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A 22 year old patient is experiencing an acute exacerberation of her asthma and iscomplaining of wheezing and shortness of breath. What is the most appropriate medication to help relieve her symptoms?
Acetylcysteine improves mucus clearance when given as an aerosol and should always be used as a mucoactive medication.
After reviewing your patient's char, you notice he experiences wheezing during his NebuPent treatments. What should you suggest to his physician?
Have the patient use a B-adrenergic bronchodilator before inhaling aerosolized NebuPent
Agents that paralyze skeletal muscle by simple competitive inhibition of acetylcholine at muscle receptor sites are called.....
Alheimer's dementia is associated with cognitive deficits secondary to:
Decreased acetylcholine levels
All of the following are advantages of aerosolized drug therapy except:
Onset of action is very slow
All patients with angina should receive what drug for prophylaxis of a myocardial infarction?
Atrovet is supplied as a 0.02% solution. if you administer 2.5ml to a patient, how many milligrams are you giving?
Barbiturates are often avoided because of what side effects?
High risk of abuse, Rapid development of tolerance, High risk of addiction, toxic potential
A chronic and progressive neurologic disorder characterized by unpleasant sensations in the legs and a compelling urge to move the legs while the patient is awake is referred to as:
RLS (Restless Leg Syndrome)
common less toxic side effects of theophylline therapy includes
headache, gastric upset, anxiety, nervousness, diuresis
Congenital a1-antitrypsin deficiency, a genetic defect, can lead to what condition at an earlier age than is normal?
Corticosteroids are used with asthmatics and patients with COPD to achieve what effect?
Breakdown of secretions
The currently recommended blood serum theophylline level for the management of asthma is:
5 to 15 micrograms (ug)/ml
The definition"when two drugs act on the same receptors and the combined effect is the simple sum of the two drugs effect describes:
The difference between a drug that the physician prescribes and one that can be bought OTC is:
The strength will be greater with a prescription
Disadvantages of theophylline therapy includes:
narrow therapeutic margin, toxic effects, unpredictable blood levels, need for individual dosing
Disease states that could benefit from the use of adrenergic bronchodilators include:
Asthma, Bronchitis, Emphysema, bronchiectasis
Diseases with hypersecretion or poor clearance of secretions includes:
Cystic fibrosis, Pneumonia, Primary ciliary dyskinesia
A dosage for pedriaric use of Albuterol (0.5%) os 0.03ml/kg. You have a 22 l, 12 month-old patient in the ER. How many milliliters of solution will you need?
The Drug Adinistration Phase describes:
The method by which a drug dose is made available to the body
A drug reaction reaction this is the opposite of, unusua, or absent of an effect is the definition of:
A drug that exhibits its pharmacologic activity once it is converted inside the body to its active form is called:
The FDA will track a new drug that is released for general clinical use for how long?
First six months
The general indication for clinical use of nonsteroidal antiasthma agents is
Prophylactic mangement of mild persistent asthma
How are Opioids (narcotic analgesics) characterized?
Highly addictive, known narcotic agents, used to treat moderate to severe pain, produce euphoria
How does N-acetyl cysteine (NAC) work?
It substitutes sulfhydryl radicals for disulfide bonds in mucus
How is pain control by blocking transmission of the pain impulse from the damaged area achieved?
through the use of local anesthetics
Inhalation is the preferred route of administering catecholamines for which of the following reasons:
Rapid onset of action, smaller dosage used, reduced side effects, drug delivered to target organ, safe and painless route
Ipratropium agents may be indicated to treat
allergic rhinitis, the common cold, non-allergic rhinitis
It is difficult to determine therapeutic doses of theophylline because:
individuals metabolize theophylline at different rates
The keyhole theory indicates that the larger the side chain attachment to a Catecholbase the:
Greater the b2 specificity
Leukotrienes exhibit what what effects?
Increased mucus secretion, inhibition of normal ciliary action, increased airway edema, bronchoconstriction, recruitment of other inflammatory cells into airways
Mucociliary slowing, bronchodilation, and increased heart rate all are a result of what?
Mucus or mucociliary clearance can be abnormal in pulmonary diseases such as:
Bronchitis, asthma, cystic fibrosis
Nicotine is capable of stimulating both sympathetic and parasympathetic autonomiccholinergic receptors.
On administering a dose of atropine to your patient, which of the following effects would you not expect to see?
A patient complains of oral thrush and hoarseness since she has been using fluticasone by MDI. The physician asks you to make a suggestion to help her without discontinuing the drug. You suggest
Add a spacer and rinse the mouth after use
A patient is experiencing changes in heart rate and papillary response to light. What division of the nervous system is responsible for these changes?
Autonomic nervous system
Patients using ipratropium aerosols should be instructed to avoid allowing the aerosol to come in contact with what?
The peripheral nervous system consists of the following:
Autonomic nervous system and the Somatic nervous system
A physician asked you to suggest an aerosolized antiinfective for a cystic fibrosis patient with chronic Pseumonas aeruginosa infection. What is the most appropriate medication?
A physician orders 3 ml of 0.83% Albuterol. How many milligrams of drug would you administer?
A physician orders that 12 mg of medication be deivered to your patient. If 30 mL of the solution contains 20 mg of active drug, how many milliliters will you need to administer?
Prior to mucomyst, you should always pre-treat with a bronchodilator to help prevent bronchospasms.
Reduced extracellular levels of which neurotransmitter can contribute to the symptoms of RLS:
Relaxation of smooth airway muscle in the presence of reversible airflow obstruction is a general indication for the use of :
Results of a patients' pulmonary function test(PFT) show that the peak flow rate increased the most when she inhaled an aerosolized sympathomimetic agent and an aerosolized parasympatholytic agent. You would recommend that she be given what:
Side effects of systemic steroid treat includes:
HPA suppression, Cough, Dysphonia, Psychiatric reactions
The sleep disorder characterizedby difficulty falling asleep, insufficient sleep , or nonrestorative sleep is:
The sleep disorder characterized by persistent excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis is:
The sleep disorder characterized by undesirable motor, sensory, or behavioral phenomena is:
Smoking cessation drugs are available in what forms?
gum, nasal spray, transdermal patch, and tablets
Sodium bicarbonate decreases the viscosity of the secretions by decreasing the pH which alters mucus bonding.
A technique used for monitoring blockage that evaluates the conduction of an impulse across the neuromuscular junction using supramaximal stimulus at a frequency of 2hz over 2 seconds is referred to as what?
theophylline is classified as a bronchodilator because:
it has a relaxing effect on bronchial smooth muscle
Thrombolytic agents should be given_____________ in relation to the onset of symptoms.
within 12 hours
The transcription on a written prerscription provides which of the following:
instructions to the patient
Treatment for NREM and REM sleep parasomnias frequently includes:
Avoidance of potential triggers and longer acting benzodiazepines
Uncontrolled hypertension increases the risks of which conditions?
Myocardial infarction, Peripheral artery disease, Angina, Stroke, Renal failur
Under normal circumstances circadian rhythms become synchronized to the:
Environmental light/dark cycle
What agents reduce total peripheral resistance by a direct action on vascular smooth muscle?
What are some local airway side effects of aerosolized pentamidine?
Wheezing, Coughing, Shortness of breath, Bad taste, Spontaneous pneumothoraces
What are some of the manifestations of digoxin toxicity?
Hyperkalemia, premature ventricular contractions, bigeminal rhythm, nausea,abdominal pain
What are some precautionary measures are suggested when administering pentamidine to reduce the risk of both drug exposure and TB infection?
Use a nebulizer system with one way valves and expiratory filter, Administer aerosol in a negative pressure room, Do not expose pregnant women and nursing mothers to the drug, Use barrier protection, Stop nebulization if the patient takes the mouthpiece out of the mouth
What are te classes of diuretuics?
Loops, potassium sparing, Osmotics, Thiazides, Carbonic anhydrase inhibitors
What are the first line agents for treating uncomplicated hypertension?
Thiazide diuretics, ACEIs, ARBs, CCBs
What are the most common adverse reactions associated with the use of diuretics?
Volume depletion, electrolyte abnormalities
What are the primary uses of neuromuscular blocking agents?
facilitate endotracheal intubation, enhance patient-ventilator synchrony, relax muscle during surgery, reduce intercrainial pressure on intubated patients
What drug is used to treat hypoxic respiratory failure in newborns with pulmonary hypertension?
What have Aminoglycosides, such as tobramycin, have been aerosolized specifically for the treatment of?
What is one of the most common psychiatric disorders and a major cause of disability worldwide?
What is the approved dose of pentamidine by aerosol for prevention of Pneumocystis pneumonia?
300mg once every four weeks
What is the asthma paradox?
Despite the fact that new treatments are available and more awareness of the condition the morbitity and mortality rates of asthma continues to rise.
What is the clinical indication for use of antileukotriene drug therapy, such as montelukast, in asthma?
As an alternative to inhaled steroids
What is the most important factor in the management of sudden cardiac death?
timely and efficient CPR and defibrillation
What is the only B-agonist formulation that is a single isomer and is approved by the U.S. Food and Drug Administration for aerosol delivery.
What is the pharmacologic modification of painful and frightening experiences while remaining conscious during medical procedures?
What is the simplest and most common method of preparing bacteria for examination and identification?
What routes are Pentamidine administered?
Inhaled aerosol, Intramuscular injection, Intravenous injection
What type of drug will prevent the conversion of short term experiences into permanent memory?
When using the "Train-of-four", how many twitches indicate that about 80% of the receptors are occupied with a blocker?
Which of the following agents are currently approved for administration as an aerosolized mucoactive agent?
N-acetylcysteine, Dornase alfa
Which of the following is the definition of a drug?
Any chemical that alters the organism's function or processes
Which route of drug adminstration is the most direct with rapid onset and peak effects, and provides 100% availability of the drug:
Which type of diuretic is used for the treatment of altitude sickness?
Carbonic anhydrase inhibitors
While working a shift in the neonatal intensive care unit you observe a patient receiving caffeinecitrate. What is the patient's likely diagnosis?
Apnea of prematurity
Yoour patient's sputum culture indicated the presence of methicillin-resistant S. aureus (MRSA) Which medication is appropriate to treat this infection?
You administer 0.5 ml of a 1:200 strength drug; how many milligrams of active ingredient are you giving?
You are administering an aerosolized bronchodilator to your patient. her pretreatment pulse was 85 bpm. You would stop treatment if her pulse reached:
You are working in the ER when a 77 year old man with viral hepatitis comes in complaining of nausea. His medications include Combivent, Advair and theophylline. Which drug is likely the cause of his nausea?
You are working the night shift when a 68 year old man with chronic obstructive pulmonary disease is admitted through the ER. He has been given Combivent and inhaled corticosteroids. The intern on call asks your recommendation for additional medication to give the patient. You would recommend.....
You enter the room of a 2-year old patient who presents with the characteristic barking cough found with croup. Once the diagnosis is confirme, which ofthe following medications could you recommend to help provide relief from subglottic swelling.
You have 80 mg of Phenobarbital in 20 mL of a Phenobarbital elixir. How many milliliters of elixir would you use to give a 20 mg dose?
You have a patient with cystic fibrosis who needs an aerosol medication to reduce the viscosity and adhesivity of infected respiratory secretions. What agent would you recommend?
You have atropine 0.4 mg/mL in a vial of liquid. How many milliliters would be needed for a 1.0 mg dose?
Your 75 year old patient with a history of COPD and bipolar disorder is experiencing tremors, cognitive slowing, and polyuria. His medications includes Combivent, Advair, and lithium. Which drug is most likely to be causing his symptoms?
You receive an order to administer 5 ml of Albuterol by SVN. You would:
Call the physician to confirm the medication dose
Your patient has been given succinylcholine in an effort to facilitate endotracheal intubation. However, you are unable to place and endotracheal . What should you do?
manually ventilate the patient until succinylcholine wears off
Your patient has cerebral edema. Which group of diuretic agents would you expect to be administered?
Your patient has mild hypertension. Which group of diuretic agents would you expect the physician to prescribe?
Your patient is diagnosed with persistent asthma. Which type of drug would you recommend for maintenance bronchodilation and control of bronchospasm?
Long-acting adrenergic agent
Your patient presentswith post extubation stridor. You recommend Racemic epinephrine for its:
a-adrenergic vasoconstricting effect
Your patient requires a dose of adenosine for confirmed supraventricular tachycardia(SVT). His only line is a peripheral IV linein the right arm. How should you proceed?
Administer the dose quickly and immediately follow with a saline flush, and hold the patient's right arm in an upright position while administering the dose
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