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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


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