Answer the following study guide questions to help guide you in your learning for this week's

topic(s).

1. What is tiotropium used to treat?

 It is an inhaled anticholinergic available to treat COPD and asthma (p. 378).

2. What are the adverse effects with montelukast (Singular)?

 Neuropsychiatric effects include depression, anxiety, and suicide. A rapid conversion

from steroids to montelukast may cause Churg-Strauss Syndrome. Signs and symptoms
of Churg-Strauss syndrome include weight loss, flu-like symptoms, and pulmonary vessel
inflammation (p. 381).

3. What patient teaching should accompany the prescription of montelukast (Singulair)?

 To take as prescribed, these medications are not for acute episodes of asthma. Patients are
not to decrease or discontinue any other asthma medications without talking with their
provider. Pregnant or nursing women should not take these medications (p. 384).

4. What patient teaching should be provided when prescribing inhaled corticosteroids?

 Teach the patient to use a spacer and wait at least a minute in between puffs. patients
need to rinse their mouth after administration to prevent oral candidiasis (p. 391).

5. What ethnic background should not be prescribed long-acting beta agonists?

 African Americans, increased incidence of death in this population (p. 365).

6. What medication would you prescribe for bronchospasm for a patient taking propranolol?

 pratropium bromide (Atrovent) (p. 369).

7. What is the mechanism of action of albuterol?

 Binds to beta 2 adrenergic receptors, resulting in bronchodilation (p. 361).

8. What is the mechanism of action of inhaled corticosteroids?

 Corticosteroids are anti-inflammatory. They inhibit the immunoglobulin E (IgE) and mast
cell–mediated migration of inflammatory cells into the bronchial tissue producing smooth
muscle relaxation (p. 384).

9. When is it appropriate to use a short acting beta agonist?

 Short acting beta agonist are used for acute symptoms of shortness of breath (p. 365).

10. What is the mechanism of action of inhaled muscarinic receptor antagonists?

 The medication binds to the muscarinic receptors, resulting in the drying up of secretions
and the dilation of the airway. Examples include tiotropium bromide (Atrovent) and
Tiotropium (Spiriva) (p. 378).

11. What are the adverse effects associated with inhaled corticosteroids?

 All the inhaled corticosteroids have association with xerostomia, hoarseness, tongue and
mouth irritation, flushing, and dysgeusia (altered taste sensation) (p.386).