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NUR 642 Pharm Exam 2 questions with correct answer1.
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NUR 642 Pharm Exam 2 questions with correctanswers
What are the adverse effects of corticosteroids? Correct Answer-
Osteoporosis, bone fractures, adrenal suppression, and growth
deceleration in children
Drugs that impede LT signaling are antileukotrienes, what are the drugs'
main actions? Correct Answer-The leukotrienes are synthesized by
activated leukocytes by the action of 5-lipoxygenase on arachidonic acid
to yield LT4A
It is then either converted to LTB4 or conjugated with glutathiaone to
yield LTC4
It is then further metabolized to a group of LTs called cysteinyl
leukotrienes
Cysteinyl leukotrienes are autocrine and parcrine signalers that exert
inflammatory and bronchostricitive effects
drugs that impede the LT signaling are antileukotrienes and consist of
agents that inhibit the synthesis of leukotrienes or antagonize the
cysteinyl leukotrienes
then not causing that bronchostrictive effect
singulair is an example
,What are the adverse effects of antileukotrienes? Correct Answer-Mood
disorders can occur
can elevate liver enzymes
reactions when given with corticosteroids
called Churg-STrauss (Asthma, eosinophilia, systemic vasculitis, skin
rashes, nerve problems, GI symptoms, sinus problems, cardiac
involvment, pulmonary involvement, fever and fatigue
What is the mechanism of action for the Beta-Adrenergic Agonists?
Correct Answer-Sympathomimetics
results in smooth muscle relaxation
nonselective b2-adrenergic receptor agonists and, to a lesser extent,
selective B2-adrenergic agonists cause reflex tachycardia
B2-selective agents have the greatest effect in bronchial, uterine, and
vascular smooth muscles
activation of beta receptors leads to smooth muscle relaxation via the
activation of K channels and membrane hyperpolarization, inhibiting
contractile filament machinery and lowering cytosolic-free CA
,beta 2s are the drugs of choice for the acute flair up like albuterol short
acting
At this tissue level, these mechanisms produce bronchodilator via
hyperpolarization through potassium channel activation
What is the difference between short and long acting beta-adrenergic
agonists? Correct Answer-Short acting beta adrenergic agonists are:
albuterol - duration is 3-6 hours when given by meter dose inhaler
(MDI) and improvement is seen in 5-19 minutes with full effect seen in
1 hour; high doses are needed for nebulized short-acting because they
have large particles and aren't easily delivered to the airway and can be
swallowed where only 20% is available; inhaler is preferred over
nebulizer.
pirbuterol
bitolterol
Long acting:
salmeterol
formoterol
indacaterol
20-40 minutes and will last about 12 hours
The main methylxanthine is theophylline: What is its role in asthma and
COPD? Correct Answer-promote bronchodilation
, stimulate vagal center causing bradycardia
in large doses, cause positive inotropic effect on myocardium and
positive chronotropic effect on sinoatrial node
both broncho dilating and inflammatory actions
prevents the catabolism between cAMP and CGMP
This leads to increased intracellular accumulation of these second
messengers, which produces smooth muscle relaxation
response of theophylline can mimic that of the glucocorticoids but target
two different pathways; suppresses chronic inflammation in COPD
whereas the glucocorticoids do not do that with longer use??
incidentally also improves the contraction of the diaphragm which
increases ventilation
taken orally
produces bronchodilation in 15-30 minutes
half life is 3-4 hours in children and about 8 hours in adults
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