Pharmacology Test 2 Ch 6, 7, 9

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1

Describe the In-Check DIAL.

It is a hand held low range inspiratory flow measurement device with a dial top. This enables clinicians to train patients to the proper inspiratory technique considering force and flow rate to achieve optimal deposition of the medication being inhaled into the lungs.

2

What is the definition for COPD?

Persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases.

3

How is COPD diagnosed?

FEV1/FVC % < 70% ratio by spirometry.

4

Describe Gold 1 - 4

card image
5

When is a LABA suggested for Managing Asthma ?

card image

Step 3 and above.

6

Beta agonist relieve __________________.

bronchoconstriction.

7

_____________ used with __________________ in moderate and severe acute asthma (specially in children) to improve airflow.

Anticholinergics, Beta Agonist

8

_______________ are used to decrease airway edema and secretions.

Systemic Steroids

9

Why are beta agonist used?

To produce bronchodilation.

10

What diseases do Beta Agonist treat?

  • Asthma
  • Emphysema
  • Pnuemonia
  • COPD
  • IEA
11

What is meant by the term reliever medication?

Medication that is used for quick relief of asthma symptoms. They are SABA's, used during exacerbation to treat an acute airflow obstruction.

12

Albuterol, Proair, Proventil, Ventolin, and Xopenex are examples of what?

SABAs

13

What is meant by the term controller medication?

Meds that work over a period of time to reduce airway inflammation and help prevent asthma from reoccurring.

Controller meds help in the prevention, maintenance of bronchodilation, and control of bronchospasm.

14

What three things do controller meds maintain/control?

It controls inflammation, prevents bronchoconstriction and reoccurring symptoms.

15

Beta _____ receptors are the major receptors stimulated.

2

16

Stimulation of Alpha receptors cause ______________________. This is the type of medication you would want to help increase blood pressure.

Vasoconstriction.

17

What 3 things does Beta 1 receptor stimulation cause?

  1. Increase myocardial conductivity
  2. Increase force of heart contraction
  3. Increase Heart Rate
18

What 3 things does Beta 2 receptor stimulation cause?

1. Relaxation of bronchial and skeletal smooth muscle

2. Inhibits inflammatory mediator release

3. Stimulates mucociliary clearance

19

Adenylyl cyclase converts ________ to _________. which in turn inactivates myosin light chain kinase. _________ intracellular ____________ and causing smooth muscle relaxation. ( Bronchodilation)

ATP, cAMP, Decreasing, Calcium

20

What are 3 inhaled preparations? Oral? parenteral?

Inhaled : MDI, DPI, SVN

Oral: Tablet, Syrup

Parenteral: IV, Subcutaneously

21

Name the 4 types of Catecholamines.

Norepinephrine, Epinephrine, Racemic Epinephrine, Dopamine.

22

DRUG CARD (RACEMIC EPINEPHRINE-VAPONEFRIN,MICRONEPHRINE,S2)

What is Racemic Epinephrine used for?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical effects?

Side effects?

Special Consideration?

Upper Airway Edema in post extubated patients or croup.

Drug ID: Sympathomimetic BD

Strength: 2.25% solution

Dosage: SVN : 0.5 ML (11.25 mg)

Mode of action: Stimulates Alpha1, B1,B2

Clinical Effects: Vasoconstriction to reduce airway swelling due to post extubation, croup, epiglotitis, bronchiolitis or control of bleeding of airway during endoscopy. NOT USED FOR ASTHMA.

Side effects: Cardiac arrhythmias, chest pain, dizziness, headache, trembling, rebound airway edema, increase heart rate, increase blood pressure.

Special consideration: S2 can not be drawn up with a needle. Don't use with MAO's. Rebound effects. Short acting.

23

DRUG CARD (ALBUTEROL)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical Effects?

Side Effects/Hazards?

Special Considerations?

Drug Name: Albuterol (Proventil, Ventolin, ProAir) Kids (AccuNeb), (VoSpire ER)

Drug ID: Sympathomimetic BD

Strength: 0.5%, Kids 0.021% and 0.04%

Dosage: SVN: 2.5 mg (0.5 ml), MDI 90 mcg/puff

Kids SVN: 0.63 mg/3 ml and 1.25/3ml

Tabs : 4 and 8 mg

Syrup: 2mg/5ml

Mode of Action: A relatively selective stimulator of Beta 2 receptor sites

Clinical effects: Relaxation of bronchial smooth muscle to produce bronchodilation

Side effects/hazards: Tolerance, tremor, CNS effect (Headache, nervousness, insomnia, anxiety, palpitations (rare), tachycardia (rare), nausea

Special Considerations: Reaction to propellant, reaction to preservatives in the neb solution, may need to prime MDI if not used in a while. Must count doses on MDI as cannot determine when empty.

24

What 2 isomers does Albuterol have?

R and S isomer.

25

DRUG CARD (LEVALBUTEROL - XOPENEX)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical Effects?

Side Effects/Hazards?

Special Considerations?

Drug Name: Levalbuterol (Xopenex)

Drug ID: Sympathomimetic BD

Strength: 0.31 mg or 0.63 or 1.25 mg/ 3 ml; MDI: 45 mcg/puff

Dosage: SVN: 0.31 mg / 3 ml

0.63 mg/3 ml

1.25 mg/3 ml

MDI 45 mcg/puff

Mode of Action: Relatively selective Beta 2

Clinical effects: Bronchoconstriction

Side effects/hazards: Slight CV and CNS effects

Special Considerations: Don't mix with other drugs. Do not use if colorless. MWust clean actuator every week and dry. MDI must release four sprays into air before use or if not used in more than 3 days. If pouch is open use within 2 weeks, if out of pouch use within 1 week.

26

What isomer does levalbuterol has?

R isomer.

(This is why it claims not to increase heart rate)

27

What are 2 advantages of Long Acting Agents?

1. Less frequent Dosing

2. Protects against night time asthma symptoms

28

What are some examples of LABAs?

These are control meds which are not used in emergencies.

  • Salmeterol
  • Formoterol
  • Arformoterol
  • Indacaterol Maleate
  • Vilanterol
  • Olodaterol
  • Albuterol tablets (4 or 8 mg)
  • Vospire ER
29

What is Salmetoral with fluticasone (steroid) called?

card image

Advair

30

How are LABAs different than other beta adrenergic drugs?

They have a longer onset of action but take longer to see an affect (about 14-22 minutes to see the effect of 15% increase in FEV1)

31

DRUG CARD (SALMETEROL XINAFOATE -SEREVENT)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical Effects?

Side Effects/Hazards?

Special Considerations?

card image

Drug Name: Salmeterol (Serevent)

Drug ID: Sympathomimetic BD

Strength: 50 mcg/dose

Dosage: DPI: 1 puff

Mode of Action: Long acting selective Beta 2 agonist

Clinical effects: Long term management of bronchoconstriction.

Side effects/hazards: Not for acute management *

Special Considerations: Diskus not to be used with spacer. Must provide a rescue inhaler. Patient must know the difference between rescue and controller drugs, no longer available as MDI.

32

Formoterol with budesonide is called?

card image

Symbicort

33

Formoterol with mometasone furoate is called?

card image

Dulera

34

What 2 isomers does formoterol have?

An R and S isomer

35

DRUG CARD (FORMORTEROL-FORADIL + PERFORMIST)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical Effects?

Side Effects/Hazards?

Special Considerations?

card image

Drug Name: Formoterol (perforomist)

Drug ID: Sympathomimetic BD

Strength: 0.001%

Dosage: SVN: 20 mcg/2 ml

Mode of Action: relative selective B2

Clinical effects: Bronchodilator

Side effects/hazards: ********

Special Considerations: Interacts with MAO inhibitors, tricyclic antidepressants. Must provide a rescue inhaler. Patient must know the difference between controllers and relievers. Neb solution has a 3 month shelf life in the fridge. Keep in foil pouch until used.

36

What isomer does arformoterol have?

R isomer

37

DRUG CARD (ARFORMOTEROL-BROVANA)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical Effects?

Side Effects/Hazards?

Special Considerations?

card image

Drug Name: Arformoterol (Brovana)

Drug ID: Sympathomimetic BD

Strength: 0.00075%

Dosage: SVN: 15 mcg/2ml

Mode of Action: relative selective B2

Clinical effects: Maintenance treatment of COPD

Side effects/hazards: pain, chest pain, back pain, diarrhea, and sinusitis

Special Considerations: Used with caution with MAO inhibitors, tricyclic antidepressants or drugs that increase QT intervals (potentiates them), Used with caution with patients with convulsive disorders or thoroxicious / unusual response to sympathomimetics, Do NOT use with other LABA or meds with LABA, Use immediately once foil is open, Must provide rescue inhaler, Patient must know the dff btwn controller and relievers

38

DRUG CARD ( INDACATEROL MALEATE-ARCAPTA NEOHALER)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical Effects?

Side Effects/Hazards?

Special Considerations?

card image

Drug Name: Indacaterol Maleate

Drug ID: Sympathomimetic BD

Strength: NA 75 mcg capsule

Dosage: 75 mcg/daily

Mode of Action: relative selective B2

Clinical effects: Maintenance treatment of COPD

Side effects/hazards: Cough, headache, nausea

Special Considerations: Contraindicated for asthma. Don't use with diuretic, xanthine derivatives, beta blockers or steroids, store in blister pack until ready to use.

39

DRUG CARD (OLODATEROL -STRIVERDI RESPIMAT)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical Effects?

Side Effects/Hazards?

Special Considerations?

card image

Drug Name: Olodaterol (Striverdi Respimat)

Drug ID: Sympathomimetic BD

Strength: NA 2.5 mcg/actuation

Dosage:

Mode of Action: relative selective B2

Clinical effects: Maintenance treatment of COPD

Side effects/hazards: Nasopharyngitis, Upper respiratory tract infection, bronchitis, urinary tract infection, cough, dizziness, rash, diarrhea, back pain, arthralgia

Special Considerations: Contraindicated for asthma. Unit must be primed. Potentiates hypokalemia if used with xanthine derivatives, steriods or diuretics. Dont use with beta blockers, MAO inhibitors and tricyclic antidepressants.

40

Describe the Keyhole theory.

This theory indicates that the larger the side chain attachment to a catechol base the greater the B2 specificity the medication is.

41

Vilanterol is a ____________ that is only available as a __________ drug.

LABA, Combo

42

Fluticasone Furoate and Vilanterol is called?

card image

Breo Elliptica

43

Umeclidinium and Vilanterol is called?

Umeclidinium is a __________.

Anoro Ellipta

LAMA

44

Umeclidinium is a ______

LAMA

Long Acting Muscanaric Antagonist

45

LABAs should not be used in patients who _____________________________________.

are controlled with low dose ICS.

46

LABAs should be used for ________ term only, and once the patient is controlled they should be discontinued.

short

47

Children ________ use LABAs with ICS

should not

48

Which drugs are not in combo for COPD maintenance?

Olodaterol and indacaterol Maleate

49

Which drugs for COPD don't have ICS?

Arformoterol and formoterol

50

When a patient doesnt respond to therapy, theyll get?

continuous nebulization.

51

What are two examples of large volume high output nebs?

The large heart and Hope neb

52

Most deliver what mg range of albuterol per hour?

10-15 mg/hr

53

What are four complications of continuous nebulization?

1. Cardiac arrythmias

2. Hyperglycemia

3. Significant Tremors

4. Hypokalemia

54

What are the adverse effects?

Tremors, cardiac effects, tolerance, loss of bronchoprotection, CNS effects, Nausea, Fall in PaO2

55

Why do tremors occur?

Swallowing aerosol meds that stimulate Beta 2 receptors in skeletal muscles.

56

Why do cardiac effects happen?

There are some B2 receptors on the heart.

57

What is down regulation? and what can reverse this?

A long term decrease in the number of beta receptors.

Steroid can reverse this.

58

What does loss of bronchoprotection cause?

Easier reactions to cold air, methacholine and histamine

59

At what HR should the Rx be stopped?

>20% increase or decrease.

60

Metabolic Disturbances

What can happen to diabetics due to side effects?

Diabetics can experience an increased glucose and insulin levels and hypokalemia.

61

Define Morbidity:

The frequency of occurrence of a disease. describing the presence of illness or disease or something that results from a disease or caused by a disease.

62

Define Mortality:

Death, on a large scale.

63

What are 5 reasons why morbidity and mortality are increasing?

  1. Expose to triggers
  2. Repeated self administration of meds
  3. Not being compliant with medication use
  4. Drug accumulation of S- isomers
  5. Pollution and lifestyle changes
64

What 2 PFT values can be monitored?

Peak flow meter and FEV1.

Peak flow best in home, FEV1 and peakflow in the office.

65

Are these subjective or objective measurements?

These are the best objective measurements!

66

Lone term desensitization of B receptors to B2 agonist, caused by a reduction in the number of B receptors, is called _________

down regulation.

67

What drug is the prototype for parasympatholytic BD?

Atropine

68

What are four other drugs similar to Atropine?

  1. Ipratrobrium Bromide (Atrovent)
  2. Tiotroprium bromide (spiriva)
  3. Aclidinium bromide (tordoza)
  4. Umeclidinium
69

What do the following terms mean, SAMA and LAMA?

Short acting muscarinic antagonist

Long acting muscarinic antagonist

70

Label the following as SAMA, LAMA, SABA or LABA

1. Ipatroprium Bromide _________

2, Ipatroprium Bromide and Albuterol combinations ______+_______

3, Tiotroprium __________

4, Aclidinium bromide _______

5. Umeclidinium ________

6. Umeclidinium and vilanterol _________+________

7. Tiotroprium abd olodaterol _________+__________

  1. SAMA
  2. SAMA+SABA
  3. LAMA
  4. LAMA
  5. LAMA
  6. LAMA+LABA
  7. LAMA+LABA
71

Which meds are specifically for COPD patients?

Umeclidinium

Umeclidinium and Vilanterol

Tiotroprium and Olodaterol

72

Primarily, who uses these drugs for maintenance therapy?

COPD, example: Chronic Bronchitis and Emphysema.

73

What drugs are part of the "older" combination therapy?

What is the combination therapy used to treat?

SAMA and SABA, used to treat COPD and Asthma

74

What drugs are part of the newer combination therapy? What is this therapy used to treat?

LAMA and LABA, used to treat COPD patients

75

What effect do these anti-cholinergic drugs have on the HR? upper airways? mucociliary escalator? airways?

Increases HR

Dries upper airway

Slows down mucociliary escalator

and inhibits bronchoconstriction in the airways

76

PNS intervention and muscarinic receptors are commonly found in the _________ airways.

large.

77

The bronchomotor tone is under control of which system?

PNS.

78

The bronchomotor tone blocks effects of Ach on Ach receptors on bronchial smooth muscle. All of the above is dependent on amount of tone that can be blocked.

See pg. 6

79

SEE ATTACHED FIGURE ON PAGE 7 and describe in your own words what the diagram is illustrating.

It's illustrating that parasymphatholytic anticholinergic agents blocks Ach from reaching the receptors and causing bronchoconstriction. Therefore it inhibits this constriction to cause bronchodilation.

80

What is the end result of vagally mediated bronchospasm?

It is a protective mechanism that causes bronchoconstriction when exposed to irritants.

81

What type of antagonist are parasympatholytics?

What do they block and what type of protein are they linked to?

Competitive Antagonist

They block reflex bronchospasm, M1 and M3 receptors.

They are linked to G-Linked Proteins.

82

When M3 receptors are stimulated they activate ______________________.

G-linked proteins.

83
  1. What type of ammonium compound is Atropine? Can is cross the BBB?
  2. What type of ammonium compound is Ipatroprium and tiotroprium? Can it cross the BBB?

1. Tertiary, and yes it can.

2. Quanternary, and no it can not

*There is far less side effects is it doesn't cross the BBB

84
card image

Drug Card: Ipatropium Bromide (A bronchodilator medication that opens up the medium and large airways in the lungs)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of action?

Clinical Effect?

Side effects/hazards?

Special Considerations?

card image

Drug Name: Ipatropium Bromide (Atrovent)

Drug ID: Parasympatholytic BD

Strength: 0.02%

Dose: SVN: 2.5 ML, MDI: 20 mcg/puff

Mode of action:

Clinical effect: Bronchodilation

Side effects: Dizziness, nausea, stomach upset, dry mouth, or constipation

Special Considerations: Does not cross the BBB. SVN dose is 10x> than MDI dose. Do not use MDI if allergic to peanuts. Do not spray drug in eyes. Patients should not be on this and spiriva.

85

Drug card: Combivent Respimat (Bronchodilator)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of action?

Clinical effects?

side effects?

Special Consideration?

card image

Drug Name: Ipratropium bromide/Albuterol (Douneb, Combivent respimat)

Drug ID: Parasympatholytic BD

Strength: 0.02% of ipratropium, 0.08% of albuterol

Dosage: SVN:0.5 mg/ 3 ml ; 20 mcg atrovent and 100 mcg albuterol per 1 puff ; SVN: 3ml vial

Mode of action:

Clinical effects: bronchodilation

Side effects:

Special Considerations: This is a combo drug so all special considerations apply for each drug. This should not be used as a rescue inhaler/ Patients should not be on this and tiotroprium or aclidinium bromide or umeclidinium. Dosing is usually 4x/day but not to exceed 6 doses/24 hours. if not used within 3 days, must release one dose. if not used in 21 days must reprime.

86
card image

How do you prime the device?

Clean the device?

What does TOP mean for patients?

You keep turning it until you see a good mist/ The device is cleaned with a damp cloths. TOP for patients means TURN, OPEN, PRESS.

87
card image

Drug Card: Tiotropium Bromide (Spiriva) It can prevent bronchospasm caused by COPD and reduce flare-ups of serious symptoms. *LAMA

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical effects?

Side effects?

Special Considerations?

card image

Drug name: Tiotropium bromide (Spiriva)

Drug ID; Parasympatholytic BD

Strength: NA (because its a DPI)

Dose: DPI: 18 mcg/capsule MDI: 2.5 mcg/inhalation

Mode of action:

Clinical Effects:Maintenance therapy of COPD

Side effects:

Special considerations: Not a rescue medication. Does not cross the BBB. Do not allow powder/mist in the eyes as it may cause blurring of vision and pupil dilation. DPI not used if lactose allergy- ok to use if lactose intolerant. DPI- store capsules in sealed blister pack and remove only immediately before use. Medication is dosed once daily.

88
card image

Drug card: Aclidinium Bromide (Aclidinium bromide is a long-acting, inhaled muscarinic antagonist, approved as a maintenance treatment for chronic obstructive pulmonary disease *LAMA

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical effects?

Side effects?

Special Considerations?

Drug Name: Aclidinium Bromide (Turdoza Pressair)

Drug ID: Parasympatholytic BD

Strength: NA (DPI)

Dosage: 400 mcg/puff BID

Mode of Action:Blocks effect of Ach on Ach receptors on bronchial smooth muscle

Clinical effects: inhibits bronchoconstriction

Side effects: Headache, nasopharyngitis, cough

Special Considerations: May worsen narrow angle glaucoma, urinary retention. Not a rescue med, discard 45 days after opening, device locks when empty.

89
card image

Drug card: Umeclidinium (anticholinergic bronchodilator for the long-term, once-daily, maintenance treatment of chronic obstructive pulmonary disease (COPD) *LAMA

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical effects?

Side effects?

Special Considerations?

Drug Name: Umeclidinium (Incruse Ellipta)

Drug ID: Parasympatholytic BD

Strength: NA (DPI)

Dosage: 62.5 mcg of umeclidinium

Mode of Action:Blocks effect of Ach on Ach receptors on bronchial smooth muscle

Clinical Effects:inhibits bronchoconstriction

Side effects: paradoxical bronchospasm, worsening of narrow angle glaucoma, urinary retention, nasapharyngitis, upper airway resp. tract infection, cough, myalgia, toothache, contusion, tachycardia

Special Considerations: Once a day dosing for COPD. It is not indicated for the relief of acute bronchospasm or for treatment of asthma. Contraindicated in pts with severe hypersensitivity to milk proteins. Dont not use with other anticholinergic agents.

90

Drug Card: Umeclidinium/vilanterol (an inhalation powder drug product for delivery of a combination of umeclidinium (an anticholinergic) and vilanterol (a LABA) to patients by oral inhalation.)

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical effects?

Side effects?

Special Considerations?

Drug Name: Umeclidinium/vilanterol ( Anora Ellipta )

Drug ID: Parasympatholytic BD/Parasympathomimetic BD

Strength: NA

Dosage:62.5 mcg/ 25 mcg

Mode of Action: Blocks effect of Ach on Ach receptors on bronchial smooth muscle

Clinical effects: inhibits bronchoconstriction

Side effects: Pharyngitis, constipation, diarrhea, muscle spasm, neck pain, chest pain, headache, back pain, sinusitis, cought, UTI, nausea, vertigo, abdominal pain, toothache, diabetes.

Special Considerations: Once a day dosing for COPD. It is not indicated for the relief of acute bronchospasm or for the treatment of asthma. Contraindicated in pts with sever hypersensitivity to milk based proteins. Do not use with other anticholinergic drugs.

91

Drug card: Tiotropium/Olodaterol

Drug Name?

Drug ID?

Strength?

Dosage?

Mode of Action?

Clinical effects?

Side effects?

Special Considerations?

Drug Name: Tiotropium / Olodaterol (Stiolto Respimat)

Drug ID: Parasympatholytic BD / SBD

Strength: N/A

Dosage: 25 mcg/ 2.5 mcg

Mode of Action: Blocks effect of Ach on Ach receptors on bronchial smooth muscle

Clinical effects: inhibits bronchoconstriction

Side effects?

Special Considerations?

92

What are the Effects and Side Effects in the:

1. Respiratory Tract

2. CNS

3. Eye

4. Cardiac

5. GI

6. GU

1. Bronchodilation, minimal effect on the mucociliary clearance, blocks nasal hyper secretion, cough, occasional paradoxical bronchospasm.

2. NONE.

3. NONE, unless sprayed in the eye

4. NONE

4. Dry mouth

6. none

93

What happens to patients with narrow angle glaucoma when drug is sprayed into the eyes?

it increase intraoccular pressure.

94

What are 4 ways to prevent side effects?

1. Prime away from the face

2. Use a reservoir tubing with a neb

3. Use a mouthpiece with a neb

4. Use neb that doesn't allow for continuous neb

95
card image

Fill out the Chart.

a. slower

b. faster

c. slower

d. faster

e.longer

f. shorter

g. none

h. yes

i. none

j. yes

k. large central airways

l. central and peripheral airways

m. none

n. yes

96

___________ is a more potent BD in bronchitis and emphysema.

Anticholinergics

They are a much better drug family for COPD patients.

97

When would ipatropirum bromide be useful in asthma?

When there is acute severe episodes that are not responding to beta agonist.

98

What is triple therapy best for?

What 3 drugs are part of this triple play?

For reducing the progression of COPD.

The 3 drugs involved are LABA, inhaled corticosteroids, LAMA

99

How do you measure effectiveness of drugs?

Peak flow at home or in office

FEV1 in office

100

Fill in the blank with the drug combos that are okay to use together.

  1. SABA and a
  2. SAMA and a
  3. SABA and a
  4. LAMA and a

1. LABA

2. LABA

3. SAMA

4. LABA

101

Fill in the blank with the drug combos that are NOT OK to use together.

  1. LABA and a
  2. SAMA and a
  3. SAMA and a
  4. LAMA and a

1. LABA

2. SAMA

3. LAMA

4. LAMA

102

Chapter 9 - Key Terms

Substances that reduce adhesion

abhesives

103

Rheologic property characteristic of solids, it is represented by the storage modulus G

Elasticity

104

Macromolecular description of pseudoplastic material having both viscosity and elasticity

Gel

105

Proteins with attached oligosaccharide units

Glycoproteins

106

The principal constituents of mucus and a high molecular weight glycoprotein that gives mucus its physical properties, such as viscoelasticity

Mucins

107

Term connoting any med or drug that has an effect on mucus secretion, may include mucolytic, expectorant, mucospiccic, ect

Mucoactive agent

108

Medications that increase cough or ciliary clearance of resp secretions

Mucokinetic agents

109

Meds that degrade polymers in secretions

Mucolytic agent

110

Med that increases the viscosity of secretions and may be effective in the therapy of bronchorrhea

Mucospissic agents

111

Secretion from surface goblet cells and submucosal glands composed of water, proteins and mucins

Mucus

112

Sugar that is the individual carb unit of glycoproteins

oligossacharide.

113

Purulent material in the airwards

Phlegm

114

Also called the periciliary layer, it is the weak gel containing attached mucins that bathes the beating cilia

Sol

115

Expectorated phlegm that contains resp tract, oropharyngeal and nasopharyngeal secretions, bacteria and products of inflammation, including polymeric DNA and actin

Sputum

116

Resistance of liquid to sheer forces or energy loss with applied stress

Viscosity

117

What are the 2 properties of mucus?

Viscosity and elasticity

118

Which phase propels mucus with the help of cilia towards the larynx?

Gel phase

119

Where are goblet, submucosal glands and clara cells located?

goblet and submucosal glands are found in cartilaginous airways and terminal bronchioles and clara cells are only found in the terminal bronchioles

120

What drug effects do B adrenergic agents and anticholinergics have on ciliary beat, mucus production and transport?

B-Adrenergic agents cause an increase in ciliary beat and production.

anticholinergics cause no change at all.

121

What two things is mucus made of?

protein which makes up the backbone and Oligosaccharides which makes up the side chain. Together they're called glycoprotein.

122

Glycoprotein internally cross linked with what two types of bonds?

Hydrogen bonds and disulfide bonds.

123

Why do CF pts have very thick mucus?

Because excessive Na is absorbed into the epithelial cells and CL secretion is decreased so less water is secreted into the mucus, in turn making the mucus very thick.

124

What does a Green/Yellow sputum color indicate?

Retained secretions due to infection.

125

Define Adhesives forces and Cohesive forces.

Adhesive forces: Force between unlike molecules

Cohesives forces: Force between like molecules


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