Asthma
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Questions and Answers

Which of the following is a key component of the pathogenesis of asthma?

  • Chronic obstructive pulmonary disease
  • Lung cancer
  • Pulmonary fibrosis
  • Bronchial hyper-reactivity (correct)

Which of the following is a non-selective sympathomimetic drug used to treat asthma?

  • Albuterol
  • Epinephrine (correct)
  • Salmeterol
  • Ipratropium

Which of the following are non-selective (beta 1 and beta 2 agonists) that lead to cardiac effects (mediated by beta 1) which can cause elevated blood pressure?

  • Metoprolol
  • Isoproterenol (correct)
  • Albuterol
  • Epinephrine (correct)

How is epinephrine administered? (Select all that apply)

<p>IM (A), Inhalation (B)</p> Signup and view all the answers

How is isoproterenol administered?

<p>Inhalation (C)</p> Signup and view all the answers

What class of drugs are the standard of care for asthma?

<p>Beta 2 Selective Sympathomimetic Agents (D)</p> Signup and view all the answers

Which of the following drugs are the standard care for asthma and are administered as inhalation metered doses? (Select all that apply)

<p>albuterol (A), terbutaline (B), metaproterenol (C), pirbuterol (D)</p> Signup and view all the answers

Which of the following beta-2 selective sympathomimetic agents are available as oral pills? (Select all that apply)

<p>terbutaline (A), albuterol (C)</p> Signup and view all the answers

Which beta 2 selective sympathomimetic agent is the only one available as a subcutaneous injection?

<p>terbutaline (C)</p> Signup and view all the answers

How long do beta 2 selective sympathomimetic agents last?

<p>3-4 hours (B)</p> Signup and view all the answers

Which of the following are newer, long action beta 2 selective agents that act for 12 or more hours?

<p>formoterol (C), salmeterol (D)</p> Signup and view all the answers

Methylxanthine drugs are naturally occurring in which substances?

<p>coffee and tea (A)</p> Signup and view all the answers

What do all methylxanthine drugs inhibit?

<p>phosphodiesterase, the enzyme that removes intracellular cAMP (A)</p> Signup and view all the answers

What happens when the inhibition of phosphodiesterase occurs?

<p>Increased cAMP (C)</p> Signup and view all the answers

What does increased cAMP induce in smooth muscle?

<p>Relaxation (B)</p> Signup and view all the answers

Which class of drugs are non-selective, with effects seen in the CNS, kidney, cardiac and skeletal muscle, and smooth muscle in the lung?

<p>Methylxanthine Drugs (A)</p> Signup and view all the answers

Which methylxanthine drug has the least CNS effects?

<p>theophylline (D)</p> Signup and view all the answers

Which methylxanthine drug has the most CNS effects?

<p>Caffeine (A)</p> Signup and view all the answers

Which class of drugs is now seldom used due to adverse drug reactions (ADRs) and have been replaced by beta-2 drugs?

<p>Methylxanthine Drugs (D)</p> Signup and view all the answers

Which of the following is an antimuscarinic drug that was used to treat asthma and is a potent competitive inhibitor at Acetylcholine receptors?

<p>atropine (C)</p> Signup and view all the answers

What is the mechanism of action (MOA) of atropine?

<p>Blocking of acetylcholine (Ach) at muscarinic receptors in the lung and the rest of the body (B)</p> Signup and view all the answers

What are the effects of acetylcholine on the lungs?

<p>Increased mucus secretion (B), Bronchoconstriction (D)</p> Signup and view all the answers

What effects does atropine have on the lungs? (Select all that apply)

<p>Reduced secretion (B), Bronchodilation (A)</p> Signup and view all the answers

What is atropine used as to limit systemic adverse effects?

<p>Aerosol (A)</p> Signup and view all the answers

Which of the following is an atropine derivative that acts the same as atropine, but does not readily enter the CNS and does not absorb well into the systemic circulation following aerosol administration?

<p>Ipratropium (A)</p> Signup and view all the answers

Which class of drugs is the standard for anti-inflammatory actions?

<p>Corticosteroids (B)</p> Signup and view all the answers

How are corticosteroids mostly administered?

<p>Inhalation (A)</p> Signup and view all the answers

Why are corticosteroids mostly given by inhalation?

<p>To reduce systemic ADRs (C)</p> Signup and view all the answers

What is the mechanism of action (MOA) of corticosteroids in treating asthma?

<p>Reduce the infiltration into asthmatic airways of lymphocytes, eosinophils, and mast cells (A)</p> Signup and view all the answers

What do eosinophils and mast cells contain?

<p>Histamine granules (B)</p> Signup and view all the answers

What is the treatment protocol in urgent critical asthma cases?

<p>Parenteral corticosteroids are started, then the patient is switched to inhalation dosing. (D)</p> Signup and view all the answers

Which of the following is a major adverse drug reaction (ADR) of corticosteroids?

<p>Oropharyngeal candidiasis (A)</p> Signup and view all the answers

What is used to treat corticosteroid-induced oropharyngeal candidiasis?

<p>Topical cotrimazole (C)</p> Signup and view all the answers

Why do corticosteroids cause candidiasis?

<p>Reduce immune function (B)</p> Signup and view all the answers

What are leukotrienes involved in? (Select all that apply)

<p>inflammation (A), anaphylaxis (B)</p> Signup and view all the answers

Which of the following is an action of leukotrienes?

<p>All of the above (@)</p> Signup and view all the answers

Which of the following are ways you can block the actions of leukotrienes? (Select all that apply)

<p>Inhibit the 5-lipooxygenase enzyme that makes leukotrienes (A), Block the binding of the LTD4 leukotriene to leukotriene cell receptors (B)</p> Signup and view all the answers

Match each leukotriene inhibitor to its role:

<p>Zileuton = 5-lipooxygenase inhibitor Zafirlukast = LTD4 receptor blocker Montelukast = LTD4 receptor blocker</p> Signup and view all the answers

How are all leukotriene inhibitors administered?

<p>PO (A)</p> Signup and view all the answers

What side effect do 5-10% of asthma patients experience after ingestion of small amounts of aspirin?

<p>severe bronchoconstriction (B)</p> Signup and view all the answers

Why does aspirin cause severe bronchoconstriction in 5-10% of asthma patients?

<p>Inhibit COX enzyme and shift arachidonic acid substrate from prostaglandins to leukotrienes (A)</p> Signup and view all the answers

Match each drug to its description

<p>omalizumab = a monoclonal antibody that binds to IgE and prevents it from binding to mast cells and trigger release of histamine mepolizumab = binds to IL-5 reslizumab = binds to IL-5 benralizumab = blocks the IL-5 receptor on cells</p> Signup and view all the answers

What is the dosage of omalizumab based on?

<p>IgE levels in plasma (B)</p> Signup and view all the answers

The airway obstruction in COPD is fully reversible with treatment.

<p>False (B)</p> Signup and view all the answers

Many of the same drugs used in asthma are also used to treat COPD.

<p>True (A)</p> Signup and view all the answers

Match each medication to its description:

<p>albuterol = Short acting inhaled beta agonist ipratropium = Anticholinergic roflumilast = Phosphodiesterase inhibitor</p> Signup and view all the answers

Match each drug to its class

<p>Beta 2 Agonists = albuterol, salmeterol, metaproterenol, terbutaline, epinephrine, isoproterenol Corticosteroids = fluticasone (inhaled) and many others; prednisone (systemic); methylprednisolone (parenteral) Methylxanthines = theophylline Leukotriene Antagonists = montelukast, zafirlukast, zileuton</p> Signup and view all the answers

Match each medication to its class:

<p>IgE Antibody = omalizumab Antimuscarinics = tiotropium (long acting); ipratropium (short acting); aclidinium; umeclidinium</p> Signup and view all the answers

Which of the following are major ADRs of albuterol?

<p>All of the above (@)</p> Signup and view all the answers

What can occur after several days of continuous use of albuterol, characterized by a common form of drug tolerance in which the regular dose no longer works?

<p>Tachyphylaxis (A)</p> Signup and view all the answers

What is the recommended dosage of albuterol after an acute asthma attack?

<p>up to four puffs every 20 minutes over one hour (D)</p> Signup and view all the answers

Which of the following devices is commonly used for administering medication directly to the lungs?

<p>Inhaler (A)</p> Signup and view all the answers

Which of the following devices is used to deliver medication directly into the lungs in the form of a mist?

<p>Nebulizer (B)</p> Signup and view all the answers

Flashcards

Capital of France (example flashcard)

Paris

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