Deck 6: Adrenergic Sympathomimeticbronchodilators

Question 1

Epinephrine is indicated for which of the following?
1)Treatment of infections
2)Severe allergic reactions
3)Acute asthma episodes
4)Cardiac stimulation

A)1 and 4 only
B)2 and 3 only
C)2,3,and 4 only
D)1,2,3,and 4

Answer 1

2,3,and 4 only

Question 2

Short-acting $\beta$ ₂ agonists are indicated for

A)reduction of airway edema.
B)relief of acute reversible airflow obstruction.
C)maintenance of bronchodilation.
D)thinning of secretions.

Answer 2

relief of acute reversible airflow obstruction.

Question 3

Relaxation of smooth airway muscle in the presence of reversible airflow obstruction is a general indication for the use of

A)mucolytics.
B)adrenergic bronchodilators.
C)antiinfective agents.
D)steroids.

Answer 3

adrenergic bronchodilators.

Question 4

Catecholamines may be given by which of the following routes?
1)Inhalation
2)Subcutaneous
3)Oral
4)Injection

A)4 only
B)2 and 4 only
C)1,2,and 4 only
D)2,3,and 4 only

Question 5

Disease states that could benefit from the use of adrenergic bronchodilators include which of the following?
1)Asthma
2)Bronchitis
3)Emphysema
4)Bronchiectasis
5)Pleural effusion

A)1 and 3 only
B)2,4,and 5 only
C)1,2,3,and 4 only
D)1,2,3,4,and 5

Question 6

Albuterol is available in which of the following forms?
1)Syrup
2)Nebulizer solution
3)Metered dose inhaler (MDI)
4)Oral tablets
5)Dry powder inhaler (DPI)

A)2 and 3 only
B)1,2,and 5 only
C)3,4,and 5 only
D)1,2,3,and 4 only

Question 7

Long-acting $\beta$ ₂ agonists are indicated for

A)acute asthma attacks.
B)mucus reduction.
C)treating infections.
D)maintenance therapy for asthmatics.

Question 8

The bronchodilating action of adrenergic drugs is due to stimulation of

A)α receptors.
B)cholinergic receptors.
C)β₁ receptors.
D)β₂ receptors.

Question 9

Levalbuterol is

A)the same as albuterol.
B)the single (R)-isomer of albuterol.
C)an equal mixture of (R)-isomers and (S)-isomers.
D)the same as racemic epinephrine.

Question 10

$\beta$ ₁-receptor stimulation

A)causes vasoconstriction.
B)provides upper airway decongestion.
C)increases heart rate and contractile force.
D)relaxes bronchiole smooth muscle.

Question 11

You enter the room of a 2-year-old patient who presents with a "barking cough" typically associated with croup.Once the diagnosis is confirmed,which of the following medications could you recommend to help provide relief from subglottic swelling?

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

Question 12

Your patient is diagnosed with persistent asthma.Which type of drug would you recommend for maintenance bronchodilation and control of bronchospasm?

A)Short-acting adrenergic agent
B)Long-acting adrenergic agent
C)α-adrenergic agent
D)Mucolytic agent

Question 13

Salmeterol is

A)a long-acting $\beta$ -adrenergic agent.
B)another name for albuterol.
C)available in nebulizer solution only.
D)indicated for acute asthma attacks.

Question 14

Adrenergic bronchodilators mimic the actions of

A)cAMP.
B)acetylcholine.
C)penicillin.
D)epinephrine.

Question 15

In a patient who is receiving large doses of catecholamines,which side effect would you expect to see?

A)Decrease in blood pressure
B)Constriction of bronchial smooth muscle
C)Diuresis
D)Bradycardia

Question 16

Racemic epinephrine comes in what percent solution?

A)0.05%
B)1.25%
C)2.25%
D)5.0%

Question 17

Your patient presents with postextubation stridor.You recommend racemic epinephrine for its

A)?-adrenergic vasoconstricting effect.
B)short-acting $\beta$ ₂-adrenergic effect.
C)long-acting $\beta$ ₂-adrenergic effect.
D)?₁-adrenergic effect.

Question 18

The keyhole theory indicates that the larger the side-chain attachment to a catechol base,the

A)shorter the duration of action.
B)more easily it is metabolized.
C)more easily it is broken down by catechol O-methyltransferase (COMT).
D)greater the $\beta$ ₂ specificity.

Question 19

Catecholamines are inactivated by

A)AchE.
B)COMT.
C)cGMP.
D)ATP.

Question 20

Epinephrine stimulates which sites?
1) $\alpha$
2) $\beta$ ₁
3) $\beta$ ₂
4)M₃

A)2 only
B)4 only
C)1,2,and 3 only
D)2,3,and 4 only

Question 21

What is the indication for use of a short-acting $\beta$ agonist in asthma?

A)As maintenance therapy in reversible airflow obstruction
B)As rescue therapy in reversible airflow obstruction
C)As an antiinflammatory agent in reversible airflow obstruction
D)As an antiinfective agent in respiratory infections

Question 22

You receive an order to administer 5 mL of albuterol by small volume nebulizer (SVN).Which of the following should you do?

A)Confirm the order on the chart and administer as directed
B)Have your supervisor administer the treatment
C)Call the physician to confirm the medication dose
D)Give 0.5 mL of medication because that is probably what the physician meant to write

Question 23

What is the main difference between salmeterol and formoterol?

A)Formoterol is short-acting,and salmeterol is long-acting.
B)Formoterol has a slower onset and peak effect compared with salmeterol.
C)Formoterol is more $\beta$ ₂-specific than salmeterol.
D)Formoterol has a quicker onset and peak effect than salmeterol.

Question 24

You are administering an aerosolized bronchodilator to your patient.Her pretreatment pulse was 86 beats/min.You would stop the treatment if her pulse reached

A)90 beats/min.
B)100 beats/min.
C)110 beats/min.
D)120 beats/min.

Question 25

You are ordered to extubate a mechanically ventilated patient who has recently undergone open heart surgery.On postextubation assessment you note that the patient has stridor with mild retractions.What type of pharmacologic agent would you recommend?

A)β₂ adrenergic
B)α adrenergic
C)Anticholinergic
D)Sympatholytic

Question 26

Metaproterenol can be taken orally because:

A)It has a fast peak time,about 3 to 5 minutes.
B)It does not contain chlorofluorocarbons (CFCs).
C)It is an antibiotic.
D)It resists inactivation by catechol O-methyltransferase (COMT).

Question 27

When monitoring a patient using Ventolin,which side effect would you expect to see?

A)Sleepiness
B)Muscle tremor
C)Bradycardia
D)Hypotension

Question 28

Which procedure would tell you that a patient has reversible airway obstruction?

A)Inspection-patient is short of breath when walking less than 25 ft
B)Pulmonary function tests before and after bronchodilator therapy
C)Pulse oximetry
D)Wheezing on auscultation

Question 29

A drug that exhibits its pharmacologic activity once it is converted inside the body to its active form is called

A)the asthma paradox.
B)a prodrug.
C)downregulation.
D)a sympathomimetic.

Question 30

The dosage recommended by NAEPP EPR 2 for continuous nebulization of adrenergic agents is

A)5 to 8 mg/hr.
B)8 to 12 mg/hr.
C)10 to 15 mg/hr.
D)20 to 30 mg/hr.

Question 31

A 7-year-old boy has been given multiple aerosolized albuterol treatments over the last several days.His father tells you that every time a respiratory therapist administers a treatment,a few minutes later the saturation falls.You explain to the father that this is

A)abnormal and call the physician.
B)abnormal and you will try to change the medication to levalbuterol.
C)normal because of increased perfusion to poorly ventilated areas.
D)normal because you are giving the treatment with air.

Question 32

What is the rationale for using the single-isomer agent levalbuterol instead of racemic albuterol?

A)The (S)-isomer is thought to promote bronchoconstriction.
B)The (S)-isomer is a weak bronchodilator.
C)The (R)-isomer is thought to cause tachycardia.
D)The (R)-isomer is thought to cause tremors.

Question 33

Which of the following is a $\beta$ -agonist formulation that is a single isomer approved by the U.S.Food and Drug Administration (FDA)for aerosol delivery?

A)Epinephrine
B)Albuterol
C)Levalbuterol
D)Tiotropium

Question 34

Smooth muscle relaxation most likely occurs as a result of

A)a decrease in intracellular cAMP.
B)an increase in intracellular cAMP.
C)an increase in ATP.
D)a decrease in ATP.

Question 35

Inhalation is the preferred route of administering adrenergic bronchodilators for which of the following reasons?
1)Rapid onset of action
2)Smaller dosage used
3)Reduced side effects
4)Drug delivered to target organ
5)Safe and painless route

A)1 and 2 only
B)3 and 4 only
C)1,3,and 5 only
D)1,2,3,4,and 5

Question 36

Is it appropriate to use Arcapta Neohaler as a rescue bronchodilator?

A)Yes
B)No

Question 37

Your patient is receiving her third continuous nebulizer of albuterol (15 mg/hr).Which potential complications should you be on the lookout for?
1)Hypokalemia
2)Cardiac arrhythmias
3)Hyperglycemia
4)Premature ventricular contractions
5)Tremor

A)2 and 4 only
B)1,2,and 5 only
C)1,2,4,and 5 only
D)1,2,3,4,and 5

Question 38

What is the generic name of Arcapta Neohaler?

A)Proventil HFA
B)ProAir HFA
C)Indacaterol
D)Arformoterol

Question 39

Continuous nebulization of inhaled $\beta$ agonists has been used for

A)severe asthma.
B)pneumonia.
C)cystic fibrosis.
D)emphysema.

Question 40

Your patient requires a once daily long-acting $\beta$ ₂ agonist.The physician asks for your suggestion regarding medication choice.What medication would you suggest?

A)Brovana
B)Arcapta Neohaler
C)Performist
D)Serevent Diskus

Question 41

Which of the following is the generic name for Brovana?

A)Formoterol
B)Salmeterol
C)Olodaterol
D)Arformoterol

Question 42

Your patient is receiving continuous albuterol treatment for an acute exacerbation of her asthma.What would you monitor during her treatment?
1)The patient's subjective reaction to treatment
2)The patient's heart rate
3)The patient's pulse oximeter saturation
4)Laboratory values (CBC)

A)1 and 2 only
B)2 and 3 only
C)2,3,and 4 only
D)1,2,3,and 4

Question 43

Which of the following medications are classified as short-acting adrenergic bronchodilators based on their duration of action?
1)Racemic epinephrine
2)Formoterol
3)Albuterol
4)Levalbuterol
5)Arformoterol
6)Olodaterol

A)2 only
B)3 and 4 only
C)2,3,and 6 only
D)4,5,and 6 only

Question 44

Which of the following is the generic name for Arcapta Neohaler?

A)Indacterol
B)Salmeterol
C)Olodaterol
D)Arformoterol

Question 45

Which of the following medications is an ultra-long-acting $\beta$ -agonist approved for the treatment of COPD?

A)Striverdi Respimat
B)Xopenex
C)VoSpire ER
D)AccuNeb

Question 46

Which of the following is the generic name for Performist?

A)Indacterol
B)Salmeterol
C)Formoterol
D)Arformoterol

Question 47

Which of the following is the generic name for Striverdi Respimat?

A)Indacterol
B)Salmeterol
C)Olodaterol
D)Arformoterol

Question 48

Which of the following medications are classified as long or ultra long-acting adrenergic bronchodilators based on their duration of action?
1)Indacterol
2)Formoterol
3)Albuterol
4)Indacaterol
5)Arformoterol
6)Olodaterol

A)1 only
B)4 only
C)4 and 6 only
D)5 and 6 only

Question 49

Which of the following medications are classified as ultrashort-acting adrenergic bronchodilators based on their duration of action?
1)Racemic epinephrine
2)Formoterol
3)Albuterol
4)Indacaterol
5)Arformoterol
6)Olodaterol

A)1,2,and 4 only
B)1 only
C)4 and 7 only
D)1,4,7,and 8 only

Question 50

The dosage and route for arformoterol is

A)5 to 8 mg PO.
B)2.5 mg tid via nebulization.
C)15 $\mu$ g bid via nebulization.
D)90 $\mu$ g tid via MDI.

Question 51

Which of the following medications are given only once daily?
1)Formoterol
2)Albuterol
3)Indacaterol
4)Arformoterol
5)Levalbuterol
6)Olodaterol

A)1 and 4 only
B)4,5 and 6 only
C)3 and 6 only
D)1,4,5,and 6 only