Asthma and COPD Medications

Practice questions covering classifications, indications, administration techniques, and side effects of asthma and COPD medications including bronchodilators and anti-inflammatories.

What are the two primary classifications of asthma and COPD medications?

Bronchodilators and Anti-inflammatories

How are reliever (rescue) medications defined?

Used PRN to provide rapid symptom relief during episodes of acute bronchoconstriction.

What is the purpose of maintenance (controller) medications?

Taken on a fixed daily schedule to control chronic inflammation and prevent symptoms; they should not be used as rescue inhalers.

What is the stepwise treatment approach for asthma?

Adjusting therapy based on symptom control.

If a client is prescribed both a bronchodilator and an inhaled corticosteroid (ICS), which should be used first?

The bronchodilator (such as albuterol) should be used first to open the airways and improve delivery of the subsequent medication.

How long should a client wait between a first and second puff of the same medication?

$$1\,min$$

How long should a client wait between puffs of two different inhaled medications?

$$5\,min$$

What are three common types of inhaler forms?

Metered dose inhalers (MDI), Dry powder inhalers (DPI), and Soft mist inhalers (SMI).

Why is a spacer recommended for use with MDIs?

To improve medication delivery and prevent oral thrush.

What effect do Beta-agonists have on the lungs?

They stimulate the beta2 receptors, resulting in bronchodilation.

What are common CNS stimulation side effects of beta-agonists?

Increased HR, increased BP, palpitations, tremors, insomnia, and increased blood glucose.

What is the action and usage frequency of Short-acting beta-agonists (SABAs) like albuterol?

They rapidly relax airway smooth muscle for immediate relief of bronchospasm; clients should carry their inhaler and avoid use more than $>2x/week$.

What is the Black Box Warning for Long-acting inhaled beta-agonists (LABAs) like salmeterol?

Do NOT use LABAs alone for acute asthma attacks due to slow onset and increased risk of asthma-related death when not combined with ICS.

What is the clinical exception for using a LABA for acute relief?

The combination of formoterol and ICS can be used for both maintenance and acute relief due to its rapid onset.

What are the common anticholinergic side effects of Muscarinic Antagonists like tiotropium?

Dry mouth, blurred vision, and urinary retention.

What is the narrow therapeutic range for theophylline?

$10\text{–}20\,mcg/mL$ ($55\text{–}110\,\mu mol/L$).

Why should a client avoid caffeine while taking theophylline?

Caffeine intensifies CNS effects (increasing risk of tachycardia, dysrhythmias, and seizures) and inhibits metabolism of theophylline, increasing the risk of toxicity.

What nursing consideration is essential to prevent complications from Inhaled Corticosteroids (ICS)?

Rinse the mouth after each use to prevent irritation and oral thrush (candidiasis).

What is the primary action of leukotriene inhibitors like montelukast?

They block leukotrienes to decrease inflammation, bronchoconstriction, and mucus production.

What specific psychiatric side effect must be monitored in clients taking montelukast?

Mood changes and suicidal thoughts.