TEST BANK
Rau's Respiratory Care Pharmacology
Douglas S. Gardenhire EdD RRT-NPS FAARC
11th Edition
,Table of Contents
Chapter 01 Introduction to Respiratory Care Pharmacology 1
Chapter 02 Principles of Drug Action 11
Chapter 03 Administration of Aerosolized Agents 24
Chapter 04 Calculating Drug Doses 39
Chapter 05 Central and Peripheral Nervous Systems 46
Chapter 06 Adrenergic (Sympathomimetic) Bronchodilators 58
Chapter 07 Anticholinergic (Parasympatholytic) Bronchodilators 73
Chapter 08 Xanthines 88
Chapter 09 Mucus-Controlling Drug Therapy 97
Chapter 10 Surfactant Agents 111
Chapter 11 Corticosteroids in Respiratory Care 119
Chapter 12 Nonsteroidal Antiasthma Agents 139
Chapter 13 Aerosolized Antiinfective Agents 147
Chapter 14 Antimicrobial Agents 156
Chapter 15 Cold and Cough Agents 167
Chapter 16 Selected Agents of Pulmonary Value 176
Chapter 17 Neonatal and Pediatric Aerosolized Drug Therapy 186
Chapter 18 Skeletal Muscle Relaxants (Neuromuscular Blocking Agents) 191
Chapter 19 Diuretic Agents 203
Chapter 20 Drugs Affecting the Central Nervous System 210
Chapter 21 Vasopressors, Inotropes, and Antiarrhythmic Agents 220
Chapter 22 Drugs Affecting Circulation 231
Chapter 23 Sleep and Sleep Pharmacology 243
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Test Bank - Rau’s Respiratory Care Pharmacology, 11th Edition (Gardenhire, 2024)
Chapter 01: Introduction to Respiratory Care Pharmacology
Gardenhire: Rau’s Respiratory Care Pharmacology, 11th Edition
MULTIPLE CHOICE
1. The listing of a drug and the amount of drug are found in which part of a prescription?
a. Superscription
b. Inscription
c. Subscription
d. Transcription
ANS: B
The superscription directs the pharmacist to take the drug listed and prepare the
medication; the inscription lists the name and quantity of the drug being prescribed; the
subscription provides directions to the pharmacist for preparing the medication; and the
transcription, or signature, is the information the pharmacist writes on the label as
instructions to the patient.
2. If generic substitution is permitted on a prescription:
a. drug from only one manufacturer must be given.
b. drug formulation may be changed by the pharmacist.
c. any manufactured brand of the drug listed may be given.
d. drug strength may be changed by the pharmacist.
ANS: C
A generic substitution allows any brand of a drug to be given, but the pharmacist may not
change a drug formulation without specific permission from the prescribing physician. A
physician can indicate to the pharmacist that generic substitution is permitted in the filling
of the prescription. In such a case, the pharmacist may provide any manufacturer’s version
of the prescribed drug, rather than a specific brand. However, the pharmacist may not
change the strength of a drug without specific permission from the prescribing physician.
3. The study of drugs, including their origin, properties, and interactions with living
organisms, is known as:
a. pharmacogenetics.
b. pharmacology.
c. therapeutics.
d. toxicology.
ANS: B
Pharmacogenetics is the study of the interrelationship of genetic differences and drug
effects. Pharmacology is the study of drugs (chemicals), including their origin, properties,
and interactions with living organisms. Therapeutics is the art of treating disease with
drugs. Toxicology is the study of toxic substances and their pharmacologic actions,
including antidotes and poison control.
4. The brand name given to a drug by a particular manufacturer is known as the drug’s:
a. chemical name.
b. generic name.
c. official name.
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Test Bank - Rau’s Respiratory Care Pharmacology, 11th Edition (Gardenhire, 2024)
d. trade name.
ANS: D
The chemical name indicates the drug’s chemical structure. The generic name is assigned
by the U.S. Adopted Name Council and is usually based loosely on the drug’s chemical
structure. The official name is the name given to the generic name once a drug becomes
fully approved for general use and is admitted to the U.S. Pharmacopeia–National
Formulary. The trade name is the brand, or proprietary, name given by a particular
manufacturer. For example, the generic drug albuterol is currently marketed by
Schering-Plough as Proventil® and by GlaxoSmithKline as Ventolin®.
5. To find official information about drugs (according to the FDA), you need to go to the:
a. Physician’s Desk Reference (PDR).
b. Basic & Clinical Pharmacology.
c. U.S. Pharmacopeia–National Formulary (USP-NF).
d. Goodman & Gilman’s The Pharmacological Basis of Therapeutics.
ANS: C
Because the PDR is prepared by drug manufacturers themselves, it may be lacking in
objectivity. Basic & Clinical Pharmacology covers only general pharmacologic principles
and drug classes. Goodman & Gilman’s The Pharmacological Basis of Therapeutics
covers only general pharmacologic principles and drug classes. The USP-NF is a book of
standards containing information about medications, dietary supplements, and medical
devices. The U.S. Food and Drug Administration (FDA) considers this book the official
standard for drugs marketed in the United States.
6. Drugs may be obtained from which of the following sources?
a. Plants
b. Animals
c. Minerals
d. Plants, animals, and minerals
ANS: D
Drugs may be obtained from plants (e.g., digitalis), animals (e.g., insulin), and minerals
(e.g., magnesium sulfate).
7. The branch of the U.S. government responsible for the process of approving drugs for
clinical use is the:
a. USAN Council.
b. FDA.
c. USP-NF.
d. PDR.
ANS: B
The U.S. Adopted Name (USAN) Council is responsible for assigning a generic name to a
chemical that appears to have therapeutic use. The U.S. Food and Drug Administration
(FDA) is responsible for the process of approving drugs for clinical use. The process by
which a chemical moves from the status of a promising potential drug to one fully
approved by the FDA for general clinical use is, on average, long, costly, and complex.
The USP-NF is a book of standards for medications, dietary supplements, and medical
devices. The PDR is a source of drug information prepared by drug manufacturers.
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Test Bank - Rau’s Respiratory Care Pharmacology, 11th Edition (Gardenhire, 2024)
8. An orphan drug is a drug that is:
a. used for rare disease.
b. used for common disease.
c. inexpensive to produce.
d. not claimed by a drug manufacturer.
ANS: A
An orphan drug is a drug or biologic product for the diagnosis or treatment of a rare
disease. Rare is defined as a disease that affects less than 200,000 persons in the United
States. Alternatively, a drug may be designated as an orphan if used for a disease that
affects more than 200,000 persons in the United States but for which there is no reasonable
expectation of recovering the cost of drug development. Orphan drugs are often quite
expensive to produce because they have a limited market in which to recoup the initial
investment.
9. Which of the following health care practitioners are authorized to write a prescription in
the United States?
1. Physicians
2. Chiropractors
3. Dentists
4. Osteopaths
5. Veterinarians
a. 1 and 3 only
b. 1, 2, and 3 only
c. 1, 3, 4, and 5 only
d. 1, 2, 3, and 5 only
ANS: C
A prescription may be written by a physician, osteopath, dentist, and veterinarian and
some other practitioners but not by chiropractors.
10. Drugs that are available to the general public without a prescription are known as:
a. illegal drugs.
b. generic drugs.
c. investigational drugs.
d. over-the-counter drugs.
ANS: D
Illegal drugs are not legally available to the general public, and many generic drugs require
a prescription. The use of investigational drugs is very closely monitored, and they are not
available to the general public. Drugs available to the general public without a prescription
are referred to as over-the-counter (OTC) products.
11. Drugs delivered by oral or nasal inhalation are intended to:
a. increase heart function.
b. provide a local topical treatment in the respiratory tract.
c. relax patients and relieve anxiety.
d. improve blood flow throughout the body.
ANS: B
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Test Bank - Rau’s Respiratory Care Pharmacology, 11th Edition (Gardenhire, 2024)
Although some inhaled drugs do increase heart rate as a side effect, most drugs intended
for this purpose are given intravenously; orally or nasally inhaled drugs are intended to
provide a local topical treatment in the respiratory tract. Most anxiolytics and drugs used
to improve blood flow are given intravenously.
12. The advantages of delivering drugs by oral or nasal inhalation include which of the
following?
1. Aerosol doses are larger therefore more effective than doses administered systemically.
2. Side effects are usually fewer and less severe.
3. The onset of action is rapid.
4. The delivery process is painless, relatively safe, and usually more convenient.
a. 1 and 3 only
b. 2 and 4 only
c. 1, 2, and 3 only
d. 2, 3, and 4 only
ANS: D
The following are advantages of this method and route of delivery:
Aerosol doses are smaller than doses used for the same purpose and given systemically.
Side effects are usually fewer and less severe with aerosol delivery than with oral or
parenteral delivery. The onset of action is rapid. Drug delivery is targeted to the
respiratory system, with lower systemic bioavailability. The inhalation of aerosol drugs is
painless, is relatively safe, and may be convenient depending on the specific delivery
device used.
13. Which of the following classes of drugs can be aerosolized?
1. Antiasthmatic agents
2. Adrenergic agents
3. Antiinfective agents
4. Mucoactive agents
5. Corticosteroids
a. 1 and 3 only
b. 2, 4, and 5 only
c. 2, 3, 4, and 5 only
d. 1, 2, 3, 4, and 5
ANS: D
Antiasthmatic agents (e.g., cromolyn sodium), adrenergic agents (e.g., racemic
epinephrine), and mucoactive agents (e.g., Pulmozyme®) can be aerosolized. Antiinfective
agents (e.g., TOBI®) and corticosteroids (e.g., budesonide) may also be aerosolized.
14. Which of the following drug groups are important to respiratory and critical care, although
they may or may not be available in an aerosol form?
1. Diuretics
2. Antiarrhythmic agents
3. Neuromuscular blocking agents
4. Anticoagulant and thrombolytic agents
a. 1 and 2 only
b. 3 and 4 only
c. 1, 2, and 3 only
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Test Bank - Rau’s Respiratory Care Pharmacology, 11th Edition (Gardenhire, 2024)
d. 1, 2, 3, and 4
ANS: D
The following groups of drugs are important in critical care:
Antiinfective agents, such as antibiotics and antituberculous drugs. Neuromuscular
blocking agents, such as curariform agents and others. Central nervous system agents,
such as analgesics and sedatives/hypnotics. Antiarrhythmic agents, such as cardiac
glycosides and lidocaine. Antihypertensive and antianginal agents, such as -blocking
agents and nitroglycerin. Anticoagulant and thrombolytic agents, such as heparin and
streptokinase. Diuretics, such as thiazides and furosemide.
15. Place the following phases of Investigational New Drug (IND) approval in the correct
order:
1. The drug is investigated as a treatment for a small number of individuals with the
disease the drug is intended to treat.
2. The drug is investigated in large, multicenter studies to establish efficacy and safety.
3. The drug is investigated in small groups of healthy volunteers to establish its activity.
a. 1, 2, 3
b. 2, 3, 1
c. 1, 3, 2
d. 3, 1, 2
ANS: D
The first step of IND approval is to test the drug on healthy volunteers. Investigation by
administration to ill individuals occurs only after the drug is proven safe in healthy
volunteers. Multicenter studies are the third and final phase of IND approval.
16. In today’s market, companies spend approximately how much money per new drug on
research, development, and preclinical and postclinical trials?
a. $2 million
b. $10 million
c. $800 million
d. $1 billion
ANS: D
In a study done in 2003 by DiMasi and associates, it was calculated that companies spend
over $800 million on research and development and on preclinical and postclinical trials of
a new drug in the current market. In a recent study by Adams and Brantner that replicated
DiMasi’s calculations, they estimated companies now spend over $1 billion to bring a new
drug to market.
17. Toxicology studies and studies on the effects of a new drug on such organs as the liver and
kidneys occur during which step of the drug approval process in the United States?
a. Animal studies
b. Investigational New Drug approval
c. Chemical identification
d. New drug application
ANS: A
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Test Bank - Rau’s Respiratory Care Pharmacology, 11th Edition (Gardenhire, 2024)
Chemical identification is the process of recognizing that a chemical may have the
potential for useful physiologic effects. No testing has occurred before this step. Once an
active chemical is isolated and identified, a series of animal studies examines its general
effect on animals and effects on specific organs such as the liver or kidneys. Toxicology
studies to examine mutagenicity, teratogenicity, effect on reproductive fertility, and
carcinogenicity are also performed. Investigational New Drug (IND) approval is a
three-phase process that involves administering the drug to human subjects. It is
imperative that safety be established before this step is taken. New drug application occurs
only after a successful IND process when the U.S. Food and Drug Administration (FDA)
approves the drug for general clinical use.
18. Regarding the therapeutic potential of a drug, the code AA symbolizes:
a. an important therapeutic gain over other drugs.
b. an important therapeutic gain, indicated for AIDS patients; “fast-track” drug.
c. modest therapeutic gain.
d. little or no therapeutic gain.
ANS: B
The U.S. Food and Drug Administration (FDA) has a classification system to help identify
the significance of new products. Codes A, AA, C, and D are used to describe therapeutic
potential. Code A is given to a drug that shows significant therapeutic gain over other
drugs. Code AA is given to a drug that shows significant therapeutic gain for patients with
AIDS; this agent is then fast-tracked. Code B is given to a drug that shows moderate
therapeutic gain. Code C is given to a drug that shows little or no therapeutic gain over
other drugs, although the drug may have important options.
Choice A: This statement describes code A.
Choice B: This statement describes code AA: Important therapeutic gain, indicated for a
patient with acquired immunodeficiency syndrome (AIDS); fast-track.
Choice C: This statement describes code B.
Choice D: This statement describes code C.
19. Which of the following may be used when writing or preparing drug orders?
1. Greek
2. English
3. Metric measures
4. Apothecary measures
a. 2 only
b. 1 and 2 only
c. 3 and 4 only
d. 2, 3, and 4 only
ANS: D
Latin, English, and metric and apothecary measures may all be used for drug orders.
20. If a drug is ordered with the Latin abbreviation qid, it should be administered:
a. every hour.
b. four times daily.
c. every other day.
d. every 4 hr.
ANS: B
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