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CH14 RESPIRATORY Pharma 5th edition
Woo, Robinson 2024-2025
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Graded A+
Christy has exercise-induced and mild persistent asthma and is prescribed two puffs of
albuterol 15 minutes before exercise and as needed for wheezing
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Teaching regarding her inhalers includes:
Use one to two puffs of albuterol per day to prevent an attack with no more than
eight puffs per day
Beclomethasone needs to be used every day to treat her asthma
Report any systemic side effects she is experiencing, such as weight gain
Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid
MDI to facilitate bronchodilation - ANSBeclomethasone needs to be used every day to
treat her asthma
Cough and cold medications that contain a sympathomimetic decongestant such as
phenylephrine should be used cautiously in what population:
Older adults
Hypertensive patients
Infants
All of the above - ANSAll of the above
Decongestants such as pseudoephedrine (Sudafed):
Are Schedule III drugs in all states
Should not be prescribed or recommended for children under 4 years of age
Are effective in treating the congestion children experience with the common cold
May cause drowsiness in patients of all ages - ANSShould not be prescribed or
recommended for children under 4 years of age
Digoxin levels need to be monitored closely when the following medication is started:
Loratadine
Diphenhydramine
Ipratropium
Albuterol - ANSAlbuterol
First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal
allergies because they are:
More effective than first-generation antihistamines
Less sedating than the first-generation antihistamines
Prescription products, therefore are covered by insurance
Able to be taken with central nervous system (CNS) sedatives, such as alcohol ANSLess sedating than the first-generation antihistamines

Harold, a 42-year-old African American, has moderate persistent asthma
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Monitoring for this patient taking diphenhydramine would include assessing
for:
Urinary retention
Cardiac output
Peripheral edema
Skin rash - ANSUrinary retention
James is a 52-year-old overweight smoker taking theophylline for his persistent asthma
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The appropriate
response would be:
Congratulate him on making a positive change in his life
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Schedule him for regular testing of serum theophylline levels during his diet due to
increased excretion of theophylline
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- ANSRecommend he try stopping smoking instead of the Atkin's
diet
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The best advice for him would be to:
Reassure him this is probably a viral infection and should be better soon
Have him seen the same day for an assessment and theophylline level
Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better
Order a theophylline level at the laboratory for him - ANSSchedule him for an
appointment in 2 to 3 days, which he can cancel if he is better
Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U
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Food
and Drug Administration due to the:
Risk of life-threatening dermatological reactions
Increased incidence of cardiac events when LTBAs are used
Increased risk of asthma-related deaths when LTBAs are used
Risk for life-threatening alterations in electrolytes - ANSIncreased risk of asthma-related
deaths when LTBAs are used
Martin is a 60-year-old patient with hypertension
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Inhaled corticosteroids need to be used daily during asthma exacerbations to be
effective
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They can triple the dose number of inhalations of medication during colds to prevent
needing systemic steroids
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When prescribing montelukast (Singulair) for asthma, patients or parents of patients
should be
instructed:
Montelukast twice a day is started when there is an asthma exacerbation
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Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking
montelukast
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- ANSAggression,
anxiety, depression, and/or suicidal thoughts may occur when taking
montelukast

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