Question Answer
A nebulizer treatment delivers what kind of medication to the respiratory tract? DW Aersolized
racemic epinephrine as an aerosolized medication is known as what? (2 answers)MG Vaponefrin or Micronefrin
An aerosolized medication is a liquid medicine that is converted into a fine ______?DW mist
What is the most common used Beta 2 in the U.S. and comes in solution, MDI, or oral dosages?MG Albuterol
Levabuterol is also known as __________?DW Xopenex
Xopenex is twice as strong Albuterol, making it’s dosage _____ to ___________mg.MG .63-1.5mg
Pirbuterol, a SABA, is also known as________.DW MAXAIR
This is a pro drug, delivered in a non-active phase, also known as Tornalate. MG Bitolterol
Aerosol drug administration is also known as ____________ therapy. DW Inhalation
This drug is Beta 2 LABA specific used twice a day for maintenance of bronchospasms and it’s trade name is Serevent.MG Salmeterol
Formoterol, a LABA, and beta 2 specific is known as ___________ when used as a DPI and as a solution is known as Performist. DW Foradil
LABA, long acting beta adrenergic, are NOT for acute asthma or ___________.MG Bronchospasms
Aerosol administration of drugs is indicated in circumstances where rapid absorption and localization effects of the drug are required to produce the appropriate response. TRUE/FALSE DW TRUE
What is a preferred anti-cholinergic drug for bronchodilation?MG Ipatropium
Atrovent is a short acting parasympatholytic also known as.DW Ipatropium Bromide
Tiotropium is a long acting parasympatholytic known as Spiriva, this drug has a slow onset, but is only used once a day because why?MG It lasts 24 hours
Aerosol medication administration is used commonly in patients that have___________.DW Asthma
A side effect of aerosolized corticosteroids might include_______________________.MG fungal infection of the mouth
Chromolin Sodium, Intal, can be used for what?DW Excercise induced asthma
It is very important that when delivering a steroid via inhalation you have the patient to ___________ after medication has been delivered. MG rinse their mouth
Combivent is a combination of _______ and ___________ to prevent wheezing, difficulty breathing, chest tightness, and coughing in pts. with COPD. DW Albuterol and Ipratropium
If you have a patient with shortness of breath with bilateral wheezing with a diagnosis of asthma, what is the most appropriate aerosol treatment drug?MG Albuterol
Swallowing of an aerosolized medicine will (increase or decrease) the side effects of that medicine. DW Increase
What is the appropriate adult dosage of albuterol?MG 2.5mg
Question Answer
Rehydration of retained secreton can cause what hazard? sd Mucus pluging
Not changing out the water in the reservoir of a humidifing divce every 24 hours will cause this hazord…sd cross contamination
A patient reacts to aerosol therapy by coughing and having trouble catching his breath. What is going on in this patient’s lungs? sd Brochospasms
What hazord can develop as water evaporates from an aerosol therapy delevery system? sd drug reconscentration
True, False: Humidification of medical gas is needed when the flow is greater than 4L/min. sd True
True, False: humidification is indicated if the upper airway is by passed. sd True
what are two consequences of humidity deficity? sd Dried secretions and Atelectiasis
A possible cause of humidity deficity that aerosol therapy can correct is? sd a by passed airway
Name for a mesured amount of humidity that does NOT change with temprature? sd Absolute Humidity
what is the formula for relitve humidity? sd (Absolute Humidity/capcity)*100
what is the formula for humidity deficity? sd Body Humidity – Absolute Humidity
What is the potential humidity at body temprature (37*C)? sd 44 mg/L or 47 mmHg
Refers to molecular water in a gas. JC Humidity
What is the humidity of air when it reaches the carina? JC 100%
What is another name for a HME? JC Artificial Nose
A cause of humidity deficit. JC Mouth breathing
What is an aerosol? JC suspension of solid or liquid particles in a gas
A hazard of aerosol therapy. JC bronchospasm
Which uses a baffle: Atomizer or Nebulizer? JC Nebulizer
What has the smallest particle size? JC Ultrasonic Nebulizer
What uses piezoelectric crystals? JC Ultrasonic nebulizer
What is used to deliver pentamadine? JC Respiragard
Penetration JC Maximum depth that suspended particles can be carried in the tracheobronchial tree
What heats and humidifies inspired air? JC Turbinates
Question Answer
Aerosol suspension of solid or liquid particles in gas
Goals of aerosol *drugs delivered directly to site of action * Therapeutic action with minimal side effects * Greater efficacy and safety
MDI Metered dose inhaler
DPI Dry powder inhaler
SVN Small volume nebulizer
USN ultrasonic nebulizer
hand-bulb atomizer nose spray
vibrating mesh nebulizer like the USN ultrasonic nebulizer
Jet Nebulizer gas powered directed through a restricted orifice (the jet) – incorporates baffles to decrease the number of large aerosol particles
Peak flow a small, hand held device used to monitor a person’s ability to breath OUT
Spacer simple valueless extension
Chamber incorporates a valve resulting in higher resirable drug dosage (will have musical note if you breath to fast)
LVN Large volume nebulizer
SPAG Small particle aerosol generator
instability tendancy for particles to be removed from suspension
penetration refers to the maximum depth that suspended particles can be carried into the pulmonary tree by inhaled tidal air
deposition result of an aerosol’s eventual instability; particles “fall out” on a nearby surface
Retention proportion of particles deposited within the respiratory tract
clearance removal, the fact that some particles are exhaled
coalescene two particles form one larger particle
nebulizer a device that generates aerosol of uniform size
gravity large particles are deposited before smaller particles
physical nature of particle some particles absorb water, become large and rain-out, while others evaporate, become smaller and are conducted further into respiratory tree.
Hygroscopic particles tend to absorb water from the resp tract, and become larger and rain out
Hypertonic particles add water, increase size, and decrease deposition to smaller airways
hypotonic particles lose water and increase deposition to small airways
isotonic solutions will remain fairly stable in size until they are deposited
For maximal deposition slow deep breath, inhale through an open mouth, end inspiration, pause, follow with a slow, complete exhaustion
Question Answer
Proventil or Ventolin SVN/2.5mg, MDI/2 puffs Albuterol Sulfate
Xopenex SVN/0.63mg or 1.25mg tid Levalbuterol
Serevent MDI/2 puffs bid Salmeterol xinafoate
Isuprel Stimulates the heart – Rarely used for inhalation Isoproterenol
Foradil DPI/12 mcg bid Formoterol
Tornalate SVN/1.25mg MDI/2 puffs bid-qid Bitolterol
Not FDA approved for inhalation Atropine
Atrovent SVN/0.50mg MDI/2 puffs qid Ipratropium bromide
Spiriva DPI/ 18 mcg qd Tiotropium bromide
Adrenaline SVN/as ordered qid Primatene mist MDI/prn, 0.2mg/puff Epinephrine
Vaponephrine or S2 SVN/as ordered Racemic epinephrine
Rx was replaced by Tilade Intal
Tilade MDI/2 puffs qid Nedocromil sodium
Mucomyst 2-4ml of 10% or 20% solution Given with a bronchodilator Used as diluent/solvent Acetylcysteine
TOBI SVN, Use separate nebulizer, pre-suction if needed, avoid post-suction Tobramycin
Colistin Pre-suction if needed, avoid post-suction Colomycin
Vancocin Pre-suction if needed; avoid post-suction Used to increase MRSA Vancomycin
Virazole 2% (20mg/ml solution by SPAG-2 device Ribavirin
Aero-Bid MDI/2 puffs bid Flunisolide
Flovent MDI 2 Puffs DPI bid Fluticasone propionate
Pulmacort SVN 0.25 or 0.50mg/2ml Budesonide
Advair DPI bid Fluticasone propionate and salmeterol
Combivent MDI 2 puffs qid Ipratropium bromide and albuterol
DuoNeb SVN Ipratropium bromide 0.50mg and albuterol 3mg Ipratropium bromide and albuterol
Belcovent/Vanceril Belcomethasone Corticosteroid
Azmacort Triamcinalone Corticosteroid
Symbicort Combo – Pulmacort (Budesonide) & Foradil (Formoterol) Long acting B2 (MDI)
HPA-axis endogeneous corticosteroid production regulator HPA = Hypothalamus – Pituitary – Adrenal
Nebupent Pentamidine Antimicrobial given via respiraguard nebulizer system
Virazole Ribavirin Antimicrobial given via SPAG-2 device
Relenza Zanamivir; Antimicrobial given via DPI Tx influenza
Nondepolarizing agents Skeletal muscle paralysis occurs, but no neurological effect: Must be given with a sedative.
Curare Tubocurarine; Nondepolarizing agent; Reversible with Tensilon (Edrophonium)
Pavulon Pancuronium; Nondepolarizing agent; Reversible with Tensilon (Edrophonium)
Norcuron Norcuronium; Nondepolarizing agent; Reversible with Tensilon (Edrophonium)
Depolarizing Agents Maintain muscle tissue in a refractory state after depolarization; Indicated for short-term neuromusucular relaxation (5 mins for intubation).
Brovana Arformoterol; Long acting B2; Competes commercially w/ Serevent
Used as pallitive tx to reduce dyspnea; and as analgesic Fentanyl; Opiod (narcotic), analgesic
Lasix Furosemide; Diuretic; Used only at certain hopitals; to reduce dyspnea.
Exubera A form of insulin
Anti-leukotrienes None available in MDI