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CMN 568 Unit 3: Questions With Solutions (Graded A+)
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CMN 568 Unit 3: Questions With Solutions (Graded A+)
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CMN 568 Unit 3: Questions With Solutions (Graded A+)What are the 3 characteristics of Asthma Right Ans - 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? Right Ans -
Ipratropium Bromide
What is the primary tx for pt. w/moderate to severe asthma exacerbations
who do not respond promptly and completely to SABA? Right Ans -
Systemic Corticosteroids
Which bacterial infections predispose exacerbations of asthma Right Ans -
M. Pneumoniae and C. Pneumoniae
Is routine use of antimicrobials recommended for acute exacerbations of
asthma Right Ans - No, only use when likelihood of acute bacterial
respiratory tract infection
Name short acting beta agonist Right Ans - albuterol, levalbuterol, bitolerol,
pirbuterol, terbutaline
What does a SABA do? Right Ans - acts directly by relaxing bronchial
smooth muscles.
What do long-term pharmacologic agents accomplish for asthma pt. Right
Ans - act primarily to attenuate airway inflammation.
Why take long-term pharmacologic agents for asthma daily? Right Ans - 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? Right Ans - daily anti-inflammatory therapy with
inhaled corticosteroids
Role of corticosteroids with asthma Right Ans - 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)
Right Ans - Inhaled Corticosteroids
How often to most patient use inhaled corticosteroids? Right Ans - Twice
daily to provide adequate control.
How long can it take to see maximum response of inhaled corticosterioids?
Right Ans - Months
What can a patient do to reduce side effects of inhaled corticosteroids?
Right Ans - Rinse mouth after each use
A patient has an exacerbation of asthma, what is the most effective treatment
to achieve prompt control? Right Ans - Systemic (oral) corticosteroids
Dose of oral corticosteroids for children during exacerbation of asthma
Right Ans - 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 Right
Ans - 40-60 mg/day
either as a single dose of divided BID
Duration of treatment of oral corticosteroids for asthma exacerbation Right
Ans - 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?
Right Ans - 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?
Right Ans - Vitamin D and Calcium
, Should systemic corticosteroids be rapidly discontinued? Right Ans - No, to
prevent adrenal insufficiency
Name some mediator inhibitors to treat asthma Right Ans - Cromolyn
sodium and nedocromil
What is the mechanism of action of mediator inhibitors? Right Ans -
prevent asthma symptoms, improve airway function in pt w/mild persistent
of exercise induce asthma
When are mediator inhibitors effective? Right Ans - Before allergen
exposure or exercise
Do not relieve asthmatic symptoms once present.
Name the Long acting beta 2 agonist (LABA) for asthma Right Ans -
Salmeterol and Formoteol
How are LABA's delivered? Right Ans - dry powder
What are LABA's used for Right Ans - Long term prevention of asthma
symptoms
Nocturnal symptoms
Prevention of exercise induced bronchospasm
Should LABA be used as monotherapy Right Ans - 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. Right Ans - 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) Right Ans - 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 Right Ans - No
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