Deck 5: Bronchodilators

Question 1

Terbutaline is a sympathomimetic beta agonist that is classified as a:

A)Resorcinol.
B)Catecholamine.
C)Xanthine.
D)Saligenin.

Answer 1

Resorcinol.

Question 2

You are called to evaluate a patient who is receiving bronchodilator therapy with albuterol via the inhalation route.The patient tells you that she experiences tremors every time she takes her aerosol treatment.The physician asks you to recommend another bronchodilator.Which of the following would you suggest?

A)Metaproterenol
B)Racemic epinephrine
C)Levalbuterol
D)Salmeterol

Answer 2

Levalbuterol

Question 3

The advantages of drug administration via the inhalation route include: I.Immediate onset of action at the desired site.
II)Smaller required doses.
III)Increased systemic drug absorption.

A)I and II
B)II and III
C)I and III
D)I only

Answer 3

I and II

Question 4

Which of the following bronchodilators is intended for long-term maintenance of asthma that does not have a rapid onset?

A)Albuterol
B)Racemic epinephrine
C)Salmeterol
D)Terbutaline

Question 5

Which of the following systems is responsible for innervation of the bronchi? I.Autonomic nervous system
II)Somatic nervous system
III)Central nervous system

A)I only
B)I and III
C)II and III
D)I,II,and III

Question 6

Which of the following is a type of sympathetic nervous system receptor found in the lungs that produces bronchodilation when stimulated?

A)Alpha₁
B)Alpha₂
C)Beta₁
D)Beta₂

Question 7

Parasympatholytic bronchodilators can be described as: I.Drugs that stimulate the parasympathetic system
II)Anticholinergic drugs
III)Drugs that block acetylcholine

A)I and II
B)II and III
C)I,II,and III
D)II only

Question 8

Which of the following drugs would be best used for maintenance of bronchospasm and would not be used during an acute attack? I.Serevent
II)Spiriva
III)Theophylline

A)I and II
B)I and III
C)II and III
D)I,II,and III

Question 9

Mechanisms of bronchoconstriction include all the following except:

A)Bronchospasm.
B)Embolism formation.
C)Airway edema.
D)Increased secretions.

Question 10

Which of the following is an anticholinergic bronchodilator?

A)Spiriva
B)Serevent
C)Salmeterol
D)Saligenin

Question 11

Sympathomimetic bronchodilators can be described as: I.Drugs that stimulate intracellular production of cyclic AMP.
II)Anticholinergic drugs.
III)Drugs that stimulate beta₂ receptors.

A)I and II
B)I only
C)I and III
D)I,II,and III

Question 12

Which of the following is referred to as a hormonal receptor?

A)Acetylcholine
B)Catecholamine
C)Cyclic AMP
D)Cyclic GMP

Question 13

Mechanisms for producing bronchodilation include drugs that cause all of the following actions except:

A)Stimulating the conversion of ATP to cyclic AMP.
B)Blocking the effects of the parasympathetic system.
C)Inhibiting the action of phosphodiesterase.
D)Stimulating the conversion of cyclic AMP to GMP.

Question 14

Toxicity can result from theophylline due to all the following conditions except:

A)A therapeutic level of 10 mcg/ml.
B)A patient having liver disease.
C)An interaction with other medications.
D)A patient having congestive heart failure.

Question 15

All except which of the following are possible disadvantages associated with administration of drugs via the inhalation route?

A)Patient cooperation is required for the appropriate breathing pattern.
B)There is a risk of increased systemic side effects.
C)Shortness of breath may hinder appropriate drug delivery.
D)Reduction in airway diameter during a bronchospastic episode may reduce drug deposition.

Question 16

Xopenex is a sympathomimetic beta agonist that is classified as a:

A)Resorcinol
B)Catecholamine
C)Methylxanthine
D)Saligenin

Question 17

A drug that is used intravenously to stop premature labor and that has shown to cause bronchodilation when administered by aerosol is:

A)Calcium.
B)Magnesium.
C)Epinephrine.
D)Theophylline.

Question 18

By what route are methylxanthines usually administered to patients with COPD?

A)Aerosol inhalation
B)Direct endotracheal instillation
C)Orally
D)Transcutaneously

Question 19

Which of the following is responsible for breaking down cyclic AMP?

A)Acetylcholinestrase
B)MOA
C)Phosphodiesterase
D)COMT

Question 20

Methylxanthines are believed to cause bronchodilation by which of the following mechanisms?

A)Inhibiting phosphodiesterase
B)Decreasing cyclic AMP
C)Increasing cyclic GMP
D)Inhibiting COMP

Question 21

Which of the following anticholinergic bronchodilators is available as a dry powder inhaler?

A)Ipratropium bromide
B)Atropine sulfate
C)Combivent
D)Tiotropium bromide TRUE/FALSE
Write 'T' if the statement is true and 'F' if the statement is false.

Question 22

Effects of parasympatholytic agents include: I.Bronchodilation
II)Decreased heart rate
III)Drying of pulmonary secretions

A)I and II
B)I and III
C)II and III
D)I,II,and III

Question 23

A physician asks you to evaluate the effectiveness of a patient's bronchodilator therapy.The test that would best quantify posttreatment improvement in airway obstruction is:

A)Arterial blood gases.
B)Chest X-ray.
C)Pulse oximetry.
D)Peak expiratory flow rate (PEFR).

Question 24

______ 3.At the synapse where the neuron meets the muscle,sympathetic fibers release acetylcholine.

Question 25

______ 1.Large airways contain incomplete rings of cartilage that provide airway support,unlike bronchioles,where cartilaginous rings are not present.

Question 26

______ 6.An increase of cyclic GMP at cellular level causes smooth muscle relaxation,resulting in bronchodilation.

Question 27

______ 5.Indirect stimulation of the sympathetic nervous system occurs as a result of release of catecholamines,referred to as "hormonal receptors."

Question 28

______ 2.The terms "bronchospasm" and "bronchoconstriction" refer to the same mechanism for decrease in the diameter of the airway.

Question 29

______ 8.Albuterol is metabolized by the enzyme COMT.

Question 30

______ 10.In addition to having weak bronchodilatory effects,theophylline is also used to increase a patient's ventilatory drive.
FILL-IN-THE-BLANK
Write the word or phrase that best completes each statement.

Question 31

While administering an aerosol bronchodilator to a pediatric patient,the parent asks if the child can be given an oral medication to open her airways.Which of the following could you suggest?

A)Albuterol
B)Salmeterol
C)Formoterol
D)Xopenex

Question 32

______ 7.Alpha-adrenergic drugs are used primarily for their bronchodilatory effect.

Question 33

Side effects of beta agonists include all except which of the following?

A)Increased respiratory rate
B)Increased heart rate
C)Nervousness
D)Palpitations

Question 34

Alpha receptor stimulation produces which of the following effects?

A)Vasoconstriction
B)Relaxation of bronchial smooth muscle
C)Increased heart rate
D)Pupil constriction

Question 35

______ 4.Beta₁ receptors stimulate the heart,while beta₂ receptors stimulate the lungs.

Question 36

After removing an endotracheal tube from a patient in the ICU,the patient develops inspiratory stridor.You suspect that there is swelling of the upper airway.To treat the patient,which of the following do you recommend?

A)Atrovent
B)Vaponefrin
C)Xopenex
D)DuoNeb

Question 37

You are called to the emergency room to treat an 18-year-old female who has been admitted in an acute asthma attack.She received two albuterol treatments prior to entering the emergency room.The patient's breath sounds reveal wheezes bilaterally,and she is unable to perform a PEFR.The physician asks you to recommend treatment.Which of the following would you suggest?

A)Subcutaneous injection of epinephrine
B)Serevent MDI
C)Continuous nebulization of albuterol
D)Spiriva DPI

Question 38

Racemic epinephrine would be indicated in all the following situations except:

A)Croup.
B)Postextubation edema.
C)Acute bronchospasm.
D)Laryngeal edema.

Question 39

______ 9.Ipratropium bromide results in bronchodilation by inhibiting increases in cellular cyclic GMP.

Question 40

While making a routine home visit to one of your COPD patients,you notice that he appears very restless and irritable.He complains that he has been dizzy and nauseated and has been urinating frequently during the past 2 days.You review his medication list and see that he is prescribed aerosolized albuterol and Atrovent,Serevent by DPI,and Theobid.You suspect that the patient is experiencing side effects from which of his medications?

A)Albuterol
B)Atrovent
C)Serevent
D)Theobid

Question 41

Selective beta₂-agonists that are used for continuous nebulization during severe acute episodes of bronchospasm include ____________ and ____________.

Question 42

The most common route of administration for sympathomimetic and anticholinergic bronchodilators is ________________.

Question 43

________________ is a catecholamine with alpha and beta effects that is used in the treatment of upper airway edema.

Question 44

The conducting airways are made up of three layers,the ________________,the ________________,and the ________________.

Question 45

Catecholamines cannot be administered orally because of the presence of ________________ in the GI tract,which deactivates the drug rapidly.

Question 46

Explain the rationale for combining sympathomimetic drugs with parasympatholytic drugs for the treatment of bronchospasm.

Question 47

Methylxanthines are believed to work by inhibiting ________________,which is the enzyme that deactivates cyclic AMP.

Question 48

The three classes of beta-agonists are____________,____________,and ____________.

Question 49

Stimulation of beta₂ receptors causes smooth muscle ________________ in the lungs,resulting in ________________.

Question 50

The therapeutic range for theophylline is ____________.

Question 51

Adrenergic agents produce bronchodilation by causing the release of ________________,which results in increased production of ________________.

Question 52

A bronchodilating drug that combines anticholinergic and adrenergic agents is ________________.

Question 53

How do resorcinols differ from catecholamines?

Question 54

In order to quantify airway obstruction and posttreatment improvement the respiratory therapist can measure a patient's ____________ or ____________.

Question 55

Albuterol and levalbuterol are classified as ____________-acting beta-agonists.

Question 56

Anticholinergic agents produce bronchodilation by causing the release of ________________,which results in the inhibition of ________________.

Question 57

Cyclic AMP decreases the amount of intracellular ________________ needed for smooth muscle contraction,which further adds to bronchodilating effects.

Question 58

Can a patient be prescribed more than one beta agonist bronchodilator simultaneously?

Question 59

Why is the efficacy of the inhalation route of administration for bronchodilating agents questionable?