Pharmacology Quiz: Montelukast & Roflumilast
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Questions and Answers

Which symptoms are commonly associated with Montelukast?

  • Weight Loss
  • Abdominal Pain (correct)
  • Dizziness (correct)
  • Anxiety

What is the primary action of Phosphodiesterase 4 inhibitors like Roflumilast?

  • Enhance bronchoconstriction
  • Reduce lung inflammation (correct)
  • Increase lung inflammation
  • Decrease cAMP levels

What serious side effect can be associated with both Montelukast and Roflumilast?

  • Bronchospasm
  • Cholestatic Hepatitis
  • Suicidal thoughts (correct)
  • Insomnia

When should Montelukast be taken for optimal effect?

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

What is a common symptom of both Roflumilast and Montelukast?

<p>Flu-Like Symptoms (B)</p> Signup and view all the answers

Which of the following is NOT a common side effect of Roflumilast?

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

What mechanism do systemic glucocorticoids use to manage inflammation?

<p>Suppressing neutrophil migration (C)</p> Signup and view all the answers

Which condition is primarily treated with Roflumilast?

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

What is the therapeutic range for Theophylline?

<p>5-15 mcg/mL (A)</p> Signup and view all the answers

What is a common side effect of Levothyroxine?

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

What is a contraindication for the use of Desiccated thyroid?

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

Which agent is preferred for treating hyperthyroidism in the first trimester of pregnancy?

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

What should be separated by 4 hours when taking Levothyroxine?

<p>Antacids (B), Iron supplements (C), Calcium supplements (D)</p> Signup and view all the answers

Which of the following is a common side effect of Ondansetron?

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

What is a serious risk associated with Propylthiouracil?

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

For which condition is Granisetron primarily used?

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

Which medication should not be used with apomorphine?

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

What effect does Theophylline have on the body?

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

What is the main mechanism of action of aspirin as an antiplatelet agent?

<p>Irreversible blockade of thromboxane A2 formation (B)</p> Signup and view all the answers

Which of the following is a common side effect associated with aspirin use?

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

What is an important contraindication for aspirin therapy?

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

What are the common side effects of aspirin that patients should be aware of?

<p>Heartburn and abdominal discomfort (B)</p> Signup and view all the answers

What should be done if a patient develops a severe skin rash while using aspirin?

<p>Stop the medication immediately (C)</p> Signup and view all the answers

Which condition might benefit from aspirin therapy?

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

What is a known risk associated with higher doses of aspirin?

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

Which patient demographic should aspirin be avoided in for viral infections?

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

What is a potential effect of aspirin related to its antiplatelet activity?

<p>Increased bleeding risk (D)</p> Signup and view all the answers

What is the role of Phytonadione (Vitamin K) in the context of aspirin therapy?

<p>Acts as an antidote to aspirin toxicity (A)</p> Signup and view all the answers

What is the primary mechanism of action of angiotensin receptor blockers?

<p>Block the binding of angiotensin II to its receptor (D)</p> Signup and view all the answers

Which of the following is a common side effect of angiotensin receptor blockers like Losartan?

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

Which angiotensin receptor blocker is specifically indicated for diabetic nephropathy?

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

What severe adverse effect is associated with angiotensin receptor blockers?

<p>Elevated serum creatinine (D)</p> Signup and view all the answers

Which two medications are combined with Valsartan for enhanced treatment options?

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

Losartan is also known by which brand name?

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

What effect does Aliskiren have when used with angiotensin receptor blockers?

<p>Should not be used together in specific patients (C)</p> Signup and view all the answers

What is the primary action of P2Y12 inhibitors on platelets?

<p>Inhibit platelet activation and aggregation (D)</p> Signup and view all the answers

What is the recommended action regarding the use of Clopidogrel before elective surgery?

<p>Stop 5 days before surgery (C)</p> Signup and view all the answers

Which of the following is a common side effect associated with Prasugrel?

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

In patients older than 75 years, what is the recommendation regarding the use of Prasugrel?

<p>It is not recommended unless special conditions apply (A)</p> Signup and view all the answers

What is a significant drug interaction concern for Ticagrelor?

<p>Interaction with grapefruit juice (C)</p> Signup and view all the answers

What is the mechanism of action for fibrinolytics?

<p>Breaking down clots by converting plasminogen to plasmin (C)</p> Signup and view all the answers

Which of the following is a common side effect of Ticagrelor?

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

Which condition increases the bleeding risk associated with Clopidogrel?

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

What is a potential complication of using Aspirin for patients with asthma?

<p>Worsening asthma symptoms (A)</p> Signup and view all the answers

What should be avoided when taking Clopidogrel?

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

Flashcards

PDE4 Inhibitor

A type of medicine that reduces inflammation in the lungs by increasing cAMP levels.

Weight Loss and Nausea

A common side effect of PDE4 inhibitors, characterized by a decrease in appetite and feeling of nausea.

Headache

A common side effect of Montelukast, a medication used to treat asthma and allergies.

Suicidal Thoughts

A serious side effect of Montelukast, characterized by changes in behavior and thoughts of self-harm.

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Systemic Glucocorticoids

A type of medicine commonly used to treat inflammation in the body, including inflammation in the lungs.

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Suppressed Immune Response

A common side effect of Systemic Glucocorticoids, characterized by a decrease in white blood cells that fight infections.

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Roflumilast

A medication used to treat COPD, belonging to the class of PDE4 inhibitors.

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Diarrhea

A common side effect of Roflumilast, characterized by a loose stool.

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Antiplatelet/COX Inhibitor

A type of medication that inhibits platelet function by preventing the formation of thromboxane A2. It's commonly used for pain, fever, and cardioprotection.

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Aspirin

A drug that is a nonsteroidal anti-inflammatory drug (NSAID) with antiplatelet and anticoagulant properties. It's often used for pain, fever, and to prevent blood clots.

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Heartburn, Dyspepsia, Abdominal Discomfort

A common side effect of Aspirin, characterized by an upset stomach and discomfort in the upper digestive system.

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Gastrointestinal (GI) Bleeding

A serious side effect of Aspirin, characterized by bleeding in the gastrointestinal tract, leading to potential health complications.

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Increased Bleeding Risk

A side effect of Aspirin that can contribute to an increased risk of bleeding.

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Renal Damage

A side effect of Aspirin that can lead to damage in the kidneys, affecting urine production.

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Aspirin for OA/RA

An anti-inflammatory medication prescribed for rheumatoid arthritis and osteoarthritis. It's associated with a higher risk of serious side effects like GI bleeding.

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Bactrim

A combination of medications used to treat urinary tract infections, caused by bacteria.

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Metronidazole

An antibiotic medication commonly used to treat infections caused by bacteria.

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Amiodarone

A medication used to treat heart rhythm problems, and also in the treatment of certain cancers.

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Antithyroid Agents

A group of medications that inhibit the synthesis of thyroid hormones, used to treat hyperthyroidism.

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Levothyroxine (Synthroid)

Levothyroxine, a synthetic thyroid hormone, used to replace missing or insufficient thyroid hormone.

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Liothyronine (Cytomel)

A medication used to treat hypothyroidism, replacing the missing thyroid hormone. It's a synthetic form of T4.

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Desiccated Thyroid (Armour Thyroid)

A medication that treats hypothyroidism by providing a combination of T3 and T4 hormones.

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Propylthiouracil (PTU)

A commonly used antithyroid agent for hyperthyroidism, preferred during the first trimester of pregnancy. It inhibits thyroid hormone synthesis.

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Methimazole (Tapazole)

Another commonly used antithyroid medication for hyperthyroidism, used during the second and third trimesters of pregnancy.

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5-HT3 Antagonists

A class of medications that block the action of serotonin in the brain to prevent nausea and vomiting.

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Ondansetron (Zofran)

A medication used to prevent and treat nausea and vomiting, particularly due to chemotherapy. It works by blocking the 5-HT3 receptor.

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Palonosetron (Aloxi)

A medication used to prevent and treat nausea and vomiting, particularly due to chemotherapy. It has a longer half-life compared to other 5-HT3 antagonists.

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H1 Antagonists

A medication that blocks histamine receptors to suppress the histamine-induced vasodepressor response.

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Angiotensin Receptor Blockers (ARBs)

A class of drugs that block the binding of angiotensin II to the AT(1) receptor, preventing vasoconstriction and aldosterone release.

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Losartan (Cozaar)

A specific ARB that is commonly used to treat hypertension, heart failure, and diabetic nephropathy.

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Valsartan (Diovan)

Another popular ARB used for hypertension and heart failure, often combined with other medications for better efficacy.

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Olmesartan (Benicar)

An ARB known for its effectiveness in treating hypertension and post-myocardial infarction.

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Irbesartan (Avapro)

This ARB is prescribed to treat hypertension, diabetic nephropathy, and sometimes post-MI conditions.

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Angioedema

A significant side effect of ARBs, characterized by a sudden swelling of the face, lips, tongue, and throat.

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Hyperkalemia

These drugs can increase potassium levels in the blood, which can be particularly dangerous in patients with kidney problems.

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What are P2Y12 inhibitors?

These medications block the activity of ADP receptors on platelets, preventing platelet aggregation. They are used for conditions like stroke, ACS, and PAD.

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What are prodrugs and CYP2C19 poor metabolizers?

A prodrug is a medication that is inactive when administered but becomes active after being metabolized in the body, while a CYP2C19 poor metabolizer is someone who breaks down drugs like Clopidogrel more slowly.

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What is Clopidogrel and what is it used for?

Clopidogrel is a P2Y12 inhibitor often used in patients with ACS, PAD, and stroke.

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What is Prasugrel and what is it used for?

Prasugrel is a P2Y12 inhibitor given to patients with ACS undergoing PCI, and has higher bleeding risks than Clopidogrel.

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What is Ticagrelor and how does it differ from other P2Y12 inhibitors?

Ticagrelor is a P2Y12 inhibitor used for ACS and has a reversible effect, so it can be stopped before surgery.

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What are fibrinolytics and how do they work?

Fibrinolytics are medications which break down blood clots by activating plasminogen to plasmin, often used in acute stroke or heart attack.

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What are second-generation fibrinolytics?

Second-generation fibrinolytics are 'clot-specific' meaning they bind to the clot and have fewer side effects.

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What is Aggrenox and what is it used for?

Dipyridamole/Aspirin (Aggrenox) is a combination medication that inhibits platelet aggregation and is used for stroke prevention in those with a history of stroke or TIA.

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What is Aspirin and what is it used for?

Aspirin is an antiplatelet medication used for various conditions like pain, fever, and reducing the risk of heart attacks and stroke.

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What is GI bleeding and how is it related to Aspirin?

It's a side effect of Aspirin and other antiplatelet medications that can lead to complications like stomach ulcers and bleeding.

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Study Notes

Top Drugs 2025

  • Inhaled Steroids: Used to inhibit airway inflammation and increase beta-2 receptor sensitivity. Common side effects include throat irritation, cough, thrush, and headache. Serious side effects include vertigo, upper respiratory infections, pneumonia-related risk, HPA axis suppression, and growth retardation in children. Rinse mouth/throat after use to prevent thrush. Avoid grapefruit juice with fluticasone.
  • ICS/LABA Combinations: Combining corticosteroids (ICS) and long-acting beta agonists (LABAs) improves pulmonary function and treatment control better than using either one alone. LABA monotherapy increases risk of asthma-related deaths/hospitalizations, especially in children and adolescents.
  • Short Acting Muscarinic Antagonists: Anticholinergic agents that decrease secretions and cause bronchodilation. Common side effects include dry mouth, bitter taste, and anticholinergic effects. Serious effects are bronchospasm, MI, and anaphylaxis.
  • Long Acting Muscarinic Antagonist: Bronchodilation via M3 receptor inhibition. It has long-acting, anticholinergic activity, and affinity for M1-M5 receptors.
  • Short Acting Beta Agonist: Activates Beta-2 receptors in bronchial smooth muscle causing relaxation and inhibiting mediator release from mast cells; mainly for rescue therapy.
  • SABA/SAMA Combinations: Combination of short-acting bronchodilators (SABA) and short-acting muscarinic antagonists (SAMA). Primarily for acute asthma or COPD.
  • Leukotriene Modifiers: Inhibits leukotriene receptors.
  • Phosphodiesterase 4 Inhibitor: Increases cAMP levels, reducing lung inflammation.
  • Systemic Glucocorticoids: Inhibit the inflammatory response by suppressing neutrophil migration, decreasing inflammatory mediators, and reversing capillary permeability. Caution in use over 10-14 days; taper slowly if receiving prolonged therapy.
  • Xanthine Derivatives: Block PDE causing increased cAMP and promoting epinephrine release for bronchodilation.

Thyroid Hormones

  • Levothyroxine: Increases cellular metabolism and plays an important role in growth, development, CNS, bone functions, food metabolism, and body temperature. Used for hypothyroidism.
  • Liothyronine: Used for TSH suppression.
  • Desiccated Thyroid: A thyroid hormone preparation often used for hypothyroidism.
  • Antithyroid Agents: Inhibit thyroid hormone synthesis. Methimazole is preferred in the first trimester of pregnancy; propylthiouracil is preferred in thyroid storm.

5-HT3 Antagonist

  • Granisetron: Blocks vomiting signals in the brain to treat nausea and vomiting, including chemo-induced nausea and vomiting.
  • Ondansetron: Used for nausea and vomiting.
  • Palonosetron: A newer agent with a longer half-life used for nausea and vomiting, often used with apomorphine.

H1 Antagonist

  • Meclizine: Used for motion sickness and vertigo; suppresses the vasodepressor response to histamine.
  • Promethazine: Treats nausea and vomiting; can cause drowsiness, lethargy, phototoxicity, nausea, vomiting, xerostomia, and extrapyramidal symptoms (EPS). Avoid in children under 2 years old.

Substance P/NK-1 Receptor Antagonist

  • Aprepitant: Used to treat chemotherapy-induced nausea and vomiting and post-operative nausea and vomiting.

Antihistamine

  • Cetirizine: Used for urticaria and upper respiratory allergies.
  • Diphenhydramine: Used for urticaria, upper respiratory allergies and some anxiety/itching concerns.
  • Levocetirizine: Alternative treatment for urticaria and upper respiratory allergies.
  • Loratadine: Treats urticaria and upper respiratory allergies.
  • Fexofenadine: Alternative treatment for urticaria and upper respiratory allergies.
  • Hydroxyzine: Used for anxiety and pruritus.

Antispasmodic

  • Dicyclomine: Used for functional bowel disorders/IBS. Avoid during early pregnancy and in patients with prolonged QT interval.

Histamine (H2) Receptor Antagonists

  • Famotidine: Used for GERD, heartburn, gastric/duodenal ulcers, and erosive esophagitis.
  • Ranitidine: No longer available; was previously used for similar indications.

Proton Pump Inhibitors

  • Omeprazole: Used for GERD, erosive esophagitis, and H pylori treatment.
  • Pantoprazole: Used for GERD, erosive esophagitis, and H pylori treatment. Available in IV and PO forms.
  • Lansoprazole: Used for GERD, erosive esophagitis, and H pylori treatment.
  • Esomeprazole: Used for GERD, erosive esophagitis, and H Pylori treatment. Available in IV and PO forms..

(and many more medications listed in the OCR)

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Description

Test your knowledge on the symptoms and mechanisms of Montelukast and Roflumilast, along with their side effects and contraindications. This quiz covers key pharmacological concepts related to anti-inflammatory therapies and thyroid medications.

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