Exam (elaborations)
CMN 568 Unit 3 Questions and Answers Full semester
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Exam of 16 pages for the course CMN 568 at CMN 568 (CMN 568 Unit 3)
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CMN 568 Unit 3What 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. Pneumoniae
and C. Pneumoniae
Is routine use of antimicrobials recommended for acute exacerbations of asthma -
answerNo, 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? - answeracts directly by relaxing bronchial smooth muscles.
What do long-term pharmacologic agents accomplish for asthma pt. - answeract
primarily to attenuate airway inflammation.
Why take long-term pharmacologic agents for asthma daily? - answerto achieve and
maintain control of persistent asthma independent of symptoms.
What does the NAEPP recommend as the cornerstone of daily treatment of persistent
asthma? - answerdaily anti-inflammatory therapy with inhaled corticosteroids
Role of corticosteroids with asthma - answerReduce 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) -
answerInhaled Corticosteroids
How often to most patient use inhaled corticosteroids? - answerTwice daily to provide
adequate control.
,How long can it take to see maximum response of inhaled corticosterioids? -
answerMonths
What can a patient do to reduce side effects of inhaled corticosteroids? - answerRinse
mouth after each use
A patient has an exacerbation of asthma, what is the most effective treatment to
achieve prompt control? - answerSystemic (oral) corticosteroids
Dose of oral corticosteroids for children during exacerbation of asthma - answer1-2
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 - answer40-60
mg/day
either as a single dose of divided BID
Duration of treatment of oral corticosteroids for asthma exacerbation - answer3-10 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? -
answerAlternate days rather than daily treatment.
What additional medications are required to be given concurrent with systemic
corticosteroids to prevent corticosteroid induced bone mineral loss? - answerVitamin D
and Calcium
Should systemic corticosteroids be rapidly discontinued? - answerNo, to prevent
adrenal insufficiency
Name some mediator inhibitors to treat asthma - answerCromolyn sodium and
nedocromil
What is the mechanism of action of mediator inhibitors? - answerprevent asthma
symptoms, improve airway function in pt w/mild persistent of exercise induce asthma
When are mediator inhibitors effective? - answerBefore allergen exposure or exercise
Do not relieve asthmatic symptoms once present.
Name the Long acting beta 2 agonist (LABA) for asthma - answerSalmeterol and
Formoteol
How are LABA's delivered? - answerdry powder
, What are LABA's used for - answerLong term prevention of asthma symptoms
Nocturnal symptoms
Prevention of exercise induced bronchospasm
Should LABA be used as monotherapy - answerNO
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. - answerThe 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) - answerReverse vagally medicated
bronchospasm but NOT allergen or exercise induced broncospasms
Is Ipratropium bromide (SAMA) as effect as a SABA for relief of acute bronchospasm -
answerNo
What is the benefit to adding Tiotropium to therapy bronchodilator (salmeterol) or
inadequately controlled low-dose inhaler. - answerImproves lung function and reduces
frequency of asthma exacerbations.
Name the phosphodiesterase inhibitor used for asthma - answertheophylline
What is theophylline used for in a pt w/ asthma? - answermild bronchodilation
What is the mechanism of action of theophylline for asthma - answeranti-inflammatory
and immunodilator properties which enhance mucociliary clearance and strengthen
diaphragmatic contractility.
Why are drug levels of Theophylline monitored? - answerDue to narrow therapeutic
ranges.
Name the leukotriene modifiers for asthma - answerZileutonn, zafirlukast, montelukast
use of leukotriene modifiers for asthma? - answeralternatives to low-dose inhaled
corticosteroids in pt. w/mild persistent asthma
*as mono-therapy are usually less effective than inhaled corticosteroids
Which recombinant antibody that binds IgE w/o activating mast cells can be used to
treat SEVERE asthma in 18 yr old and older - answerOmalizumab and Reslizumab
Which vaccinations should the FNP ensure that a pt with asthma receives? -
answerpneumovac and influenze
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