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Lehne: Pharmacology for Nursing Care, 6th Edition

Answer Key

Chapter 74: Drugs for Asthma

Critical Thinking Case Study

You should tell John and his mother that cromolyn is used for acute and long-term prophylaxis of
asthma. The drug does not stop an ongoing asthma attack. It is administered via inhalation.
Review the proper use of either the metered-dose inhaler (MDI) or nebulizer that John has been
instructed to use. For acute prophylaxis, John should administer the cromolyn 15 minutes before
exercise or encountering other precipitating factors, such as cold or environmental agents. For
long-term prophylaxis, the cromolyn should be administered on a regular schedule. Be sure to
inform John and his mother that it may take several weeks for therapeutic effects to develop. You
should teach John and his mother how to record the asthma attacks he has and the use of
cromolyn in relation to these attacks.

Open-Book Quiz
1. immune-mediated airway inflammation
2. anti-inflammatory drugs, bronchodilators
3. bronchodilation
4. chronic
5. adrenal suppression, osteoporosis, hyperglycemia, peptic ulcer disease, growth suppression in
young patients
6. stabilizing the cytoplasmic membrane of mast cells, thereby preventing release of histamine
and other mediators
7. leukotriene modifiers
8. cromolyn sodium

Answer Key

Chapter 75: Drugs for Allergic Rhinitis, Cough, and Colds

Critical Thinking Case Study

1. You can tell Ms. K that decongestants can be used to reduce nasal congestion. They work by
causing the blood vessels of the nose to constrict, which results in shrinkage of the swollen
nasal membranes. When nasal sprays are used for more than a few days, the effects of each
application wear off, and the congestion becomes more severe. To overcome the rebound
congestion, the patient must use progressively larger and more frequent doses. Hence a cycle
can develop. To break the cycle, use of the decongestant can be discontinued abruptly. This is
very uncomfortable for the patient. The discomfort can be lessened by discontinuing use of
the drug in one nostril at a time.
2. You can tell Ms. K that rebound congestion can be minimized by use of topical agents for 3
to 5 days.

Elsevier Inc. items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.
Open-Book Quiz
1. oral antihistamines, intranasal glucocorticoids, intranasal cromolyn, sympathomimetics
2. Antihistamines are of no value against the common cold because they do not reduce nasal
congestion.
3. They can relieve sneezing, rhinorrhea, and nasal itching. Antihistamines are most effective
when taken prophylactically and less helpful when taken after symptoms have appeared.
Therefore they should be administered on a regular basis throughout the allergy season, even
when symptoms are absent.
4. azelastine
5. Cromolyn reduces symptoms by suppressing the release of histamine and other inflammatory
mediators from mast cells.
6. omalizumab
7. codeine, hydrocodone
8. Dextromethorphan