinal segments to enhance absorption (C)</p> Signup and view all the answers

    What is the primary function of the gallbladder in the digestive process?

    <p>Storage and concentration of bile (A)</p> Signup and view all the answers

    Which part of the gastrointestinal system is primarily responsible for nutrient absorption?

    <p>Small intestine (B)</p> Signup and view all the answers

    What initiates the vomiting reflex?

    <p>Stimulation of the chemoreceptor trigger zone (A)</p> Signup and view all the answers

    How does the peritoneum contribute to the function of the gastrointestinal system?

    <p>Lining that supports and protects the GI tract (A)</p> Signup and view all the answers

    What is the composition of chyme?

    <p>Ingested food mixed with gastric secretions (D)</p> Signup and view all the answers

    Which of the following structures has a role in local control of GI tract secretions and movements?

    <p>Nerve plexus (A)</p> Signup and view all the answers

    What is the significance of normal flora in the gastrointestinal tract?

    <p>They aid in digestion and protect against harmful bacteria. (D)</p> Signup and view all the answers

    What is the primary function of the epithelial cells in the mucosal layer of the GI tract?

    <p>Quick reproduction (C)</p> Signup and view all the answers

    Which layer of the GI tract contains the submucosal plexus, important for regulating secretions and contractions?

    <p>Submucosal layer (A)</p> Signup and view all the answers

    What unique feature does the stomach have in its muscularis externa compared to the rest of the GI tract?

    <p>It has muscles that run obliquely. (C)</p> Signup and view all the answers

    Which nervous system is involved in stimulating GI activity during 'rest-and-digest' responses?

    <p>Parasympathetic nervous system (A)</p> Signup and view all the answers

    What is the purpose of mucus secretion in the GI tract?

    <p>To protect epithelial lining (A)</p> Signup and view all the answers

    Which of the following substances is NOT secreted by the stomach?

    <p>Bicarbonate (D)</p> Signup and view all the answers

    How does the sympathetic nervous system affect GI tract activity?

    <p>Decreases muscle tone (A)</p> Signup and view all the answers

    What role does the myenteric plexus play in the GI tract?

    <p>Regulates motility of content (B)</p> Signup and view all the answers

    What initiates the cephalic phase of digestion in the stomach?

    <p>Sight or smell of food (D)</p> Signup and view all the answers

    Which type of muscle is primarily involved in the movement of contents down the GI tract?

    <p>Smooth muscle (B)</p> Signup and view all the answers

    During digestion, the secretion of which substance is increased in response to high levels of proteins, caffeine, and alcohol?

    <p>Gastrin (B)</p> Signup and view all the answers

    What is the primary role of the enteric nervous system in the GI tract?

    <p>To allow local control over GI functions (B)</p> Signup and view all the answers

    Which layer of the GI tract serves as a barrier and produces digestive enzymes?

    <p>Mucosal layer (C)</p> Signup and view all the answers

    Which of the following is NOT a common adverse effect associated with topical decongestants?

    <p>Drowsiness (A)</p> Signup and view all the answers

    What is the primary mechanism of action for topical decongestants?

    <p>Constricting blood vessels to reduce edema and inflammation (D)</p> Signup and view all the answers

    If a patient is experiencing rebound congestion, what should the nurse recommend?

    <p>Discontinue the use of the topical decongestant (B)</p> Signup and view all the answers

    What is the primary indication for the use of nasal decongestants?

    <p>Relief of nasal congestion associated with the common cold (B)</p> Signup and view all the answers

    What is the recommended duration of use for topical decongestants?

    <p>No more than 3 to 5 days (B)</p> Signup and view all the answers

    A patient presents with a history of glaucoma. Which of the following nasal decongestants should be used with caution?

    <p>Xylometazoline (Otrivin) (D)</p> Signup and view all the answers

    Which of the following nasal decongestants is a steroid?

    <p>Flunisolide (generic) (D)</p> Signup and view all the answers

    Which of the following oral decongestants is indicated for use in children aged 6 to 12 years?

    <p>Pseudoephedrine (Sudafed) (B)</p> Signup and view all the answers

    Which of the following is a potential benefit of administering nasal decongestants to a patient with otitis media?

    <p>Improving drainage of the eustachian tube (D)</p> Signup and view all the answers

    A patient is prescribed nasal decongestant spray. Which of the following instructions should the nurse include in patient teaching?

    <p>Hold the spray bottle upright when administering the medication (B)</p> Signup and view all the answers

    What precautions should be taken when administering nasal decongestants to pregnant women?

    <p>Use with caution due to potential systemic effects (B)</p> Signup and view all the answers

    What is the most important aspect of patient education regarding the use of topical decongestants?

    <p>The potential for rebound congestion with prolonged use (B)</p> Signup and view all the answers

    Which of the following medications is indicated for the treatment of seasonal allergic rhinitis?

    <p>Fluticasone (Flonase Allergy Relief) (D)</p> Signup and view all the answers

    A patient reports experiencing a burning sensation in the nasal passages after using a nasal decongestant spray. What is the appropriate nursing action?

    <p>Discontinue the use of the medication and notify the healthcare provider (C)</p> Signup and view all the answers

    Which of the following drug classes is most likely to be used to treat the inflammatory component of asthma?

    <p>Steroids (C)</p> Signup and view all the answers

    A patient with chronic obstructive pulmonary disease (COPD) is prescribed a medication to dilate their bronchi. Which of the following drug classes would be most likely?

    <p>Anticholinergics (B)</p> Signup and view all the answers

    What is the primary mechanism of action for leukotriene receptor antagonists in the treatment of asthma?

    <p>Inhibiting the production of leukotrienes (B)</p> Signup and view all the answers

    A patient taking theophylline for asthma has recently started smoking. Which of the following is the most likely effect of smoking on theophylline levels?

    <p>Theophylline levels will increase. (C)</p> Signup and view all the answers

    Which of the following is a potential benefit of inhaled corticosteroids over oral corticosteroids for the treatment of asthma?

    <p>Inhaled corticosteroids are less likely to cause systemic side effects. (C)</p> Signup and view all the answers

    A patient with asthma is prescribed an inhaled beta-agonist. When should the patient use this medication?

    <p>Only when they feel short of breath. (D)</p> Signup and view all the answers

    A patient with emphysema is treated with amoxicillin for acute otitis media. What important patient education should the nurse provide regarding amoxicillin?

    <p>Amoxicillin may cause allergic reactions, including skin rash and difficulty breathing. (B)</p> Signup and view all the answers

    Which of the following is an accurate statement regarding the use of lung surfactants in premature infants?

    <p>Lung surfactants are instilled into an endotracheal tube properly placed in the baby’s lungs. (C)</p> Signup and view all the answers

    A patient with asthma is taking a leukotriene receptor antagonist. Which of the following conditions is this medication most likely to be prescribed for?

    <p>Asthma (B)</p> Signup and view all the answers

    Which of the following medications would be most appropriate for a patient with frequent bronchospasms and COPD exacerbations who has hypertension and known heart disease?

    <p>An inhaled sympathomimetic (A)</p> Signup and view all the answers

    Treatment of obstructive pulmonary disorders is aimed at which of the following?

    <p>Opening the conducting airways or decreasing the effects of inflammation. (B)</p> Signup and view all the answers

    Which of the following instructions would be the most appropriate for a patient who has been newly prescribed budesonide?

    <p>Rinse your mouth out with water after taking the medication. (B)</p> Signup and view all the answers

    A patient with many adverse reactions to drugs is tried on an inhaled steroid for treatment of bronchospasm. For the first 3 days, the patient does not notice any improvement. You should anticipate that the provider will:

    <p>Encouraget he patient to continue the drug for 2 to 3 weeks. (B)</p> Signup and view all the answers

    Respiratory distress syndrome occurs in babies with:

    <p>Who are premature or of low birth weight. (B)</p> Signup and view all the answers

    Which of the following is NOT a common adverse effect of drugs affecting the upper respiratory tract?

    <p>Increased blood pressure (D)</p> Signup and view all the answers

    Study Notes

    Upper Respiratory Tract Drugs

    • Key Terms:

      • Antihistamines: Block histamine release/action, reducing secretions and airway narrowing.
      • Antitussives: Block cough reflex.
      • Decongestants: Decrease blood flow to upper respiratory tract, reducing secretions.
      • Expectorants: Increase productive cough, clearing airways.
      • Mucolytics: Increase/liquefy respiratory secretions.
      • Rebound congestion/Rhinitis medicamentosa: Congestion from decongestant overuse.

    • Drug Classes & Examples:

      • Antitussives: benzonatate, codeine, dextromethorphan, hydrocodone
      • Topical Nasal Decongestants: naphazoline, oxymetazoline, phenylephrine, tetrahydrozoline, xylometazoline
      • Oral Decongestants: phenylephrine, pseudoephedrine
      • Steroid Nasal Decongestants: beclomethasone, budesonide, flunisolide, fluticasone, triamcinolone
      • Antihistamines (First Generation): brompheniramine, carbinoxamine, chlorpheniramine, clemastine, cyproheptadine, dexchlorpheniramine, dimenhydrinate, diphenhydramine, hydroxyzine, meclizine, promethazine, triprolidine
      • Antihistamines (Second Generation): azelastine, cetirizine, desloratadine, fexofenadine, levocetirizine, loratadine
      • Expectorant: guaifenesin
      • Mucolytics: acetylcysteine, dornase alfa

    • Contraindications/Cautions (Antitussives):

      • Avoid in patients requiring cough for airway maintenance (post-op, etc).
      • Use with caution in asthma/emphysema patients.
      • Caution in hypersensitive/addicted patients (codeine, hydrocodone).
      • Extreme caution for those operating vehicles or requiring alertness.
      • Avoid during pregnancy and lactation.

    • Adverse Effects (Antitussives):

      • Drying mucous membranes, increased secretion viscosity.
      • Central nervous system effects (respiratory depression, drowsiness, sedation).
      • GI upset (nausea, vomiting, constipation).
      • Risk of addiction with opioid substances.
      • Local antitussives: GI upset, headache, congestion, dizziness.

    Decongestants

    • Mechanism: Cause local vasoconstriction, shrinking swollen nasal membranes, improving airflow.
    • Topical Nasal Decongestants:
      • Rapid onset, less systemic effects.
      • Examples: naphazoline, oxymetazoline, phenylephrine, tetrahydrozoline, xylometazoline.
      • Frequent/prolonged use can lead to rebound congestion (rhinitis medicamentosa).
    • Oral Decongestants:
      • Associated with more systemic effects.
      • Examples: phenylephrine, pseudoephedrine.
      • Use with caution in cardiovascular conditions.
    • Nasal Steroid Decongestants:
      • Inflammatory response blockade.
      • Slow acting (days to weeks).
      • Treatment of chronic rhinitis.

    Antihistamines

    • Mechanism: Block histamine release/action, relieving allergy symptoms.
    • First-Generation: More sedating, greater anticholinergic effects.
    • Second-Generation: Less sedating, preferred for alertness.
    • OTC misuse: Potential for misuse for colds and influenza treatment.

    Expectorants

    • Mechanism: Increase productive cough, thinning secretions to aid expulsion.
    • Example: Guaifenesin (Mucinex).
    • Use: Symptomatic relief of respiratory conditions.
    • Contraindications: Allergy to the drug, persistent cough (potential for underlying problems), more than 1 week of persistent cough.

    Mucolytics

    • Mechanism: Increase or liquefy respiratory secretions, facilitating airway clearance.
    • Examples: Acetylcysteine, dornase alfa.
    • Acetylcysteine: Liver protection (acetaminophen overdose), mucus thinning, 6.25h half-life
    • Dornase Alfa: Recombinant DNA, specifically for cystic fibrosis mucus.
    • Use: Especially in high-risk patients with difficult-to-move secretions.

    Lower Respiratory Tract Drugs

    • Drug Classes (Bronchodilators/Antiasthmatics):
      • Xanthines: aminophylline, caffeine, theophylline.
      • Sympathomimetics: albuterol, arformoterol, ephedrine, epinephrine, formoterol, indacaterol, isoproterenol, levalbuterol, metaproterenol, olodaterol, salmeterol, terbutaline.
      • Anticholinergics: aclidinium, glycopyrrolate, ipratropium, revefenacin, tiotropium, umeclidinium
    • Drugs Affecting Inflammation:
      • Inhaled Steroids: beclomethasone, budesonide, ciclesonide, fluticasone, triamcinolone.
      • Leukotriene Receptor Antagonists: montelukast, zafirlukast, zileuton.
      • Immune Modulators: benralizumab, dupilumab, mepolizumab, omalizumab, reslizumab.
    • Lung Surfactants: beractant, calfactant, poractant.
    • Drugs for Pulmonary Fibrosis: nintedanib, pirfenidone

    Important Considerations

    • Age-Specific Use: Important considerations for pediatric, adult, and older adult patients due to differences in metabolism, absorption, and risk of adverse reactions.
    • Pregnancy/Lactation: Many drugs have unknown safety profiles, requiring caution.
    • Drug Interactions: Specific interactions should be considered, especially for OTC medications and combination products.
    • Respiratory Symptoms: Underlying causes (infection) should be ruled out with persistence of certain conditions.
    • Respiratory Insufficiency: Patients might require multiple medications.

    Additional Lower Respiration Notes

    • Obstructive Pulmonary Diseases: Asthma and COPD involve airway narrowing from inflammation and/or muscular constriction.
      • COPD is often chronic, irreversible.
      • RDS: Surfactant deficiency in infants, causing alveolar collapse.
    • Treatment: Focus on bronchodilation and inflammation reduction. Inhaled steroids are frequently used for the prevention and treatment of inflammation.
    • Lung Surfactants (RDS): Replace missing surfactant, allowing alveoli to expand

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    Description

    This quiz focuses on nursing considerations and pharmacological actions of medications used for upper respiratory tract disorders. It covers important aspects like pharmacokinetics, therapeutic actions, and specific drug classifications. Test your knowledge on antitussives, expectorants, and antihistamines.

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