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Exam (elaborations)

Nurs8024 Module 8 (Questions With Detailed Answers)

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  • NURS 8024
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  • NURS 8024

Nurs8024 Module 8 (Questions With Detailed Answers)

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  • September 23, 2024
  • 18
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NURS 8024
  • NURS 8024
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LeCrae
NURS8024: M6 – Questions & Accurate Answers (A+)

Drugs affecting the ANS. Right Ans - Cholinergic: act on receptors that are
activated by ACh

Adrenergic: act on receptors that are stimulated by NE and E

BOTH: act by either stimulating or blocking receptors of the ANS

Sympathomimetics Right Ans - drugs that mimic that actions of E or NE

Adrenergic receptor agonists - relaxes airway, inhibits bronchoconstriction,
inhibits microvasc leakage

Stimulation of B2 receptors - relaxes airway, inhibits mediator release

Optimally delivered by inhalation

Benefits of inhaler spacer. Right Ans - decreases deposition of drug in
mouth

Reduces velocity of large-particle drugs

Improved amount of small-particle drug that gets into airway

Reduced GI absorption of drug

Adrenergic Agonists (Inhaled B2) Right Ans - selective B2 agonists


Drug of choice ONLY for mild intermittent symptoms (monotherapy)

Rescue therapy for all types of asthma

Direct-acting B2 agonists are potent vasodilators that relax airway smooth
muscle

Short-Acting B-Adrenergic Agonists (SABAs) Right Ans - bronchodilators
with DOS 2-4 hrs

,MOA: B2 stimulation, smooth muscle relaxation and bronchodilation

E.g. albuterol (PO/inhaled), levalbuterol, pirbuterol, terbutaline,
metaproterenol

Clinical Uses: asthma, COPD, bronchoconstriction, hyperK (temporarily)

ADEs: tachyC, tremor, N/V, HA, nervousness, hypoK, palpitations, insomnia

Serious ADEs: paradoxical bronchospasm, arrhythmias, angioedema,
increased LFTs (effects minimized with inhaled route)

OD: symptoms of excessive B stimulation - HTN, seizure, angina, tachyC,
arrhythmia, nervousness, dizziness, cardiac arrest, death

Notes: increased effect w/ other sympathomimetics, toxicity with
methylxanthines, decreased effect with BB use, decreased effectiveness of
insulin and PO hypoglycemics

Long-Acting B-Adrenergic Agonists (LABAs) Right Ans - bronchodilators
with DOA 12 hrs

MOA: B2 stimulation, smooth muscle relaxation and bronchodilation

E.g. salmeterol (dry powder), formoterol

ADEs: tremor, nervousness, tachyC, HA, palpitations, nasal congestion,
insomnia

Serious ADEs: bronchospasm, rash, angina, hypersensitivity reaction,
angioedema, arrhythmia, hypoK, metabolic acidosis

BBW: small (but sig) increase in asthma related death

Notes: MUST be combined with ICS in asthma

Ultra-Long-Acting B-Adrenergic Agonists
(U-LABAs) Right Ans - indacaterol, olodaterol, & vilanterol

, taken daily

currently approved only for COPD Tx

Ipratropium (Atrovent) Right Ans - inhaled cholinergic (muscarinic)
antagonist, short-acting (DOA 4-6 hrs)

MOA: blocks muscarinic receptors in ANS, promotes bronchodilation

less effective than B2 agonists

ADEs: HA, dizziness, fatigue, rash, cough, palpitations, URI symptoms, dry
mouth, constipation, urinary retention

Serious ADEs: anaphylaxis, worsening of NA glaucoma, paradoxical
bronchospasm, tachyC, urticaria

Notes: inhaled only, less effective in elderly, limited use in asthma, 1st line for
COPD, OK for preg/lact

Caution: myasthenia gravis, glaucoma, BPH, bladder neck obstruction

Tiotropium (Spiriva) Right Ans - inhaled cholinergic (muscarinic)
antagonist, long-acting (half-life 5-6 days)

MOA: blocks muscarinic receptors in ANS, promotes bronchodilation

Similar side effect/ADEs/contraindications as ipratropium

Corticosteroids Right Ans - modify the immune response to control
inflammation

Suppression of cytokine production, inhibits infiltration of irways by WBCs,
inhibits release of leukotrienes

Decreased mucosal edema & cap perm, decreased airway
hyperresponsiveness (AHR), decreased frequency and severity of

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