1. A client has a prescription to take guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action?
    1. Take an extra dose if fever develops.
    2. Take the medication with meals only.
    3. Take the tablet with a full glass of water.
    4. Decrease the amount of daily fluid intake.
    3. Take the tablet with a full glass of water.
  2. The nurse is preparing to administer a dose of naloxone hydrochloride intravenously to a client with an intravenous opioid overdose. Which supportive medical equipment should the nurse plan to have at the client’s bedside if needed?
    1. Nasogastric tube
    2. Paracentesis tray
    3. Resuscitation equipment
    4. Central line insertion tray
    3. Resuscitation equipment
  3. The nurse teaches a client about the effects of diphenhydramine (Benadryl), which has been prescribed as a cough suppressant. The nurse determines that the client needs further instruction if the client makes which statement?
    1. “I will take the medication on an empty stomach.”
    2. “I won’t drink alcohol while taking this medication.”
    3. “I will use sugarless gum, candy, or oral rinses to decrease dryness in my mouth.”
    4. “I won’t do activities that require mental alertness while taking this medication.”
    1. “I will take the medication on an empty stomach.”
  4. A cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the side and adverse effects of this medication and should tell the client that which undesirable effect is associated with this medication?
    1. Insomnia
    2. Constipation
    3. Hypotension
    4. Bronchospasm
    4. Bronchospasm
  5. Terbutaline is prescribed for a client with bronchitis. The nurse understands that this medication should be used with caution if which medical condition is present in the client?
    1. Osteoarthritis
    2. Hypothyroidism
    3. Diabetes mellitus
    4. Polycystic disease
    3. Diabetes mellitus
  6. Zafirlukast (Accolate) is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication?
    1. Platelet count
    2. Neutrophil count
    3. Liver function tests
    4. Complete blood count
    3. Liver function tests
  7. A client has been taking isoniazid for 1½ months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem?
    1. Hypercalcemia
    2. Peripheral neuritis
    3. Small blood vessel spasm
    4. Impaired peripheral circulation
    2. Peripheral neuritis
  8. A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action?
    1. Use alcohol in small amounts only.
    2. Report yellow eyes or skin immediately.
    3. Increase intake of Swiss or aged cheeses.
    4. Avoid vitamin supplements during therapy.
    2. Report yellow eyes or skin immediately.
  9. A client has been started on long-term therapy with rifampin (Rifadin). The nurse should provide which information to the client about the medication?
    1. Should always be taken with food or antacids
    2. Should be double-dosed if one dose is forgotten
    3. Causes orange discoloration of sweat, tears, urine, and feces
    4. May be discontinued independently if symptoms are gone in 3 months
    3. Causes orange discoloration of sweat, tears, urine, and feces
  10. The nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states he or she will immediately report which finding?
    1. Impaired sense of hearing
    2. Gastrointestinal side effects
    3. Orange-red discoloration of body secretions
    4. Difficulty in discriminating the color red from green
    4. Difficulty in discriminating the color red from green
  11. A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed?
    1. Electrolyte levels
    2. Coagulation times
    3. Liver enzyme levels
    4. Serum creatinine level
    3. Liver enzyme levels
  12. The nurse has a prescription to give a client salmeterol (Serevent Diskus), two puffs, and beclomethasone dipropionate (Qvar), two puffs, by metered-dose inhaler. The nurse should administer the medication using which procedure?
    1. Beclomethasone first and then the salmeterol
    2. Salmeterol first and then the beclomethasone
    3. Alternating a single puff of each, beginning with the salmeterol
    4. Alternating a single puff of each, beginning with the beclomethasone
    2. Salmeterol first and then the beclomethasone
  13. Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side/adverse effects of the medication should the nurse monitor? Select all that apply.
    1. Signs of hepatitis
    2. Flulike syndrome
    3. Low neutrophil count
    4. Vitamin B6 deficiency
    5. Ocular pain or blurred vision
    6. Tingling and numbness of the fingers
    • 1. Signs of hepatitis
    • 2. Flulike syndrome
    • 3. Low neutrophil count
    • 5. Ocular pain or blurred vision
  14. A client has begun therapy with theophylline (Theo-24). The nurse should plan to teach the client to limit the intake of which items while taking this medication?
    1. Coffee, cola, and chocolate
    2. Oysters, lobster, and shrimp
    3. Melons, oranges, and pineapple
    4. Cottage cheese, cream cheese, and dairy creamers
    1. Coffee, cola, and chocolate
  15. The nurse has just administered the first dose of omalizumab (Xolair) to a client. Which statement by the client would alert the nurse that the client may be experiencing a life-threatening effect?
    1. “I have a severe headache.”
    2. “My feet are quite swollen.”
    3. “I am nauseated and may vomit.”
    4. “My lips and tongue are swollen.”
    4. “My lips and tongue are swollen.”
  16. The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions?
    1. “I must take the medication exactly as prescribed.”
    2. “Once I start the medication, I will no longer be contagious.”
    3. “I will not get any colds or infections while taking this medication.”
    4. “This medication has minimal side effects and I can return to normal activities.”
    1. “I must take the medication exactly as prescribed.”
  17. The nurse is administering a dose of pirbuterol (Maxair Autohaler) to a client. The nurse should monitor for which side/adverse effect of this medication?
    1. Drowsiness
    2. Hypokalemia
    3. Hyperglycemia
    4. Increased pulse and blood pressure
    4. Increased pulse and blood pressure
  18. Ribavirin (Virazole) is prescribed for a hospitalized child with respiratory syncytial virus (RSV). The nurse prepares to administer this medication via which route?
    1. Oral
    2. Oxygen tent
    3. Intramuscular
    4. Subcutaneous
    2. Oxygen tent
  19. Isoniazid is prescribed for a child with human immunodeficiency virus infection who has a positive Mantoux tuberculin skin test result. The mother of the child asks the nurse how long the child will need to take the medication. For how long should the nurse tell the mother the medication will need to be taken?
    1. 4 months
    2. 6 months
    3. 9 months
    4. 12 months
    4. 12 months
  20. A client with an exacerbation of chronic obstructive pulmonary disease has been on oral glucocorticoids and is currently being weaned to triamcinolone (Azmacort) by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states the need to report which signs and symptoms?
    1. Chills, fever, and generalized rash
    2. Vomiting, diarrhea, and increased thirst
    3. Blurred vision, headache, and insomnia
    4. Anorexia, nausea, weakness, and fatigue
    4. Anorexia, nausea, weakness, and fatigue
  21. A client diagnosed with active tuberculosis has been prescribed a combination of isoniazid and rifampin (Rifadin) for treatment. The nurse teaches the client to perform which action?
    1. Report any change in urine color.
    2. Take both medications with food.
    3. Take both medications together once a day.
    4. Expect to take the medication for 2 to 3 weeks.
    3. Take both medications together once a day.
  22. A client with tuberculosis receiving cycloserine (Seromycin Pulvules) orally twice daily must have blood drawn in 1 week to measure the serum concentration of the medication. The nurse prepares the client for this test by providing which information to the client?
    1. Withhold the morning dose on the day of the scheduled blood test.
    2. Take the morning dose and have the blood drawn 2 hours after taking the dose.
    3. Withhold the evening dose before the test and the dose scheduled for the morning of the test.
    4. Double the dose the evening before the test and withhold the morning dose on the day of the test.
    2. Take the morning dose and have the blood drawn 2 hours after taking the dose.
  23. A client with a documented exposure to tuberculosis is being started on medication therapy with isoniazid. The nurse plans to set up appointments for the client to have which laboratory study done periodically during the course of therapy?
    1. Platelet count
    2. Liver function testing
    3. Serum creatinine determination
    4. Blood urea nitrogen determination
    2. Liver function testing
  24. A client has begun a course of therapy with rifampin (Rifadin). The home care nurse instructs the client to perform which action while taking this medication?
    1. Avoid wearing contact lenses.
    2. Always take the medication with food or antacids.
    3. Double the next medication dose if one is forgotten.
    4. Stop the medication if symptoms disappear in 2 months.
    1. Avoid wearing contact lenses.
  25. A client is taking a prescribed course of therapy with ethambutol (Myambutol). The home health nurse assesses the client at each home visit for which adverse effect of this medication?
    1. Orange urine
    2. Visual disturbances
    3. Hearing disturbances
    4. Gastrointestinal (GI) upset
    2. Visual disturbances
  26. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline (Theo-24). The nurse monitors the serum theophylline level and concludes that the medication dosage may need to be increased if which value is noted?
    1. 5 mg/mL
    2. 10 mg/mL
    3. 15 mg/mL
    4. 20 mg/mL
    1. 5 mg/mL
  27. The nurse is administering a dose of morphine sulfate to a client via an epidural catheter after nephrectomy. Before administering the medication, what should the nurse plan to do?
    1. Place the head of the bed flat.
    2. Ensure that naloxone is readily available.
    3. Flush the catheter with 6 mL of sterile water.
    4. Aspirate with a syringe to ensure presence of a cerebrospinal fluid (CSF) return.
    2. Ensure that naloxone is readily available.
  28. A client has been given a prescription for benzonatate (Tessalon). Which observation should the nurse look for to evaluate the effectiveness of the medication?
    1. Increasing the client’s comfort level
    2. Decreasing the client’s anxiety level
    3. Calming the client’s persistent cough
    4. Eliminating the client’s nausea and vomiting
    3. Calming the client’s persistent cough
  29. A client has begun using a methylxanthine bronchodilator. What beverage should the nurse plan to teach the client to avoid while taking this medication?
    1. Coffee
    2. Orange juice
    3. Mineral water
    4. Cranberry juice
    1. Coffee
  30. A client taking albuterol (ProAir HFA) by inhalation cannot cough up secretions. What should the nurse suggest that the client do to assist in expectoration of secretions?
    1. Get more exercise each day.
    2. Use a dehumidifier in the home.
    3. Drink increased amounts of fluids every day.
    4. Take an extra dose of albuterol before bedtime.
    3. Drink increased amounts of fluids every day.
  31. A client who has been receiving theophylline by the intravenous (IV) route has the medication prescription changed to an immediate-release oral form of the medication. After discontinuing the IV medication, when should the nurse schedule the first dose of the oral medication?
    1. Just after the next meal
    2. Just before the next meal
    3. 4 hours after discontinuing the IV form
    4. Immediately on discontinuing the IV form
    3. 4 hours after discontinuing the IV form
  32. A client has been taking pyrazinamide (Pyrazinamide) for 6 months. The nurse determines that the medication is effective if which cultures yield a negative result?
    1. Urine
    2. Blood
    3. Wound
    4. Sputum
    4. Sputum
  33. A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. What statement by the client indicates the need for further education regarding his prescription?
    1. “I will take the daily dose at bedtime.”
    2. “I need to drink at least 2 liters of fluid per day.”
    3. “I know to avoid changing brands of the medication without my health care provider’s approval.”
    4. “I’ll avoid over-the-counter cough and cold medications unless approved by my health care provider (HCP).”
    1. “I will take the daily dose at bedtime.”
  34. A client with tuberculosis (TB) has a prescription for rifampin (Rifadin). What instruction should the nurse include in the client’s teaching plan?
    1. Yellow-colored skin is common with this medication.
    2. The medication must always be taken on an empty stomach.
    3. Wearing glasses instead of soft contact lenses will be necessary.
    4. As soon as the cultures come back negative, the medication may be stopped.
    3. Wearing glasses instead of soft contact lenses will be necessary.
  35. Cromolyn sodium is prescribed for the client with allergic asthma. The nurse should plan care understanding that which is an action of this medication?
    1. Dilate the bronchi.
    2. Increase the number of eosinophils.
    3. Promote the migration of eosinophils into the inflammatory site.
    4. Inhibit the release of mediators from mast cells after exposure to an antigen.
    4. Inhibit the release of mediators from mast cells after exposure to an antigen.
  36. A client has been taking pyrazinamide for 1 month. The client asks the nurse whether the therapy is due to be terminated soon. The nurse determines that the medication probably will be continued based on a positive finding in which report?
    1. Blood culture
    2. Urine culture
    3. Wound culture
    4. Sputum culture
    4. Sputum culture
  37. A client has a prescription to take guaifenesin (Mucinex). The nurse should conclude that the client understands the most effective use of this medication if the client states that they need to take which action?
    1. Watch for irritability as a side effect.
    2. Take the tablet with a full glass of water.
    3. Take an extra dose if the cough is accompanied by fever.
    4. Crush the sustained-release tablet if immediate relief is needed.
    2. Take the tablet with a full glass of water.
  38. A nurse is preparing to administer albuterol (Proventil HFA) to a client. Which parameters should the nurse assess before and during therapy?
    1. Nausea and vomiting
    2. Headache and level of consciousness
    3. Lung sounds and presence of dyspnea
    4. Urine output and blood urea nitrogen level
    3. Lung sounds and presence of dyspnea
  39. A home care nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse understands that this is the result of which occurrence?
    1. Insufficient dosage of the medication, which needs to be increased
    2. Probable interaction of this medication with an over-the-counter cold remedy
    3. Tolerance to the medication, indicating a need for a stronger type of bronchodilator
    4. Paradoxical bronchospasm, which must be reported to the health care provider (HCP)
    4. Paradoxical bronchospasm, which must be reported to the health care provider (HCP)
  40. A client receiving oral theophylline is due to have a theophylline level drawn. The nurse should question the client to ensure that the client has not ingested which substance before the blood sample is drawn?
    1. Coffee
    2. Oatmeal
    3. Ginger ale
    4. Bagel with cream cheese
    1. Coffee
  41. A nurse has administered a dose of salmeterol (Serevent Diskus) to a client. The client develops a generalized rash and urticaria, and the eyelids begin to swell. Which action should the nurse take?
    1. Apply a lanolin-based cream to the rash.
    2. Encourage the client to drink fluids quickly.
    3. Assess the client’s vision with a Snellen chart.
    4. Call the health care provider (HCP) immediately.
    4. Call the health care provider (HCP) immediately.
  42. A client taking rifampin (Rifadin) reports, “My urine has blood in it.” When the nurse assesses the urine, it is brown. Which is the nurse’s best action?
    1. Notify the health care provider.
    2. Chart the finding as a normal response to the rifampin.
    3. Get the client into bed, and put the bed in Trendelenburg’s position.
    4. Immediately start prescribed intravenous (IV) fluids to prevent shock.
    2. Chart the finding as a normal response to the rifampin.
  43. A clinic nurse is assessing a client who has been on isoniazid for 6 months. Which client complaint should most concern the nurse?
    1. Dry mouth
    2. Cramping diarrhea
    3. Frequent headaches
    4. Difficulty tying shoes
    4. Difficulty tying shoes
  44. The client questions the nurse as to why the health care provider switched the usual prescription from a metered-dose inhaler (MDI) to a dry powder inhaler (DPI). The nurse should respond correctly by providing which fact? Select all that apply.
    1. Dry powder inhalers have fewer side effects.
    2. Dry power inhalers pose no environmental risks.
    3. Dry powder inhalers deliver more medication to the lungs.
    4. Dry power inhalers can be administered more frequently.
    5. Dry powder inhalers require less hand-to-lung coordination.
    • 2. Dry power inhalers pose no environmental risks.
    • 3. Dry powder inhalers deliver more medication to the lungs.
    • 5. Dry powder inhalers require less hand-to-lung coordination.
  45. Which of the following statements by a client taking montelukast (Singulair) should indicate the need for further teaching?
    1. “I will need to have my liver function checked.”
    2. “I can take the medication with food or without.”
    3. “I may be able to decrease the use of my metered-dose inhaler.”
    4. “I will take the medication when I first notice I am having trouble breathing.”
    4. “I will take the medication when I first notice I am having trouble breathing.”
  46. When evaluating an asthmatic client’s knowledge of self-care, the nurse recognizes that additional instruction is needed when the client makes which statement?
    1. “I use my corticosteroid inhaler each time I feel short of breath.”
    2. “I see my doctor if I have an upper respiratory infection and always get a flu shot.”
    3. “I use my bronchodilator inhaler before walking so I don’t become short of breath.”
    4. “I use my bronchodilator inhaler before I visit places like the zoo because of my allergies.”
    1. “I use my corticosteroid inhaler each time I feel short of breath.”
  47. Which is the expected duration for the pharmacological management of latent tuberculosis (TB)?
    1. 10 days
    2. 14 days
    3. 1 month
    4. 9 months
    4. 9 months
  48. Which is the nurse’s priority assessment for monitoring the client taking isoniazid?
    1. Electrolytes
    2. Liver function tests
    3. Arterial blood gases (ABGs)
    4. White blood cell (WBC) counts
    2. Liver function tests
  49. The nurse would expect the health care provider (HCP) to add which medication to the regimen of the client receiving isoniazid?
    1. Niacin
    2. Neurontin
    3. Pyridoxine (vitamin B6)
    4. Cyanocobalamin (vitamin B12)
    3. Pyridoxine (vitamin B6)
  50. A postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, she may develop which complaint?
    1. Bradycardia
    2. Decrease in sensation
    3. Sudden onset of itching
    4. Increase in her pain level
    4. Increase in her pain level
  51. The nurse should monitor the client receiving the first dose of albuterol (Proventil HFA) for which side effect of this medication?
    1. Drowsiness
    2. Tachycardia
    3. Hyperkalemia
    4. Hyperglycemia
    2. Tachycardia
  52. The client has a prescription to receive pirbuterol (Maxair Autoinhaler) two puffs and beclomethasone dipropionate (Beclovent) two puffs by metered-dose inhaler. The nurse plans to give these medications in which way to ensure effectiveness?
    1. Administering the pirbuterol before the beclomethasone
    2. Alternating a single puff of each hourly, beginning with the beclomethasone
    3. Alternating a single puff of beclomethasone with pirbuterol; repeat the steps
    4. Administering the pirbuterol; wait 30 minutes and administer the beclomethasone
    1. Administering the pirbuterol before the beclomethasone
  53. A client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone (Azmacort) by inhalation. The nurse plans to monitor the client for which signs/symptoms during the change?
    1. Chills, fever, generalized rash
    2. Vomiting and diarrhea, increased thirst
    3. Blurred vision, headache, and insomnia
    4. Anorexia, nausea, weakness, and fatigue
    4. Anorexia, nausea, weakness, and fatigue
  54. A client taking theophylline has a serum theophylline level of 15 mcg/mL. How does the nurse interpret this laboratory value?
    1. Below therapeutic range
    2. In excess of the therapeutic range
    3. Near the top of the therapeutic range
    4. In the middle of the therapeutic range
    4. In the middle of the therapeutic range
  55. A client is taking cetirizine (Zyrtec). The nurse should inform the client of which side effect of this medication?
    1. Diarrhea
    2. Excitability
    3. Drowsiness
    4. Excess salivation
    3. Drowsiness
  56. A client is scheduled to receive acetylcysteine (Mucomyst) 20% solution diluted in 0.9% normal saline by nebulizer. Which outcome would the nurse expect to see as a result of the administration of this medication?
    1. Bronchodilation
    2. Decreased coughing
    3. Absence of wheezing
    4. Thinning of respiratory secretions
    4. Thinning of respiratory secretions
  57. The health care provider (HCP) prescribes cromolyn (Intal) for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will produce which effect?
    1. Promote bronchodilation.
    2. Decrease the risk of infection.
    3. Suppress an allergic response.
    4. Eliminate the need for a rescue inhaler.
    3. Suppress an allergic response.
  58. A nurse is teaching a client about the effects of diphenhydramine (Benadryl), an ingredient in the cough suppressant prescribed for the client. The nurse should plan to tell the client to take which measure while taking this medication?
    1. Take it on an empty stomach.
    2. Avoid activities requiring mental alertness.
    3. Use alcohol for additional effect in reducing cough.
    4. Avoid chewing sugarless gum or using oral rinses mouth.
    2. Avoid activities requiring mental alertness.
  59. The health care provider (HCP) has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse should teach the client to monitor for which side effect of the medication?
    1. Constipation
    2. Painful coughing
    3. Increased urination
    4. Difficulty swallowing
    1. Constipation
  60. A client has begun therapy with oxtriphylline (Choledyl). The nurse determines that the client understands dietary alterations if the client states to limit which items while taking this medication? Select all that apply.
    1. Milk
    2. Coffee
    3. Oysters
    4. Oranges
    5. Pineapple
    6. Chocolate
    • 2. Coffee
    • 6. Chocolate
  61. Which supplies should the nurse obtain for the administration of ribavirin (Virazole) to a hospitalized child with respiratory syncytial virus (RSV)?
    1. A mask and pair of goggles
    2. Isolation gown and sterile gloves
    3. An intravenous (IV) pole and hood
    4. Intramuscular (IM) syringe and needle
    1. A mask and pair of goggles


    Question Answer
    What are the three phrases of drug action and what happens in each smal gropu of healthy volunteers-onset of drug action elimination side effects, treatment in small group with disease- 100-300 is drug safe, large multicenter studies 1000-3000 is drug better than regular treatment control group receives regular treatment
    when was the original food and drug act passed? 1906 USP and NF were given official status
    When was the current food and drug act passed? 1938 food drug and cosmetic act becomes law, it protects the public
    What is the FDA’s role in sale and control of drug use power to approve or deny new drug applications and ensure compliance via inspections
    define Affinity cell recipient
    define efficacy how well a drug produces its desired effect
    define agonist drug that binds to a specific receptor broducing a stimulatory response
    define antagonist drug that prevents an agonist from binding to its specific receptor
    define receptor site The site either on a cell surface or inside cell that binds with a specific substance or drug
    define potency amount of a drug that must be given in order to produce a particular response
    define half life major determining factor of the length of a drugs action in the body
    define anaphylactic shock severe sudden allergic reaction that may be life-threatening
    what is informed consent  
    list different receptor types commonly acted upon by RC drugs lipid soluble (Corticosteroids), transmembrane receptor (Albuterol)
    be able to tell how G protein receptors work start effector system, produces second messenger that causese cell response
    what is a side effect effects that were not necessarily intended
    what is the advantage of the aerosol route of drug administration deliver medication to the immediate site of action with few systemic adverse effects
    what things affect deposition of aerosol drugs in the lung  
    give causes of medication errors manufacturing errors ,prescribing errors, administration errors
    list rights of drug adminstration right patient, right drug, right dose, right route, right time, right technique, right documentation
    what do you chart after nebulizer therapy  
    review generic and trade names of adrenergic drugs  
    review different routes of drug admnistration enteral via gi tract, sublingual, buccal, Parenteral injection, topical, transdermal, inhalation, nasal, rectal, vaginal, eyes, ears
    review different names drug goes through during approval chemical name-unique one of a kind often complicated and lengthy, generic name- less complicated there is only one generic name for each drug, trade name- created by a namufacturer to establish a product name that belongs to them
    define pharmacology study of drugs including their origin properties and interactions with living organisms
    define respiratory care pharmacology application of pharmacology to the treament of cardiopulmonary disease
    what does MAR stand for Medication administration records
    define therapeutic classification of drugs What condition the drug is used to treat
    define pharmacological classification of drugs how the drug works in the body’s systems, tiessues, and molecues
    what is an aerosol liquid or fine powder that is sprayed in a fine mist
    what are the three common delivery devices for aerosol drug administration nebulizers, dry powder inhalers (DPI’s), Metered dose inhalers (MDI’s)
    what is the most common source of therapeutic drugs today  
    what factors affect drug action weight, age, sex, race
    which receptors are found in the sympathetic nervous system and what do they do when stimulated  
    which receptors are found in the parasympathetic nervous system and what do they do when stimulated nicotinic, muscarinic
    define adrenergic bronchodilators  
    define anticholinergic bronchodilators  
    list anticholinergic bronchodilators  
    give anticholinergic bronchodilators side effects  
    give anicholinergic bronchodilators clinical use  
    list adrenergic bronchodilators  
    give adrenergic bronchodilators side effects  
    give adrenergic bronchodilators clinical uses  
    list adrenergic bronchodilators  
    give antiadrenergic bronchodilators side effects  
    give antiadrenergic bronchodilators clinical uses  
    what is the dosage for giving albuterol in a continuous nebulizer  
    how do we asses effectiveness of beta 2 bronchodilators  
    how are peak flow meters used  
    how do we get percentage of predicted for peak flow readings  
    how are green, yellow and red zones determined for peak flow readings  
    how do you find a patients personal best peak flow reading  
    what distributes drugs throughout the body bloodstream
    what organ metabolizes drugs liver
    what organ eliminates drugs from the body kidney
    what will happen to drug elimination of drugs if a patient has liver or kidney disease  
    define tolerance the development of resistance to a drugs effects to the degree that does must be raised continually to acheive the desired response
Question Answer
When was Albuterol introduced? 1980’s
What is the generic name for Alupent? Metaproterenol
What’s the diff between a sympathomimetic bronchodilator (B- agonist) and an adrenergic bronchodilator? Sympathomimetic bronchodilators are derived from epinephrine.
What are other names for Albuterol? Proventil, Ventolin, ProAir
What is the normal dose of Albuterol via SVN? 0.5ml (2.5mg) via SVN
What is the onset of Albuterol? 15 min
What is the Normal dose of Levalbuterol? 2 puffs of 90mcg/puff Q4-6 hr. MDI
What is the other name for Levalbuterol? Xopenex
What are advantages of levalbuterol? No increased HR, no jitters
Name 2 long acting bronchodilators? Samlmeterol & formoterol
What is the duration of long acting bronchodilators? 12 hrs.
What is the Normal dose for foradil DPI? 12 mcg/blister DPI BID
What is the Normal dose for Albuterol MDI? 2 puffs of 90 mcg/puff MDI
What is the Normal dose of Xopenex MDI? 2 puffs of 90mcg/puff Q4-6 hrs
Adrenergic bronchodilators attach to receptors via what? a, B1, B2 receptor stimulation
What is the Normal dose of Atrovent SVN? 0.5mg solution via SVN TID or QID
What is the normal dose of 1 puff Atrovent MDI? 18mcg/puff MDI QID
what is combevent? Combination MDI product
what is the onset time for combivent? 15 min
what is Duo neb? combination product SVN
what is the onset time for DuoNeb? 30 min
what is another name for Atrovent? Ipatropium bromide
what is another name for Spiriva? Tiotropium bromide
what is the duration of Spiriva? 24 hours
what is the onset time for Spiriva? 30 min
what is the normal dose of Spiriva? 18 mcg/inhalation Qday DPI
what is the mode of action for Anticholinergic agents? blocks the action of acetylcholine
what are the indication for Adrenergic bronchodilators? reversible airflow obstruction
what are the short acting bronchodilators? albuterol levalbuterol pirbuterol
what are the Racemic Epinephrine bronchodilators? vaponephrine
what is the duration of albuterol? 5-8 hrs
normal dose for salmeterol? 25 mcg/puff MDI 50 mcg/ blister DPI bothe given BID
what is the on set time for salmeterol? 20 min
what is the duration of salmeterol? 12 hrs or longer
what are othe names for salmeterol? serevent advair
what are other names for Formoterol? Foradil Perforomist symbicort
what si another name for Arformoterol? Brovana
what is the normal dose for Brovana? 15 mcg via SVN BID
what is another name for Maxair? Pirbuterol
what is the normal dose for Maxair? 2 puffs Q4-6 hrs 200 mcg/puff MDI
what is the onset time for maxair? 5 min
what is the duration for Maxair? 5 hrs


QUESTION ANSWER
What are the two(2) CYCLIC NUCLEOTIDES that interact within BRONCHIAL SMOOTH MUSCLE CELLS? cAMP (adenyl cyclase) & cGMP (guanyl cyclase)
What is cAMP and cGMP net physiologic effect on Bronchial Smooth Muscle? cAMP-B2 andrenergic recepror sites are stimulated, uses Mg2+ to convert ATP to cAMP to result in Bronchodilation.cGMP – A-andrenergic receptors stimulated , coverts guanosine triphosphate (GTP) to cyclic GMP
What does the A-andrenergic blockade drugs do? Influences the biochemical event of preventing guanyl cyclase activation which PREVENTS bronchoconstriction
What does B2-andrenergic stimulation drugs do? influences the biochemical event of adenyl cyclase activation causing brochodilation
What is the purpose of a Phosphodiestrase inhibition medications? influences the biochemical event prevents dehydration of cyclic AMP to 5-AMP, thus keeping it active longer which PREVENTS the chance of bronchoconstriction.
Whis is the main use of cholinerginergic stimulation medications? influences the biochemical event guanyl cyclase activation resulting in bronchoconstriction.
Describe the significance of antigen-antibody reactions on the surface of the mast cell? When exsposure of an appropriate antigen occurs (2 IgE molecules) of the same specificity, the antibody reaction triggers the biochemical sequence that leads to mast cell degranulation.
ALBUTEROL( Ventolin,Proventil) B2 stimulation; adenyl cyclase activation, increase in cyclic AMP
BITOLTEROL(Tornalate) B2 stimulation; adenyl cyclase activation, increase in cyclic AMP
PIRBUTEROL(Maxair) B2 stimlation; adenyl cyclase activation, increase cyclic AMP
TERBUTALINE(Brenthine,Brieanyl) B2 stimulation; adenyl cyclase activation, increase in cyclic AMP
EPINEPHRINE(Adrenaline) B2 stimulation(cardiac);adenyl cyclase activation, increase in cyclic AMP
IPRATROPIUM BROMIDE(Atrovent) Cholinergic Blockade;prevents guanyl cyclase activation,decrease cGMP
OXYTOPIUM BROMIDE(Spiriva) cholinergic blockade; prevents guanyl cyclase activation,decreses in cGMP
PHENTOLAMINE A-BLOCKADE(CARDIAC); PREVENTS guanyl cyclase, Deacrease cGMP
TOLAZOLINE(priscoline) A-BLOCKADE;PREVENTS guanyl cyclase, decrease cGMP
ZAFIRLUKAST(Accolate) LEUKOTRIENE MODIFIER;ANTI-INFLAMMATION,BRONCHODILATION
MONTELUKAST(Singulair) LEUKOTRIENE MODIFIER; ANTI-INFLAMMATION, BRONCHODILATION
ZILEUTON(zyflo) LEUKOTRIENE MODIFIER; 5′ lipoxygenase inhibitor
CROMOLYN SODIUM(Intal) BLOCKS ANTIGEN-ANTIBODY REACTION; PREVENTS MAST CELL DEGRANULATION AND MEDIATOR RELEADE
NEDOCROMIL(Tilade) BLOCKS antigen-antibody reaction; PREVENTS mast cell degranulation and mediator release
METHYLXANTHINES(Theophyline,caffene,Theobromide,Aminophylline) PHOSPHODIESTERASE inhibition; prevents degradation of cyclic AMP to 5′- AMP; increases cAMP
ATROPINE BLOCKS cholinergic-induced bronchospasm,bronchodilatory action
TERBUTALINE B2 agonist stimlation during a bronchospasm
Relate the utility of cromolyn for the treatment of asthma. non-steriodal medication (anti-inflammatory) can reduce the need for quick relivers and reduce bronchial hyperrespnsiveness. also can improve morning peak flow and decrease symptoms of nocturnal asthma
Describe the make-up of methemoglobin? Ferrous ion (Fe2+) in the heme portion of hemoglobin becomes oxidized to the ferric state (Fe3+);tyrosine substitutes histidine in either A or B chain in the Globin protion of the hemeglobin molecule. tyrosine causes ferrous ion to oxidize to ferric state
How does mehemoglobin affect tissue oxygenation? I
Oxygen attachment on hemoglobin? Pyrrole Ferrous ion(heme portion)
Attachment od CO2 on hemoglobin? Teminal Amine group Globin portion
Attachment of H+ on hemoglobin? imidazole group on deoxygenated hemoglobin
Discuss how coperativity enhances the binding of oxygen to hemoglobin at the lungs and how it facilitates the release of oxygen to the cells at the tissues? Cooperativity ehances bonding of oxygen by increasing bonding potentional. Conversely, at the tissue level the unloading of oxygen molecule facilitates the release at oxygen at the other sited
4 factors that inflence oxygen- hemoglobin affinity? body temp. , PaCO2, Arterial pH, 2-3-DPG
Define Bohr Effect: Effect of Carbon Dioxide or (H+) pn uptake and relase of oxygen from the hemoglobin(effect mild)
Define Haldane Effect: influence of CO2 binding and unbinding on the release and uptake of oxygen , respectively, by the hemoglobin molecule