Pharm test 3

A patient receives a drug that causes bronchodilation, increased heart rate, and pupil dilation. Which branch of the ANS is being stimulated, and what type of drug is this?

Sympathetic stimulation; a sympathomimetic (adrenergic agonist).

If a medication causes increased secretions, bronchoconstriction, and slowed heart rate, what system is activated?

Parasympathetic system.

A patient on a parasympathetic blocker suddenly develops urinary retention. Explain why.

Parasympathetic blockade reduces smooth muscle tone → bladder cannot contract effectively.

A patient with thick, tenacious mucus receives a mucolytic. What happens to the mucus at the molecular level?

Disulfide bonds in mucus are broken → mucus becomes thinner and easier to mobilize.

Why is acetylcysteine useful in acetaminophen overdose?

It replenishes glutathione, allowing the liver to detoxify harmful metabolites.

A patient coughs more after receiving a mucolytic. Is this expected? Why?

Yes — mucus becomes thinner and mobilizes, triggering cough for clearance.

: A patient on long‑term inhaled corticosteroids develops oral thrush. What caused it?

Local immune suppression in the mouth from ICS use.

Why are corticosteroids NOT rescue medications?

They reduce inflammation over hours–days, not immediately.

A patient with chronic asthma has fewer exacerbations after starting ICS. Explain the mechanism.

ICS reduce airway inflammation, decrease hyperresponsiveness, and prevent swelling.

A patient uses albuterol frequently and develops tremors and tachycardia. Why?

β‑agonists stimulate sympathetic receptors → increased HR, muscle activation.

Why does a LABA never replace a SABA for acute attacks?

LABAs have slow onset; SABAs act within minutes.

A patient is given a catecholamine. Why must it be given frequently?

Catecholamines are rapidly inactivated by COMT and MAO.

What makes DuoNeb effective for severe bronchospasm?

Combination of albuterol (β‑agonist) + ipratropium (anticholinergic) → dual bronchodilation.

Why are anticholinergics preferred in COPD over asthma?

COPD involves chronic bronchoconstriction driven by vagal tone; anticholinergics block acetylcholine.

A patient with acute bronchospasm receives a SAMA. What effect should you expect?

Reduced mucus production and bronchodilation.

A patient on theophylline develops nausea and arrhythmias. What is happening?

Theophylline toxicity — narrow therapeutic window.

Why might theophylline help a patient with nocturnal asthma?

It stimulates the CNS and respiratory drive and provides mild bronchodilation.

A patient with chronic smoking history has impaired mucociliary clearance. Explain why

Smoking damages cilia → reduced mucus movement → increased infection risk.

What is the role of goblet cells in airway defense?

Produce mucus to trap particles and pathogens.

Why do premature infants require surfactant therapy?

Type II alveolar cells are immature → insufficient surfactant → alveolar collapse.

How does surfactant improve oxygenation?

Reduces surface tension → prevents alveolar collapse → improves gas exchange.

A patient uses cromolyn daily but still has acute asthma attacks. Why?

Mast cell stabilizers prevent inflammation but do NOT treat acute bronchospasm.

What do mast cell stabilizers inhibit?

Histamine release and inflammatory mediator release.

A patient withdraws their hand from a hot surface before feeling pain. Which pathway acted first?

Efferent motor reflex arc.

Which division controls voluntary skeletal muscle movement?

Somatic nervous system.

T/F: Maintenance medications are used for chronic control, not acute rescue.

True

T/F: Parasympatholytics are superior to sympathomimetics for acute asthma attacks.

False — SABAs are first‑line for acute rescue.

T/F: Epinephrine causes bronchodilation, vasoconstriction, increased HR, and pupil dilation.

True

T/F: An adrenergic antagonist blocks sympathetic receptors.

True