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FNP Pharmacology part 3
Finals for pharmacology, part 3, respiratory agents.
30
Medical
Graduate
04/22/2009

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Term
Name one example of a long-acting beta 2 receptor agonist.
Definition
Serevent (salmeterol)
Term
What is the #1 adverse effect of beta agonist use?
Definition
Tachycardia
Term
What electrolyte abnormality can be found in patients on high doses of beta 2 agonists?
Definition
Hypokalemia.
Term
What are common side effects of beta 2 agonists?
Definition
Tachycardia, fine tremor, nervousness, headache, muscle cramps, palpitations and anxiety.
Term
What is the mechanism of action of beta 2 agonists?
Definition
Action on the beta 2 receptors causes smooth muscle relaxation in the respiratory tract.
Term
What respiratory condition are anticholinergics often used to treat?
Definition
COPD
Term
Describe the mnemonic for describing anticholinergic reactions.
Definition
Can't see, can't pee, can't spit, can't shit.
Term
What urinary condition in men necessitates cautioius use of anticholinergics?
Definition
BPH.
Term
what are the two primary effects of theophylline when used for asthma?
Definition
Bronchial smooth muscle relaxation and suppression of the response of the airways to stimuli (i.e. non-bronchodilator prophylactic effects).
Term
Is theophylline's therapeutic window narrow or wide?
Definition
Narrow - it needs to be monitored.
Term
What is montelukast's (Singulair's) mechanism of action?
Definition
It modifies leukotrienes, which are roducts of arachidonic acid metabolism and released from various cells including mast cells and eosinophils.
Term
How bad is montelukast's (Singulair's) side effect profile?
Definition
It's actually quite good and well-tolerated.
Term
Aside from asthma, what other condition can montelukast (Singulair) be used to treat?
Definition
allergic rhinitis.
Term
What's the biggest advantage of using inhaled corticosteroids over oral ones?
Definition
Less long-term side effects.
Term
After how many days of oral corticosteroid use do clinicians need to taper?
Definition
5 days.
Term
Name a common inhaled corticosteroid.
Definition
Fluticasone (Flovent), beclomethasone (QVAR)
Term
Why should asthmatics rinse their mouths after every corticosteroid inhalation?
Definition
To decrease the risk of developing thrush.
Term
How different will asthmatics feel after initiating Flovent therapy?
Definition
They'll likely feel unchanged.
Term
What mast cell stabilizer can be used to prevent exercise-induced asthma?
Definition
the mast cell stabilizer, Cromolyn (Intal)
Term
What are the 2 ingredients in Combivent?
Definition
Ipratropium bromide, albuterol.
Term
What are the 2 ingredients in Advair?
Definition
Fluticasone & salmeterol.
Term
If a pt is well-controlled on Advair, then is a separate rescue inhaler still needed?
Definition
Yes.
Term
What's the most common side effect of nasally inhaled corticosteroids?
Definition
dry and bleeding nose.
Term
Name a common nasally inhaled corticosteroid.
Definition
Fluticasone (Flonase).
Term
How many consecutive days can Afrin be used?
Definition
No more than 3.
Term
What basic philosophy should be employed when dealing with asthma exacerbations?
Definition
"big guns, then back off"
Term
What is an appropriate prescription for a 16 y.o. with mild intermittent asthma?
Definition
albuterol 90mcg, 2 puffs q4h PRN
Term
What is the preferred drug class in a patient with mild persistent asthma?
Definition
Inhaled corticosteroid +SABA
Term
What is the preferred drug combination for persistent, but worse than mild (steps 3-5), asthma?
Definition
Low/Medium/High dose of inhaled corticosteroid + long-acting beta agonist.
Term
After how many months of well-controlled asthma can the practitioner move pts down a treatment step?
Definition
3 months.
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