CMN 568 Unit 3 Exam Questions And
Correct Answers
What are the 3 characteristics of Asthma - answerBronchoconstriction
Airway Inflammation
Reversible airflow limitation
Which inhaled anticholinergic is best used for asthma pt. w/an intolerance to beta agonist or w/
bronchospasms due to beta b...
What are the 3 characteristics of Asthma - answer✔✔Bronchoconstriction
Airway Inflammation
Reversible airflow limitation
Which inhaled anticholinergic is best used for asthma pt. w/an intolerance to beta agonist or w/
bronchospasms due to beta blocker meds? - answer✔✔Ipratropium Bromide
What is the primary tx for pt. w/moderate to severe asthma exacerbations who do not respond
promptly and completely to SABA? - answer✔✔Systemic Corticosteroids
Which bacterial infections predispose exacerbations of asthma - answer✔✔M. Pneumoniae and
C. Pneumoniae
Is routine use of antimicrobials recommended for acute exacerbations of asthma - answer✔✔No,
only use when likelihood of acute bacterial respiratory tract infection
Name short acting beta agonist - answer✔✔albuterol, levalbuterol, bitolerol, pirbuterol,
terbutaline
What does a SABA do? - answer✔✔acts directly by relaxing bronchial smooth muscles.
What do long-term pharmacologic agents accomplish for asthma pt. - answer✔✔act primarily to
attenuate airway inflammation.
Why take long-term pharmacologic agents for asthma daily? - answer✔✔to achieve and
maintain control of persistent asthma independent of symptoms.
What does the NAEPP recommend as the cornerstone of daily treatment of persistent asthma? -
answer✔✔daily anti-inflammatory therapy with inhaled corticosteroids
Role of corticosteroids with asthma - answer✔✔Reduce inflammation (acute and chronic) =
improved airflow, decreased airway hyper-responsiveness and fewer asthma exacerbations, and
potentiate the action of beta-adrenergic agonist.
1st. line treatment agent for all pt w/persistent asthma (long term controller) - answer✔✔Inhaled
Corticosteroids
How often to most patient use inhaled corticosteroids? - answer✔✔Twice daily to provide
adequate control.
How long can it take to see maximum response of inhaled corticosterioids? - answer✔✔Months
What can a patient do to reduce side effects of inhaled corticosteroids? - answer✔✔Rinse mouth
after each use
A patient has an exacerbation of asthma, what is the most effective treatment to achieve prompt
control? - answer✔✔Systemic (oral) corticosteroids
Dose of oral corticosteroids for children during exacerbation of asthma - answer✔✔1-2
mg/kg/day.
Can be either a single dose or divided BID.
MAX 60 mg/day
Dose of oral corticosteroids for adults during exacerbation of asthma - answer✔✔40-60 mg/day
either as a single dose of divided BID
Duration of treatment of oral corticosteroids for asthma exacerbation - answer✔✔3-10 days or
until symptoms resolve
(no evidence that tapering dose of PO steroids prevents relapse)
When treating exacerbation of asthma, what is the preferred treatment plan? -
answer✔✔Alternate days rather than daily treatment.
What additional medications are required to be given concurrent with systemic corticosteroids to
prevent corticosteroid induced bone mineral loss? - answer✔✔Vitamin D and Calcium
Should systemic corticosteroids be rapidly discontinued? - answer✔✔No, to prevent adrenal
insufficiency
Name some mediator inhibitors to treat asthma - answer✔✔Cromolyn sodium and nedocromil
What is the mechanism of action of mediator inhibitors? - answer✔✔prevent asthma symptoms,
improve airway function in pt w/mild persistent of exercise induce asthma
When are mediator inhibitors effective? - answer✔✔Before allergen exposure or exercise
Do not relieve asthmatic symptoms once present.
Name the Long acting beta 2 agonist (LABA) for asthma - answer✔✔Salmeterol and Formoteol
How are LABA's delivered? - answer✔✔dry powder
What are LABA's used for - answer✔✔Long term prevention of asthma symptoms
Nocturnal symptoms
Prevention of exercise induced bronchospasm
Should LABA be used as monotherapy - answer✔✔NO
linked to fatal asthma when used alone
has no anti-inflammatory effects- so use w/a corticosteroid.
What does LABA + low or medium dose of corticosteroids given together provide for the
patient. - answer✔✔The equivalent to what would be if doubled the inhaled corticosteroid.
Name the action of anticholinergic agents, short acting muscarinic agents (SAMA) and long
acting muscarinic agents (LAMA) - answer✔✔Reverse vagally medicated bronchospasm but
NOT allergen or exercise induced broncospasms
Is Ipratropium bromide (SAMA) as effect as a SABA for relief of acute bronchospasm -
answer✔✔No
What is the benefit to adding Tiotropium to therapy bronchodilator (salmeterol) or inadequately
controlled low-dose inhaler. - answer✔✔Improves lung function and reduces frequency of
asthma exacerbations.
Name the phosphodiesterase inhibitor used for asthma - answer✔✔theophylline
What is theophylline used for in a pt w/ asthma? - answer✔✔mild bronchodilation
What is the mechanism of action of theophylline for asthma - answer✔✔anti-inflammatory and
immunodilator properties which enhance mucociliary clearance and strengthen diaphragmatic
contractility.
Why are drug levels of Theophylline monitored? - answer✔✔Due to narrow therapeutic ranges.
Name the leukotriene modifiers for asthma - answer✔✔Zileutonn, zafirlukast, montelukast
use of leukotriene modifiers for asthma? - answer✔✔alternatives to low-dose inhaled
corticosteroids in pt. w/mild persistent asthma
*as mono-therapy are usually less effective than inhaled corticosteroids
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