pharmacology 4
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- 4 Effects of disease on mucus
- Change in volume, change in color, change in odor, change in viscosity
- Clinical indication of Active agents
- Treatment pf pulmonary Edema and IRDS
- 2 layers of the Mucociliary Blanket
- Sol layer, Gel layer
- 2 Aerosolized steroids side effects
- Canida Albicans, Thrush
- Flunisolide is Longer acting than which drug
- Azmacort
- Form of Theophylline used for maintenance in asthma
- Oral
- What are Exogenous surfactants
- Surfactants produced outside of patient's body
- Why must a bronchodilator be administered with Acetylcysteine
- Acetylcysteine causes severe bronchospasms
- Define Lysis of mucus
- Break down of mucus
- Goblet cells function
- Split open and discharge mucus or secretions
- Dosage of Exosurf
- 5ml/kg in 2 divided doses of 2.5ml/kg
- Function of an Expectorant
- Stimulate to cough
- Cilia length
- 2-5 microns
- When should serum Theophylline levels be monitored
- At the time of peak absorption , 1-2 hours after administration for immediate release
- Side effects of Dornase Alfa
- Pharyngitis, Laryngitis, rash, chest pain, conjunctivitis in eye
- Dosage of Survanta
- 100mg/kg
- What does advair not replace
- Fast acting bronchodilators in asthma attacks
- what are Corticosteroids
- Group of chemicals secreted by the adrenal cortex
- Indication for Acetylcysteine
- Thick retained mucoid secretions, Acetaminophen overdose
- Representative drug of natural surfactant
- Survanta
- Range of serum Theophylline is the therapeutic range
- 10-20ug/ml
- What must be administered with Acetylcysteine
- Bronchodilator
- Trade name for beclamethasone
- Vanceril, beclovent
- What improvements should be seen after use of Systemic steroids
- Less SOB less Inflamation
- List 6 Aerosolized Corticosteroids
- Dexamethasone (decadron), Beclamethasone (Meclovent, Vanceril), Triamcinolone (Azmacort), Flunisolide (aerobid), Fluticasone (flovent), Advair Diskus (Flovent &serevent)
- Synthetic surfactant
- Artificial Surfactant
- 3 negative aspects of natural surfactant
- expensive, time consuming, not readily available
- Physiologic effects of Xanthine
- CNS stimulation, skeletal muscle stimulation, bronchodialation, pulmonary & coronary vasodialation, cardiac stimulation , diuresis
- Indication for Ethyl Alchol
- Acute Pulmonary Edema
- How Exosurf is stored
- As a powder
- Function of the Mucociliary Escalator
- Keep airway clean and lubricated
- A true mucolyic
- Liquefying expectorant
- What must you monitor closely when using Theophylline
- Serum level
- Rrange of serum Theophylline has no effect?
- < 5ug/ml
- 5 characteristics of Asthma
- Inflamation in the lungs, stimuli releases chemical mediators from the mast cells, inflammatory response, increase in eosinophils and neutrophils, goblet cell hyperplasia
- Form of Theophylline used for acute episodes of asthma
- IV
- List 3 systemic steroids
- hydrocortisone, prednisone, cortisone
- Acetylcysteine is incompatible with which 4 drugs
- Ampicillin, Amphotericin B, Erythromycin, Tetracycline
- What are surfactant also known as
- Surface active Agent
- Why proteolysis is no longer used
- It not only breaks down the protein of mucus but also the protein of the lungs which is damaging
- How Exosurf is reconstituted
- with 8ml of sterile water
- Mechanism of action of Corticosteroid
- Anti-inflammaotory effect due to the ability to inhibit the activity of inflammatory cells and mediators of inflammation.
- Trade name for Acetylcysteine
- Mucomyst
- Survanta is what type of agent
- natural surfactant
- What is the goal of Systemic steroids
- Optimal pulmonary treatment with lowest possible dose
- Cause of viscosity of mucus
- Dehydration
- Make up of Synthetic Surfactant
- mixture of DPPC, Cetyl Alcohol, Tyloxapol
- Range of serum Theophylline causes cardiac arrhythmias
- >30ug/ml
- What should you not do to survanta bottle
- shake it
- Dosage for Theophylline Anhydrous5
- 100% (100mg)
- A classic Xanthine derivative
- Theophylline
- Dosage for Triamcinolone Acetonide
- high inital doses100mcg/puff 12-16 inhalations per day
- 7 Complications of surfactant therapy
- Airway occlision, bradycardia, desaturation, hyperoxia, hypocarbia, apnea, pulmonary hemorrhage
- Dyphylline is a derivative of what drug?
- Theophylline
- 2 mucus controlling agents
- Liquefying expectorant, stimulant expectorant
- Representative drug of Synthetic surfactant
- Exosurf
- Action of Ethyl Alchol
- Lowers the surface tension
- 2 parts of the adrenal cortex
- Adrenal medulla and Cortex
- Exosurf is what type of agent
- synthetic surfactant
- How is Exosurf administered
- instilled dirctly into trachea on inspiration
- Indication of exogenous surfactant
- ARDS-stiff lungs
- List the 4 wetting agents
- Sterile water, Normal Saline, Hypotonic saline, Hypertonic saline
- Trade name for Triamcinolone Acetonide
- Azmacort
- clinical application of surfactant
- Prevention of IRDS in LBW infants and preemies, rescue treatment of infants with IRDS
- Action of Dornase Alfa
- Decrease viscosity by breaking down extracellular DNA
- What are wetting agents
- Dilutents
- Dosage of beclamethasone
- 12-16 inhalations per day
- What are Synthetic Natural Surfactants
- Genetically engineered surfactants
- Beclamethasone is stronger topically than which drug
- dexamethasone
- Mediator Antagonists
- Nonsteroid Antiasthma Agents
- Range of serum Theophylline causes Nausea
- >20ug/ml
- Action of Acetylcysteine
- Lysis of disulfide bonds
- 3 types of lysis of mucus
- Proteolysis, Ph adjustment, disulfide disruption
- Dosage for Acetylcysteine
- 10% 6-10ml, 20% 3 -5ml
- Dosage of Dornase Alfa
- 1 Ampule (2.5mg in 2.5ml solution) every day
- Range of serum Theophylline causes seizures
- >40-45ug/ml
- Have Synthetic Natural Surfactants been FDA approved
- NO
- Make up of Synthetic Natural Surfactants
- combination of natural and artificial agents
- Indication of Dornase Alfa
- Cystic Fibrosis
- Drug Name for Decadron Respihaler
- Dexamthasone
- Are Alevaire and Tergemist still used
- NO
- The Pharmacological class of Theophylline
- Third class of bronchodilators
- What action must be taken after use of airosolized steroids(MDI)
- rinse mouth and gargle
- Corticosteroids are referred to as
- Adrenal cortical hormones
- Cause of change in color of mucus
- Infection
- 2 Clinical uses of Theophylline
- Management of asthma and COPD, Treat Apnea in premature newborns
- Primary use of corticosteroids
- Prevent or reduce inflammation, severe asthma
- Define proteolysis
- Breaks down protein in mucus
- Surface Active Agents
- Detergents,Ethyl Alcohol
- HPA pathway
- Stimulate hypothalmus--release of CRF--pituitary gland--releases ACTH--stimulates Adrenal Cortex--release of Corticosteroid in the body
- What doesn't the wetting agents do when it comes to mucus
- does not control mucus
- how Survanta is administered
- divide dose in 1/4, give through french catheter in E-T tube.
- What color is Exosurf drug
- white milky substance
- 8 Therapeutic use of steroids
- Asthma, adrenal insufficiency, suppression of immune response in organ transplant, arthritis, rheumatic carditis, osteoarthritis, acute inflammatory disease, bronchitis
- Beat per minute cilia move
- 1200-1300 bpm
- First available MDI
- Decadron Respihaler
- 2 Representative drugs of Detergents
- Alevaire, Tergemist
- How natural surfactants are obtained
- humans and animals- cow lung
- Diurnal Steroid cycle
- Rhythmic circadian cycle
- Mucus is made up of what percentage water and mucin
- 95%H2O, 5%mucin
- what does HPA stand for
- Hypothalmus Pituitary Adrenal Axis
- Why should you not shake survanta bottles
- it will be useless
- 4 Xanthine derivatives
- Theophylline, Oxtriphylline, Aminophylline, Dyphylline
- What does the Diurnal Steroid Cylce prepare the body for
- Stress
- Make up of Survanta
- mixture of natural bovine and DPPC
- Trade name for Dornase Alfa
- Pulmozyme
- How exogenous surfactants obtained
- Obtained from other humans, animals, or lab synthesis
- 3 Clinical applications of Corticosteroids
- Control of asthma, treat bronchospasm, control allergic responses
- 6 Side effects of corticosteroids
- Cushings disease, hypertension, aggravation of diabetes mellitus, aggravation of peptic ulcer, psychotic manifestations, adrenal atrophy
- Dosage of Oxtriphylline
- 64%(156mg)
- Optimum serum level of Theophylline that must be achieved for maximum therapeutic bronchodilation
- 10-20ug/ml
- What is Triamcinolone Acetonide used in
- built-in spacer device
- Principle of surfactant
- LaPlace's Law-greater the radius the lower the surface tension
- Trade Name for Flunisolide
- Aerobid
- position of infant recieving Exosurf
- in midline position then rotated to the right after first half of dose. then rotated to the left after second half of dose
- what the diurnal steroid cycle mimic
- Normal fall and rise in body so not comatose
- Side effects of Acetylcysteine
- Bronchospasm, excessive liquification, stomatitis, nausea
- Advair diskus make up
- Combined inhaled corticosteroid and inhaled long-acting bronchodilator
- Dose of Theophylline for chronic therapy
- 16mg/kg per 24 hours
- The 3 different types of steroids produced by adrenal cortex
- Glucocorticoid (cortisol), Mineralocoricoid (aldosterone), Androgenic Corticosteroid (testosterone)
- Decadron Respihaler anti-inflammatory activity
- 30 times greater that hydrocortisone
- Initial oral dose of Theophylline
- 5mg/kg
- First line drug for therapy of Asthma
- Theophylline
- Secretory structures of mucus
- Surface epithelial cells, subepithelial cells, submucosal glands.
- Dosage for Aminophylline?
- 79%(127mg)
- 2 representative drugs of Exogenous surfactants
- Exosurf and survanta
- 4 Mucociliary properties
- Cohesive force, adhesive force, viscosity, elasticity
- Approximately how many cilia per cell are there
- 200
- Action of Detergents
- Alter surface Tension