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Questions and Answers
A patient with asthma is prescribed both albuterol and salmeterol inhalers. How should the patient be instructed to use these medications?
A patient with asthma is prescribed both albuterol and salmeterol inhalers. How should the patient be instructed to use these medications?
- Alternate between the two inhalers every other day to prevent tolerance.
- Use albuterol as needed for acute symptoms and salmeterol daily for maintenance. (correct)
- Use both inhalers at the same time whenever experiencing symptoms.
- Use salmeterol as needed for acute symptoms and albuterol daily for maintenance.
Which of the following is a significant concern associated with the use of salmeterol monotherapy in asthma patients?
Which of the following is a significant concern associated with the use of salmeterol monotherapy in asthma patients?
- Severe hypertension
- Increased risk of asthma-related death (correct)
- Paradoxical bronchospasm
- Increased risk of glaucoma
A patient is prescribed ipratropium for COPD. What is the primary mechanism of action of this medication?
A patient is prescribed ipratropium for COPD. What is the primary mechanism of action of this medication?
- Stimulation of beta-2 receptors in the lungs
- Blockage of muscarinic receptors in the airways (correct)
- Leukotriene receptor antagonism
- Phosphodiesterase inhibition, leading to bronchodilation
Theophylline, a methylxanthine, is prescribed for a patient with chronic asthma. What potential adverse effect requires careful monitoring?
Theophylline, a methylxanthine, is prescribed for a patient with chronic asthma. What potential adverse effect requires careful monitoring?
Why is budesonide often considered a first-line treatment for persistent asthma?
Why is budesonide often considered a first-line treatment for persistent asthma?
Montelukast is most likely to be effective in which of the following asthma patients?
Montelukast is most likely to be effective in which of the following asthma patients?
Omalizumab carries a black box warning for the potential risk of which adverse effect?
Omalizumab carries a black box warning for the potential risk of which adverse effect?
Which medication's effectiveness can be decreased by concurrent use of beta-blockers?
Which medication's effectiveness can be decreased by concurrent use of beta-blockers?
A patient taking theophylline reports nausea, vomiting, and insomnia. What is the most appropriate initial action?
A patient taking theophylline reports nausea, vomiting, and insomnia. What is the most appropriate initial action?
A patient with persistent asthma is prescribed montelukast. What should the patient be told about the onset of action for this medication?
A patient with persistent asthma is prescribed montelukast. What should the patient be told about the onset of action for this medication?
A patient with COPD is prescribed tiotropium. How does this medication improve the patient's respiratory function?
A patient with COPD is prescribed tiotropium. How does this medication improve the patient's respiratory function?
Why is theophylline use limited despite its bronchodilatory effects?
Why is theophylline use limited despite its bronchodilatory effects?
What is the most important counseling point for a patient who is starting on inhaled budesonide?
What is the most important counseling point for a patient who is starting on inhaled budesonide?
Which of the following best describes the mechanism of action of montelukast in managing asthma?
Which of the following best describes the mechanism of action of montelukast in managing asthma?
Omalizumab is prescribed for a patient with severe allergic asthma. What is the primary mechanism by which omalizumab helps to control asthma symptoms?
Omalizumab is prescribed for a patient with severe allergic asthma. What is the primary mechanism by which omalizumab helps to control asthma symptoms?
A patient is prescribed both albuterol and salmeterol for asthma. How do these medications differ in their primary purpose in asthma management?
A patient is prescribed both albuterol and salmeterol for asthma. How do these medications differ in their primary purpose in asthma management?
A patient on theophylline therapy complains of insomnia and irritability. What is the most likely cause?
A patient on theophylline therapy complains of insomnia and irritability. What is the most likely cause?
Which of the following is a key clinical consideration when prescribing long-acting beta-agonists (LABAs) like salmeterol for asthma?
Which of the following is a key clinical consideration when prescribing long-acting beta-agonists (LABAs) like salmeterol for asthma?
How does ipratropium provide relief in COPD patients experiencing an exacerbation?
How does ipratropium provide relief in COPD patients experiencing an exacerbation?
A patient with allergic asthma is prescribed omalizumab. What should the patient be closely monitored for after each injection?
A patient with allergic asthma is prescribed omalizumab. What should the patient be closely monitored for after each injection?
Flashcards
Albuterol
Albuterol
Short-acting beta-agonists (SABAs) like Albuterol are bronchodilators used for quick relief of asthma symptoms.
Salmeterol
Salmeterol
Long-acting beta-agonists (LABAs) such as Salmeterol are bronchodilators used as controllers for asthma; must be used with an inhaled corticosteroid for asthma.
Ipratropium/Tiotropium
Ipratropium/Tiotropium
Ipratropium and tiotropium are anticholinergic bronchodilators. Ipratropium is a rescue medication, while tiotropium is a controller.
Theophylline
Theophylline
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Budesonide
Budesonide
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Montelukast
Montelukast
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Omalizumab
Omalizumab
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Albuterol MOA
Albuterol MOA
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Salmeterol MOA
Salmeterol MOA
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Ipratropium/Tiotropium MOA
Ipratropium/Tiotropium MOA
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Theophylline MOA
Theophylline MOA
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Budesonide MOA
Budesonide MOA
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Montelukast MOA
Montelukast MOA
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Omalizumab MOA
Omalizumab MOA
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Albuterol Adverse Effects
Albuterol Adverse Effects
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Study Notes
- Medications that affect the respiratory system, including bronchodilators and anti-inflammatory drugs, are crucial in managing conditions like asthma and COPD.
Bronchodilators
- These medications work by relaxing the muscles in the bronchioles, widening the airways, and making it easier to breathe.
Albuterol (Rescue)
- Albuterol is a short-acting beta-2 agonist (SABA) used for quick relief of bronchospasm.
- MOA: It stimulates beta-2 adrenergic receptors in the lungs, leading to bronchodilation.
- Adverse effects include tachycardia, palpitations, tremor, and anxiety.
- Contraindications: Caution in patients with heart conditions or hyperthyroidism.
- Drug interactions: Beta-blockers can reduce its effectiveness.
Salmeterol (Controller)
- Salmeterol is a long-acting beta-2 agonist (LABA) used for long-term control of asthma symptoms.
- MOA: Similar to albuterol, but with a longer duration of action.
- Adverse effects are similar to albuterol but can also include prolonged QT interval.
- Black Box Warning: Increased risk of asthma-related death if used alone.
- Should always be used in conjunction with an inhaled corticosteroid for asthma treatment.
- SABAs are for acute symptoms; LABAs are for maintenance.
Ipratropium (Rescue), Tiotropium (Controller)
- These are anticholinergic bronchodilators.
- MOA: They block acetylcholine receptors in the airways, reducing bronchoconstriction.
- Ipratropium is short-acting, while tiotropium is long-acting.
- Adverse effects include dry mouth, blurred vision, and urinary retention.
- Drug interactions: Additive anticholinergic effects with other anticholinergic drugs.
- Clinical considerations: Monitor for anticholinergic side effects, especially in the elderly.
Theophylline (Controller)
- Methylxanthine bronchodilator.
- MOA: Relaxes bronchial smooth muscle and suppresses airway responsiveness to stimuli.
- Adverse effects include nausea, vomiting, insomnia, and potentially fatal arrhythmias or seizures.
- Route: Administered orally.
- Drug interactions: Many, including caffeine and certain antibiotics.
- Clinical considerations: Requires monitoring of serum levels due to narrow therapeutic window.
Anti-Inflammatory Medications
- These medications reduce airway inflammation, a key component of asthma and COPD.
Budesonide (Controller)
- Inhaled corticosteroid (ICS).
- MOA: Reduces inflammation in the airways by suppressing the release of inflammatory mediators.
- Adverse Effects: Oral candidiasis (thrush), hoarseness, and increased risk of pneumonia.
- Considered a 1st line treatment for persistent asthma.
- Rinse mouth after use to prevent thrush.
Montelukast (Controller)
- Leukotriene receptor antagonist.
- ASTHMA ONLY
- MOA: Blocks the action of leukotrienes, reducing airway inflammation and bronchoconstriction.
- Adverse effects are generally mild, including headache and gastrointestinal upset.
- Monitoring: Watch for behavioral changes.
- Most effective for patients with allergic asthma.
Omalizumab (Controller - Add On)
- Monoclonal antibody.
- ASTHMA ONLY
- MOA: Binds to IgE, reducing the allergic response.
- Black Box Warning: Risk of anaphylaxis.
- Adverse effects include injection site reactions and, rarely, malignancy.
- Route: Subcutaneous injection.
- Clinical considerations: Administered in a healthcare setting due to anaphylaxis risk; is an add-on medication.
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