Beta 2 Bronchodilator: Levalbuterol (BBL)
What branch of the nervous system controls involuntary functions like heart rate and brachial tone?
What is the Autonomic nervous system?
What does it mean if a drug has a short half-life?
Drugs get eliminated from the body quickly, meaning the drug needs to be given more frequently.
Explain why end-inspiratory breath hold is so important during aerosol therapy
Increases drug deposition by allowing particles to settle and diffuse in the lungs.
How many drops are in 1mL of liquid?
16 gtts.
What would you give a patient with glottic edema or stridor?
Racemic Epinephrine
What type of drug would mimic the parasympathetic nervous system and cause bronchoconstriction?
What are Parasympathomimetic or Cholinergic agents?
Define Parenteral and Enteral Drug Administration.
Parenteral refers to the need for a needle to administer medication, while enteral refers to medication administered through the GI tract.
Common mistakes made by patients when using an MDI. What can help combat this?
Failing to shake the inhaler, not using a spacer, poor hand-breath coordination, and not holding breath. Patient education on MDI use.
You're ordered to give 2mL of a 5% albuterol solution? How many milligrams of albuterol are you delivering?
5%= 50mg/mL → 2mL x 50mg/mL = 100mg
Your patient is diagnosed with persistent asthma. What drugs would you recommend for maintenance bronchodilation?
Salmeterol, olodaterol, formoterol, indacaterol, arformoterol.
Explain what beta 1 and alpha 2 receptors do.
Beta 1 increases heart rate and blood pressure. Alpha 2 inhibits norepinephrine and decreases blood pressure.
Name the three factors that affect drug absorption.
Metabolism, route of admission, and first bypass effect.
What delivery device is used for ribavirin?
SPAG (small particle aerosol generator).
You give a patient 1.5mL of a 1:100 solution. How many milligrams will you have administered?
1:100= 1000 mg in 100mL = 10mg/mL → 1.5 x 10= 15mg
Your patient is on their third round of continuous albuterol nebulizer. What adverse effects should you be looking out for?
Hypokalemia, tremors, tachycardia, headache, arrhythmia, hyperglycemia.
What is the purpose of each of the following main drug groups used in respiratory care?
Corticosteroids, bronchodilators, mucolytics, and antibiotics
Corticosteroids reduce inflammation in the airways. Bronchodilators open airways by relaxing bronchial muscle, mucolytics- thin out thick mucus for easy clearance, and antibiotics fight infection.
What is the therapeutic index, and why is it important?
TI measures drug safety. The narrower the TI, the greater the risk the drug is of being toxic. A high TI typically means the drug is safer, while a low TI means the drug is riskier in terms of dosing and toxicity.
What are the main components of an MDI device?
Canister, metering valve, mouthpiece (actuator), dose counter
What volume of a 0.25% Decadron solution is needed to deliver a 5mg dose?
0.25%= 2.5mg/mL → 5፥ 2.5= 2mL
Explain how spirometry can determine if airway obstruction is reversible
By comparing FEV1 pre- and post-bronchodilator. If there is a significant increase, then the obstruction is reversible.
Why would a cholinergic agent like mannitol be used in a clinical setting?
Cholinergic agents are used to help diagnose asthma by deliberately causing bronchial constriction.
How does tolerance develop in patients using bronchodilators, and how is it managed?
Consistent use of bronchodilators over time becomes less effective and is managed by adding corticosteroids to improve response to medication.
You are assigned to educate a pediatric parent on aerosol therapy, and the child is acutely dyspneic. Which delivery device would you recommend and why? Include breathing pattern and device setup.
The device chosen should be SVN, due to the patient being a child, it is assumed that the child would not be able to coordinate inhalation. Device setup should be filling volume of 3-5mL, flow rate 6- 10L/min, and nebulation time 10-15 min. The breathing pattern should be normal breathing.
Physician orders 2mL of a 2.5% strength solution. How many mg will be administered?
2.5%= 25mg/mL → 2 x 25= 50mg.
What is the duration time of all the long-acting beta agonists (LABAs)
Salmeterol, formoterol, and arformoterol- 12-hour duration
Olodaterol and indacaterol- 24-hour duration