Chapter 10 Respiratory Drugs

Quiz Yourself

1. Sympathomimetic bronchodilator drugs

stimulate beta2 receptors in the smooth

muscle around the bronchi (they mimic the

action of epinephrine from the sympathetic

division of the nervous system). Xanthine

derivative bronchodilator drugs act directly

on smooth muscle around the bronchi and

stimulate the respiratory center in the brain.

Anticholinergic bronchodilator drugs block

the action of acetylcholine on muscarinic

receptors in the smooth muscle around

bronchi.

2. False.

3. A metered-dose inhaler (MDI) is an Lshaped device. The top of the device holds asmall, removable metal canister that containsthe drug in an aerosol form. The patient holds the device in an upright “L” position,puts the mouthpiece in the mouth, presses down on the canister, and then inhales theaerosol drug.

A Diskus is a round device that contains

the drug in a powdered form. The

patient holds the Diskus in a horizontal position, slides the lever to release one dose of drug, puts the mouthpiece into the mouth, and then inhales the powdered drug.

A Handihaler contains three pieces:

a base that holds a capsule that contains

the powdered drug, a mouthpiece, and a

protective upper cap. After a capsule is

inserted into a small chamber in the base,

the mouthpiece is snapped into place over

the base, and the capsule-piercing button

is pushed to break open the capsule and

release the powder. The patient puts the

mouthpiece into the mouth and inhales the

powdered drug.

A Turbuhaler and a Twisthaler are

similar in that each consists of a protective

cap and a combination mouthpiece and

base that contains the powdered drug. As

the cap is twisted off from the base, a new

dose of powdered drug is prepared. The

patient holds the Turbuhaler vertically and

the Twisthaler horizontally, inserts the

mouthpiece into the mouth, and inhales the

powdered drug.

4. Mast cell stabilizer drugs are used to prevent asthma attacks. Mast cell stabilizer

drugs stabilize the cell membrane of mast

cells and prevent them from releasing histamine during the immune system’s response to an antigen. This prevents bronchospasm in patients with asthma due to allergies.

5. The monoclonal antibody drug omalizumab (Xolair) must be given by subcutaneous injection in the doctor’s office.

6. The suffix –mab at the end of a generic drug name means that it is a monoclonal antibody drug.

7. The bacterium Legionnella pneumophilia,

was named for its first recognized outbreak,

which occurred in 1976 at an American

Legion convention in Philadelphia. The bacterium is especially attracted to the

environment of the lungs, and so its full scientificname is Legionnella (based on where it originated) and pneumophilia (which means thing that loves the lungs).

8. Tuberculosis is caused by the bacterium

Mycobacterium tuberculosis.

9. These are the six primary drugs used to

treat tuberculosis.

ethambutol (Myambutol)

isoniazid (INH) (Nydrazid)

pyrazinamide

rifampin (Rifadin, Rimactane)

rifapentine (Priftin)

streptomycin

10. Tuberculosis patients who refuse to (or are unable to) be compliant with drug treatment may be required to participate in

directly observed therapy (DOT), in which

the patient must come to a clinic each day

and be observed while actually taking

each dose.

11. True.

12. Drugs such as Nicoderm CQ are nicotine drugs that provide a gradual withdrawal from nicotine to diminish the craving andhelp persons to successfully stop smoking. Varenicline (Chantix) binds to nicotine receptors and blocks them from being activated by nicotine.

13. The syllable sur or surf in drugs used to

treat respiratory distress syndrome means

that those drugs contain surfactant to reduce surface tension to prevent the lungs from collapsing with each breath.

14. a. bronchodilator drug

b. mast cell stabilizer drug

c. corticosteroid drug

d. drug used to treat tuberculosis

e. leukotriene receptor blocker drug

f. bronchodilator drug

g. drug used to treat tuberculosis

h. bronchodilator drug

i. corticosteroid drug

j. drug used to stop smoking

k. leukotriene receptor blocker drug

Clinical Applications Questions

1. a. albuterol

b. ProAir HFA, Proventil HFA, Ventolin HFA

c. bronchodilator drug

d. To relax the smooth muscle around the

bronchi so that they can dilate, and this

increases air flow.

2. a. Flovent inhaler and albuterol inhaler

b. Flovent inhaler, 110 micrograms per milliliter,

2 puffs twice a day. Albuterol

inhaler, 2 puffs every 4 hours as needed.

3. a. funisolide

b. AeroBid

c. No, this is the same drug because Aero-

Bid is the trade name for the generic

drug funisolide.

d. albuterol

e. Ventolin

f. Funisolide (AeroBid) is a corticosteroid

drug that reduces inflammation and

tissue edema that is associated with

asthma and other chronic lung diseases

and thereby prevents acute attacks.

Albuterol (Ventolin) is a bronchodilator

drug that relaxes the smooth muscle

around the bronchi and lets them

enlarge. This increases air flow during an

asthma attack.

4. The drugs are different (the green Diskus

contains salmeterol [Serevent] while the

red Diskus contains fluticasone [Flovent]).

The doses are different (the green Diskus

has a dose of 50 mcg while the red Diskus

has a dose of 100 mcg). Their therapeutic

effects are different (the green Diskus contains bronchodilator drug while the red

Diskus contains a corticosteroid drug).

5. a. Combivent

b. ipratropium and albuterol

c. Both are bronchodilator drugs.

d. inhalation

e. It contains 200 metered actuations (puffs).