A nurse is teaching a client with a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use when experiencing an acute asthma attack?
Ipratropium bromide
Albuterol
Salmeterol
Budesonide
The Correct Answer is B
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.
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Correct Answer is A
Explanation
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.
Correct Answer is C
Explanation
A. Inhibits the production of leukotrienes and histamine, preventing further asthma attacks: This statement is misleading. Omalizumab does not directly inhibit the production of leukotrienes or histamine; rather, it works by targeting IgE, which is involved in the allergic response.
B. Inhibits mast cells from releasing histamine, preventing further asthma attacks: While omalizumab does reduce the overall allergic response, it does so by binding to IgE rather than directly inhibiting mast cell activity. Therefore, this description does not accurately represent its primary mechanism of action.
C. Selectively binds to IgE, reducing allergic mediators and asthma attacks: This statement correctly describes the mechanism of action of omalizumab. By binding to immunoglobulin E (IgE), omalizumab prevents IgE from attaching to mast cells and basophils, thus reducing the release of allergic mediators that contribute to asthma attacks.
D. Stimulates alpha-adrenergic receptors to assist in reduction of allergic-related symptoms: This statement is incorrect. Omalizumab does not stimulate alpha-adrenergic receptors; such action is associated with certain bronchodilators. Omalizumab specifically targets IgE to mitigate allergic responses.