251 terms

Bio 137 final study guide

Study guide for Mr. B's 137 final. Made by a thug, for thugs. Thug life.
The size or MMAD of aerosol particles that deposit within the nose and mouth is
10-15 micron
every 6 hrs
Four times a day
3 times a day
Give as needed
Do this immediately!
Oral administration
Twice a day
Which of the following is the main site of drug elimination?
How much of the total drug is delivered to the lung, regardless of the delivery device used?
Heparin comes as 1000U/mL. How many mL do you need to deliver 650 U of Heparin?
0.65 ML
What particle size of an aerosol would increase delivery to the lung parenchyma?
3-0.8 microns
Parenteral administration
Other than the GI tract
Enteral administration
Through the GI tract
Buccal administration
Inside cheek
Within upper layers of skin.
Intraosseous administration
Directly into the bone
gastrotomy administration
Directly to stomach via surgical tube
Sublingual administration
Under tongue
Two drugs combined having many times the effect of increasing the dose of either one
potentiation effect
A patient has been taking a drug for several months; lately the patient requires more of the drug to produce the same effect. This is called:
1 + 1 = 3
1 + 1 = 2
1 + 0 = 2
1 Kg
1000 g
1 mcg
0.000001 g
1% solution
1000 mL
1 mg
0.001 g
1 tsp
3 : 5 mL
Factors that affect drug action include. I patient's age II. patient's gender III. Patient's body weight IV diseases V patients IQ.
I, II, III and IV only
Of the following routes of administration, which gets the drug to the target cells or tissues the fastest?
Which of the following is the best example of direct drug delivery?
Ointment applied for sunburn.
Which of the following aerosol devices could be used for a child 6 months old, admitted to the ED with a diagnosis of bronchiolitis?
Which of the following is the only route of administration that cannot exert a local effect?
Which of the following is included in the pharmacokinetic phase of medication effect on the body?
Metabolism of the drug in the liver
When two drugs are taken together, one will greatly amplify the affect of the other. An example is valium and alcohol:
Potentiation Effect
What does the term PO mean when applied to drug delivery
Absorption in the gastrointestinal tract
A child's cough medicine comes as 0.2% solution. The pediatrician orders 3ml, what is the dose in mgs?
6 mg
Bioavailability is a measure of the drug in the _____?
A ________________ is a substance that is dissolved in a solution.
The gauge of a needle is the:
inside diameter
Pharmacology as a science has to do with:
Prevention of disease
Curing of infection
All of them are true
Alleviation of symptoms of disease
All of them are true
The Durham-Humphrey Amendment (1951) to the Food, Drug, and Cosmetic Act (1938), separated legend drugs from OTC drugs. What are legend drugs?
Drugs requiring a prescription with the Rx symbol.
Which route of administration would have to cross the endothelial barrier in order to circulate systemically ? I. IV II. IM III. Subcutaneous IV. Inhalation
II and III
The average dose of sodium nitroprusside is 3 micrograms/Kg/min. If you have a prepared-strength vial of of sodium nitroprusside at 50 micrograms/mL, how much of that drug preparation should you give to a 70Kg man?
4.2 ml/min
A special case of potentiation where one drug has no effect on its own but can increase the activity of another drug, is an example of:
A high L/T ratio means:
good bronchoactivity
A small volume nebulizer is best for use by which of the following individuals?
A patient with poor inspiratory capacity and who is tachypneic.
The Pharmaceutical phase of drug action includes which of the following?
Route of administration
Which of the following is likely to escape the first pass effect?
Nitroglycerin pill
Which of the following is considered "enteral route"? I oral. II Transdermal III. Colorectal. IV Topical
I and III.
Which drug is more potent? Drug A (ED50 =10mg) or Drug B (ED50 = 6mg)?
Which of the following organ system is responsible for biotransformation or breaking down of a drug in the body?
A drug not cleared from the body because of liver or kidney failure
Accumulative Effect
: A drug that blocks another drug's action
Antagonist Effect
Stimulates receptor
Agonist Effect
A life threatening allergic reaction to a drug
Rapid tolerance to a drug a higher dose is needed to get the desired result
Which of the following is the main site of drug metabolism?
Which of the following bronchodilator drugs is commonly used as a tocolytic (labor slowing) medication when given IV?
A common side effect of the anticholinergic Atrovent is
dry mouth and dysphagia (difficulty swallowing)
Muscarinic receptors types on submucosal glands and
smooth muscle are:
*A pediatric patient has stridor, and has been diagnosed
with croup. To help reduce the swelling in the upper
airway, which of the following medications can be used
because of it's alpha effect?
Racemic Epinephrine
In comparing anticholinergic and beta adrenergic
agents, anticholinergic agents are associated with which
of the following:
No development of tolerence
Which of the following enzymes is responsible for
breaking down c-AMP into 3,5 AMP?
Which of the following are considered common side
effects of aerosolized bronchodilator adminstration?
(pick as many as appropriate)
What is the trade name for the combination of
ipratropium bromide and albuterol sulfate?
Which of the following occurs when Beta 1 receptors are
stimulated? (pick as many as appropriate)
Increased cardiac contraction/Vasoconstriction/ Increased heart rate/ Increased smooth muscle relaxation
Which of the following bronchodilators is considered an
A parasympathomimetic agent that intensifies the level
of bronchial tone to the point of bronchial constriction
and is used in bronchial provocation testing is:
Which of the following aerosolized medications would
you suggest at this time, if after the first treatment no
benefit showed but if after the second treatment you
heard diminished breath sounds with faint wheezing.
A drug with cholinergic effects would NOT result in which
of the following?
Increased heart rate
Xopenex dosage?
0.63 mg to3ml to 1.25 mg in 2.5 ml saline
Albuterol dosage?
2.5 mg in 2.5 ml normal saline
Isoetharine Dosage?
(1%) solution of 0.25 ml to 0.5 ml in 3 ml normal saline
Racemic epinephrine Dosage?
(2.25%) solution of 0.25 ml to 0.5 ml in 3 ml normal saline
Metaproterenol Dosage?
0.15 ml to 0.3 ml in 3 ml normal saline
Which of the following describes quaternary amonium compounds?
They do not cause CNS changes
Which of the following is true of tertiary amonium compounds?
They are associated with more CNS side effects than are quartenary amonium compounds.
What is the adult dose for a unit dose of albuterol and normal saline?
2.5 mg in 2.5 ml normal saline
Which of the following is the most effective treatment of COPD? I Anticholinergic agents II. Beta Adrenergic agents III. Alternate-day therapy IV. Isoproterenol
I and II only
A known COPD patient calls you, the RT, in the pulmonary rehabilitaion department and tells you that she has been taking Spiriva twice per day for the past 2
days. You should tell the patient to:
Reduce the treatment to once a day
A life threatening allergic reaction to a drug
A drug that blocks another drug's action
Antagonist Effect
A drug not cleared from the body because of liver or kidney failure
Accumulative Effect
Rapid tolerance to a drug - a higher dose is needed to get the desired result
Stimulates receptor
Agonist Effect
Can there be tachycardia with Levalbuterol, a preferentially beta 2 agonist?
Yes Beta 2 receptors have also been found in the heart
Muscle tremor side effect with beta agonists is due to stimulation of which receptors in skeletal muscle?
beta 2
Which of the following is considered the less likely brochodilator to have cardiac side effects and is a split isomer of albuterol?
An RT from another school complains to you, a CCSD graduate, that the patient appears to be staring at him more after the Atrovent treatment. You observe dilated pupils in the patient and tell the RT who went to the other school to:
Adjust the face mask better so the anticholinergic
aerosol is not sprayed into the eyes.
If after the first treatment no benefit showed but if after the second treatment you heard diminished breath sounds with faint wheezing, how would you chart the treatment results?
Asthma symptoms relieved
If the patient's heart rate increased to 128 after the first treatment which of the following would you recommend if another treatment were needed to quickly relieve the patient's dyspnea?
Which of the following is responsible for the intracellular reaction in bronchial smooth muscle that causes it to relax?
Decongestion agents for nasal passages stimulate which receptors?
Which of the following are components of the bronchial lumen and lamina propria?
Parasympathetic nerves
Goblet Cells
Submucosal Glands
Blood Vessels
All dem mugffugaz
What are the standard doses for Xopenex?
0.63 mg to 1.26 mg
A physician orders 2% lidocaine be instilled down a patient's endotracheal tube to prepare for a bronchoscopy procedure. You have 10 ml of a 5% lidocaine solution at hand. How many ml of dilute must be added to arrive at the prescribed concentration?
15 ml
Which of the following aerosolized medications is considered a catacholamine drug?
Resorcinol agents were created by modifying the catechol nucleus, so it would no longer be inactivated by:
Which of the following is considered a catacholamine beta 2 agonist?
Isoetherine (Bronkosol)
Which of the following bronchodilators is catagorized as an anticholinergic medication?
ipratropium bromide
Which of the following beta 2 agonists is considered to have the longest duration of effect?
Parasympathetic innervation and muscarinic receptors are concentrated:
In the larger airways gradually diminshing in numbers at the respiratory bronchioles
All of the following drugs increase ciliary beat except:
When administering N acetyl Cysteine by aerosol it is important to include which of the following to reduce the incidence of bronchospasm?
Rapid onset bronchodilator
What is the most common side effect of delivering ACETYLCYSTEINE solution via the aerosol route?
Cystic Fibrosis(CF) is associated with chronic airway infection, often with:
Pseudomonas aeruginosa
Why is caffeine citrate used with premature infants?
It works on the CNS to stimulate breathing.
Common side effects with Pulmozyme do NOT include:
Three types of methylxanthines are I Theophylline. II Caffeine. III Theobromine. IV Acetylcysteine
I, II and III
What is the trade name for Acetylcysteine?
Which of the following mucolytics works by breaking the disulfide bonds of secretions?
What is the trade name for alpha dornase?
Which of the following mucolytics works to dissolve mucus by breaking the DNA chains of the secretions?
Alpha Dornase
Another name for surface acting agents is:
For an alveolus, LaPlace's Law which states the relationship of the vessel radius, the internal pressure, and the surface tension, is written as:
Pressure = (2 x surface tension)/radius
Lack of pulmonary surfactant in respiratory distress syndrome of the newborn results in:
high surface tension of alveolar liquid
The term used to describe surfactant produced outside of the patient's body is:
Surfactant is composed primarily of:
A major stimulant for secretion of surfactant into the alveolus is:
lung inflation
Which of the following are natural surfactant preparations? I. Surfaxin II. Curosurf III. Survanta IV. Infasurf
II, III and IV
Natural surfactant is obtained by all of the following methods except:
in vitro preparation
Which of the following are approved indications for surfactant therapy? I. Prophylaxis in very low birth weight (<1250 g) infants II. Prophylaxis in infants of higher birth weight (>1250 g) but with immature lungs III. Rescue treatment in infants with respiratory distress syndrome IV. Acute respiratory distress syndrome in the adult
I, II, and III only
Which of the following are currently used methods for delivering surfactant into infants? I. Instillation through side-port adapter II. Instillation through catheter III. Nebulization IV. ECMO
I and II only
You are in the room of a 36-week gestational baby that has just been born. The newborn weighs 2200 g. On assessment you find the baby has good color, no retractions, no nasal flaring, a respiratory rate (RR) of 25 breaths/min, a heart rate (HR) of 110 beats/min, and pulse-ox of 96% on room air. Which of the following would you choose?
No indication for drug therapy at this time
A newborn baby weighing 1000 g exhibits symptoms of respiratory distress syndrome (RDS), including poor color, suprasternal retractions, nasal flaring, and desaturation. The therapist should recommend:
Poractant alfa.
What is not considered a natural surfactant?
Dornase alfa.
Which of the following is considered the mode of action for surfactant?
To replace missing surfactant.
All the following are hazards or complications of exogenous surfactant except:
You are in the room of a 26-week gestational baby that has just been born. The newborn weighs 1200 g. On assessment you find the baby has poor color, substernal retractions, nasal flaring, a RR of 45 breaths/min, and a HR of 140 beats/min. You note that the baby is difficult to ventilate using an AMBO bag. Which of the following agents would you recommend?
A significant side effect of corticosteroid use is inhibition of:
HPA axis.
All of the following are types of corticosteroids produced in the adrenal cortex except:
corticotropin-releasing factor.
Which of the following are examples of steroids available for inhalation? I. Flunisolide II. Azmacort III. QVAR IV. Interleukin
I, II, and III only
The inflammatory process includes which of the following activities? I. Mediator cascade: Histamine and chemoattractant factors are released at the site of injury, and various inflammatory mediators such as complement and arachidonic acid products are generated. II. Increased vascular permeability: an exudate (any fluid that filters from the circulatory system into lesions or areas of inflammation) is formed in the surrounding tissues III. Leukocytic infiltration: white cells emigrate through capillary walls (diapedesis) in response to attractant chemicals (chemotaxis) IV. Phagocytosis: White cells and macrophages (in the lungs) ingest and process foreign material such as bacteria
I, II, III, and IV
The major cells responsible for an inflammatory response in asthma are:
mast cells and eosinophils.
The early phase of an asthmatic reaction occurs during what time frame?
15 minutes to 1 hour
The product combining an inhaled steroid and a bronchodilator is:
Side effects of infrequent aerosolized steroid use include all of the following except:
In chronic obstructive pulmonary disease (COPD), the primary inflammatory cells are:
In what dosage form is/are corticosteroids available for use in the United States?
Nebulizer solution
Which of the following is a very common side effect of inhaled corticosteroids?
Oral candidiasis: is an infection of yeast fungi of the genus Candida on the mucous membranes of the mouth.
A patient has been taking oral prednisone for 1 week following a severe episode of asthma. In order to switch to an aerosol corticosteroid:
begin the aerosol and begin to gradually taper off of the oral dose.
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.
Use of systemic corticosteroids can cause all of the following, except:
increased endogenous steroid production.
Your patient tells you that she is having chest tightness and wheezing four to six times per week, plus she wakes up with chest tightness and wheezing about once per week. She uses albuterol each time, with relief. She is taking no other medication, except her albuterol MDI. What other medication would you suggest be prescribed to her?
Beclomethasone MDI
Systemic administration side effects of corticosteroids include:
Fluid retention and changes in the integrity of the skin
Decreased activity of the immune system
all of them
Symbiocort is a combination of:
Budesonide and Formoterol
Steroid diabetes is term that describes:
Gluconeogenesis and increased plasma glucose levels
The rationale for giving an IV bolus of steroid in acute asthma that is not responding to beta adrenergics is:
glucocorticoids restore beta adrenergic response.
What is the clinical indication for use of leukotriene modifiers, such as montelukast, in asthma?
As an alternative to, or in combination with, inhaled steroids.
Local airway side effects of aerosolized pentamidine include which of the following? I. Wheezing II. Coughing III. Shortness of breath IV. Bad taste V. Spontaneous pneumothorax
I, II, III, IV, and V
Cromolyn sodium is available in all of the following forms except:
Tablet form
Systemic side effects of aerosolized pentamidine can include which of the following? I. Pancreatitis II. Conjunctivitis III. Neutropenia IV. Renal insufficiency V. Rash
I, II, III, IV, and V
The most commonly reported side effect of cromolyn sodium is:
nasal congestion.
Which of the following drugs is available in a DPI?
The aminoglycoside antibiotics are effective in treating:
gram-negative infections.
Which of the following microbial agents is used for treatment of pneumocystis caranii pnuemonia in AIDs patients?
When delivering aerosolized antibiotic medication to a patient which of the following are precautions that should be taken?
A) The patient should be monitored carefully for any adverse drug reaction
B) Care should be taken to prevent the aerosolized medication from entering the machine of a mechanically ventilated patient
C) The RT should be careful not to expose themselves to the medication exhaled out
D) An antibiotic should not be given in the same nebulizer as Mucomyst
After a patient begins using cromolyn sodium, how long may it take before clinical improvement in patient symptoms is seen?
2 to 4 weeks
The normal dose of ribavirin administration is:
20 mg/ml nebulized for 12 to 18 hours per day, for 3 to 7 days.
When treating an infant for RSV pneumonia, which of the following medications are used?
Aerosolized antibiotics should not be mixed in the same nebulizer preparation with which of the following drugs?
Tilade is effective as an antiinflammatory by inhibiting activation and activity of which of the following? I. Sensory neurons II. Mast cells III. Airway epithelial cells IV. Eosinophils
I, II, III, and IV
Ribavirin is classified as a(n):
Nedocromil sodium is administered by:
Pentamidine can be administered by which of the following routes? I. Inhaled aerosol II. Intramuscular injection III. Syrup IV. Tablet V. Intravenously
I, II, and V only
Relenza is a(n)
antiviral agent.
A drug that is used to prevent serious lower respiratory tract infections with RSV in children under 24 months of age is:
Tobramycin is a member of which antibiotic group?
Zileuton interacts with which of the following respiratory care drugs? I. Theophylline II. Albuterol III. Warfarin IV. Ipratropium bromide V. Beclomethasone
I and III only
The brand name for cromolyn sodium is:
Pentamidine is a(n):
antifungal agent.
Zafirlukast is a:
leukotriene receptor antagonist.
Which of the following pulmonary infections occurring in cystic fibrosis patients is often treated with aerosolized antibiotics?
Pseudomonas aeruginosa
Which type of aerosol device must be used for the delivery of Ribavirin to infants with RSV pneumonia?
Small particle aerosol generator
Which type of aerosol device must be used for the delivery of Ribavirin to infants with RSV pneumonia?
Small particle aerosol generator
Respiratory syncytial virus (RSV) can cause which of the following? I. Asthma II. Bronchiolitis III. Pneumothorax IV. Pneumonia V. Cystic fibrosis
II and IV only
Nonsteroidal antiasthma drugs are:
Zanamivir would be indicated for:
uncomplicated influenza.
What antimicrobial agent has been given orally in the treatment of Pneumocystis jirovecii?
Which type of asthma is associated with allergic reactions?
Advantages to the use of antileukotrienes include all of the following except:
effective in more than 90% of patients.
Which of the following is a monoclonal antibody used to treat asthma?
RSV-IGIV would be used to:
prevent RSV infections.
Leukotrienes exhibit which of the following effects? I. Increased mucus secretion. II. Inhibition of normal ciliary action. III. Increased airway edema.IV. BronchoconstrictionV. Recruitment of other inflammatory cells into airways
I, II, III, IV, and V
Ribavirin is active against which of the following? I. TB organisms II. Influenza virus III. RSV IV. Pneumocystis carinii organisms V. Herpes simplex virus
II, III, and V only
Inhalation of nebulized Tobramycin is associated with an increase in airway reactivity (bronchospasm). What would be the recommended method to avoid this problem?
pretreatment with an aerosolized beta agonist
41. Which of the following are antileukotrienes? I. Zafirlukast II. Zileuton III. Cromolyn sodium IV. Montelukast V. Nedocromil sodium
I, II, and IV only
The small particle aerosol generator (SPAG) unit operates on what principle?
Jet shearing
The general indication for clinical use of nonsteroidal antiasthma agents is:
prophylactic management of mild persistent asthma.
It has been suggested that Intal and Tilade are effective as antiinflammatory agents by blocking transport of what ion into inflammatory cells?
Pentamidine is administered by aerosol with which nebulizer?
Respirgard II
The disease that aerosolized antibiotics have been most consistently used for is:
cystic fibrosis.
The usual dose of nebulized cromolyn sodium is:
20 mg four times per day.
The only antileukotriene agent currently approved for use in pediatric patients is:
The approved dose of pentamidine by aerosol for prevention of Pneumocystis carinii pneumonia (PCP) is
300 mg, once every 4 weeks.
Cromolyn sodium is effective in preventing bronchospasm by:
inhibiting mast cell degranulation
Epinephrine stimulates which sites?
I. alpha
II. beta 1
III. beta2
IV. Cholinergic
I, II, and III only
Beta1 Receptor stimulation will:
increase heart rate and contractile force.
A heartbeat that did not originate from the SA node is called?
Ectopic beat
When stimulated, the sympathetic fibers cause an increase in the:
I. heart rate.
II. AV conduction.
III. cardiac contractility.
IV. excitability.
I, II, III and IV
Which of the following formulas is used to calculate the total amount of blood pumped by the heart per minute, or cardiac output?
rate x SV
Which of the following is the desired result from medication that is classified as an inotropic drug?
Increased strength of cardiac muscle contraction
What is a primary use for digitalis drugs?
Cardiotonic in congestive heart failure.
Which of the following drugs is indicated in cases of sinus bradycardia?
Atropine sulfate
You are treating a patient who has severe asthma. Which classification of drugs may pose some risk of bronchoconstriction and should be carefully utilized in patients with asthma and chronic obstructive pulmonary disease?
Non cardio-specific beta blockers
Which agent is a parasympatholytic used in cardiac resuscitation for asystole?
Cardiac glycosides would:
increase myocardial contractility.
Lidocaine is used to treat:
ventricular arrhythmias.
Atropine would be given to:
increase heart rate.
Which of the following is considered the mainstay for improving hypotensive episodes?
Which of the following is not considered an inotropic agent?
Your patient is suffering from heart failure secondary to decreased contractility and has a confirmed severe allergy to sulfites. Which of the following inotropic medications would you not recommend?
Your patient requires a dose of adenosine for confirmed SVT. At present his only line is a peripheral IV in the right arm. How should you proceed?
Both, hold the patient's right arm in an upright position and administer the dose quickly and follow with a saline flush.
The most important factor in the management of sudden cardiac death is:
timely/efficient CPR and defibrillation.
Your patient is a 67-year-old homeless male who suffers from malnutrition. His labs show that he suffers from hypomagnesemia. What arrhythmia should you be on the lookout for until a dose of magnesium can be administered?
Torsades de pointes
Which cardiac agent may be administered endotracheally?
All of them
Which of the following conditions are detected by the ECG? I. Abnormal heart rhythms II. Conduction problems III. Location of damaged heart muscle IV. Force of contraction
Which of the following medications would be used to prevent thrombus formation in the legs?
During a bronchoscopy with biopsy the patient starts to bleed. Which of the following would be injected down the bronchoscope to stop the bleeding?
A patient is in cardiac shock with a blood pressure of 70/30. Which of the following drugs would you recommend to help correct the hypotension?
Dopamine (Intropin)
A patient has increased systemic vascular resistance resulting in hypertension. Which of the following drugs would be used to treat this condition?
Nitroprusside (Nipride)
Which of the following would be used to treat a patient having a stroke or coronary artery occlusion to break up the clot?
Antithrombitic medication
In a hospitalized patient suffering from a pulmonary embolus, where would the most likely site of the original clot formation occur?
Deep veins of the legs (DVT)
What is not considered common complications of hypertension?
Decreased perfusion to vital organs
Which of the following is the drug of choice to treat frequent PVCs?
Which of the following is the drug of choice for hypotension in the ICU setting and can be used to increase renal perfusion, cardiac contractility and vasoconstriction depending on the dose?
Any substance that increases urine flow is termed a(n):
Your patient is suffering from cerebral edema. Which group of diuretic agents would you expect to be administered?
Osmotic diuretics
Benzodiazepines are used to:
Reduce anxiety
A drug is termed a hypnotic medication when it is used to:
Induce sleep
Morphine, codeine, Dilaudid, Demerol, and Darvon are all examples of:
Pain control by blocking transmission of the pain impulse from the damaged area is achieved through the use of:
local anesthetics
Which of the following is considered the antidote for opiate based analgesics such as morphine?
One major side effect of most non-depolarizing neuromuscular agents is that they cause the release of histamine, a potent bronchodilator. Which one has no histamine release and can be safely used as a muscle relaxant for asthmatics.
Vagolytic agents competitively block post synaptic ________receptors
Nicotinic and Muscarinic
Identify two drugs you could use prior to reversing the effect of non depolarizing vagolytic drugs like vecuronium, in order to minimize unwanted muscarinic side-effects like bradycardia, peristalsis and salivation.
Atropine and Glycopyrollate
Succinylcholine is a:
depolarizing neuromuscular relaxant
Succinylcholine is contraindicated for:
male children under 12.
Shock is:
a life threatening drop in blood pressure
Stimulant drugs are used to treat narcolepsy, ADHD, AOP or recreationally as when one drinks too much coffee to stay awake. How are these different from Narcan (Naloxone)used to counter drug overdose?
Narcan is an opiod receptor antagonist, the others are sympathomimetics.
Neuromuscular blocking agents cause muscle paralysis but...
but do not block the sensation of pain.