A client's severe asthma has necessitated the use of a long-acting beta2-agonist (LABA). Which of the client's statements suggests a need for further education?
make sure to use this each time I feel an asthma attack coming on."
"I know that these drugs can sometimes make my heart beat faster."
"I've heard that this drug sometimes gets less effective over time."
"I've heard that this drug is particularly good at preventing asthma attacks during exercise."
The Correct Answer is A
A. "Make sure to use this each time I feel an asthma attack coming on": This statement indicates a need for further education. LABAs are not intended for immediate relief of acute asthma symptoms or attacks; they are designed for long-term control and prevention of symptoms. Clients should use a short-acting beta agonist (SABA) for quick relief during an asthma attack, not a LABA.
B. "I know that these drugs can sometimes make my heart beat faster": This statement reflects an understanding of a potential side effect of LABAs. Increased heart rate is a known side effect, and it is important for clients to be aware of this possibility.
C. "I've heard that this drug sometimes gets less effective over time": This statement is accurate. Tolerance can develop with LABA use, and clients should be informed about this possibility to monitor their symptoms and report any changes to their healthcare provider.
D. "I've heard that this drug is particularly good at preventing asthma attacks during exercise": This statement is correct. LABAs can be beneficial for preventing exercise-induced bronchospasm when used as part of a regular asthma management plan, and clients should understand this use.
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Correct Answer is B
Explanation
A) Ipratropium bromide: While ipratropium is used to manage bronchospasm, it is typically not the first choice for acute asthma attacks. It has a slower onset of action compared to short-acting beta-agonists like albuterol and is generally used as an adjunct therapy rather than for immediate relief.
B) Albuterol: This medication is a short-acting beta-agonist that provides rapid relief of bronchospasm during an acute asthma attack. It works by relaxing the muscles in the airways, making it the preferred first-line treatment for quick relief in asthma exacerbations.
C) Salmeterol: This medication is a long-acting beta-agonist (LABA) used for long-term control of asthma symptoms, not for immediate relief. It has a delayed onset of action and should not be used as a rescue medication during an acute attack, as it may take longer to provide effects.
D) Budesonide: This is an inhaled corticosteroid that helps in controlling chronic inflammation associated with asthma. While important for long-term management, it is not effective for the rapid relief of acute symptoms and should not be used during an asthma attack.
Correct Answer is ["B","D","E","F"]
Explanation
A) Ipratropium is the drug of choice for acute asthma exacerbations: This statement is incorrect. While ipratropium is used in the management of asthma, it is not the first-line treatment for acute exacerbations. Short-acting beta-agonists, such as albuterol, are the preferred choice for rapid relief during an acute asthma attack due to their quick onset of action.
B) Mechanism of action includes blocking acetylcholine receptors in the airway: This statement is accurate. Ipratropium is an anticholinergic agent that works by blocking acetylcholine receptors in the bronchial smooth muscle. This action leads to bronchodilation and helps to decrease mucus production, making it effective for managing airway constriction.
C) Mechanism of action includes antagonizing histamine receptors of the upper airway: This statement is incorrect. Ipratropium does not act on histamine receptors; rather, it specifically targets acetylcholine receptors. Antihistamines are the medications that block histamine receptors, primarily used for allergic reactions and rhinitis, but not for bronchodilation in asthma.
D) Client's who are allergic to soybean should avoid taking ipratropium: This statement is true. Ipratropium bromide may contain soy lecithin, which can pose a risk for patients with soybean allergies. Therefore, it is essential for healthcare providers to assess a patient’s allergy history before prescribing this medication.
E) Urinary retention is a side effect of Ipratropium bromide: This is correct. Anticholinergic medications, including ipratropium, can lead to urinary retention as a side effect due to their action of inhibiting acetylcholine, which plays a role in bladder function. Patients should be monitored for this side effect, especially if they have a history of urinary issues.
F) Ipratropium (Atrovent) is a medication for asthma and chronic obstructive pulmonary disease (COPD): This statement is accurate. Ipratropium is indicated for both asthma and COPD management, as it helps to relieve bronchospasm and improve airflow. It is often used as an adjunct therapy in combination with other bronchodilators for better management of respiratory conditions.