Respiratory Medicine: COPD and Bronchodilators

What is a common adverse effect of beta agonists?

Bronchodilation
Arrhythmias
Tachycardia
Skeletal muscle tremor (correct)

What is a characteristic of beta selectivity in high clinical dosages?

It is absent
It is relative and has significant β1-agonist effects (correct)
It is absolute
It has no β1-agonist effects

What is a potential risk for patients with COPD using beta agonists?

Gastrointestinal disorders
Neurological disorders
Cardiac disease (correct)
Concurrent respiratory disease

What is the mechanism of action of theophylline as a bronchodilator?

Non-selective phosphodiesterase (PDE) inhibitor (D) Signup and view all the answers

What is the primary elimination pathway of theophylline?

Hepatic metabolism by P450 enzymes (D) Signup and view all the answers

What is a therapeutic use of methylxanthines?

Asthma and COPD (D) Signup and view all the answers

What is an effect of theophylline on the diaphragm?

Increased strength of contraction (B) Signup and view all the answers

What is an additional effect of theophylline?

Cardiac and CNS stimulant effects (D) Signup and view all the answers

What is the main difference between COPD and asthma?

COPD is poorly reversible with bronchodilators (A) Signup and view all the answers

What is the main advantage of inhalational route in medications?

It decreases the systemic dose and adverse effects (A) Signup and view all the answers

What is the mechanism of action of beta adrenoceptor agonists?

They stimulate adenylyl cyclase and increase cAMP in smooth muscle cells (B) Signup and view all the answers

What is the main characteristic of short-acting beta2-agonists?

They have a rapid onset of action and a short duration of action (A) Signup and view all the answers

What is the main use of short-acting beta2-agonists?

They are used for acute episodes of bronchospasm (C) Signup and view all the answers

What is the main difference between short-acting and long-acting beta2-agonists?

Short-acting beta2-agonists have a rapid onset of action and a short duration of action (D) Signup and view all the answers

What is the main concern with using long-acting beta2-agonists?

They increase asthma mortality (D) Signup and view all the answers

What is the main therapeutic use of sympathomimetics?

They are first-line therapy for acute asthma (D) Signup and view all the answers

What is aminophylline a salt of?

Theophylline (A) Signup and view all the answers

Which effect is NOT associated with methylxanthine derivatives like pentoxifylline?

Bronchodilation (C) Signup and view all the answers

What severe adverse effect could result from an overdose of these drugs?

Seizures (A) Signup and view all the answers

Which substance is useful in reversing severe cardiovascular toxicity from theophylline?

Beta blockers (D) Signup and view all the answers

Which medication was replaced by ipratropium for treating asthma?

Atropine (B) Signup and view all the answers

What is the mechanism of action for muscarinic antagonists in treating respiratory conditions?

Blocking muscarinic M3 receptors (D) Signup and view all the answers

Why might antimuscarinic agents be preferred over β2 agonists in COPD?

They are more effective and less toxic (B) Signup and view all the answers

What minor effect is seen at high doses of muscarinic antagonists in some patients?

Dry mouth (D) Signup and view all the answers

What is the primary long-term controller for asthma?

Inhaled corticosteroids (ICS) (B) Signup and view all the answers

What is a common adverse effect of inhaled corticosteroids in children?

Growth slowing (B) Signup and view all the answers

What is the effect of systemic glucocorticoid treatment for more than 2 weeks?

Systemic toxicities (A) Signup and view all the answers

What condition may parenteral steroids be lifesaving?

Status asthmaticus (C) Signup and view all the answers

Which is an adverse effect of frequent aerosol administration of glucocorticoids?

Adrenal suppression (D) Signup and view all the answers

When should leukotriene receptor blockers not be used?

For acute episodes of asthma (C) Signup and view all the answers

How can adrenal suppression be reduced when using oral corticosteroids?

Using alternate-day therapy (D) Signup and view all the answers

Which adverse impact is specifically associated with COPD patients using steroids?

Increased risk of pneumonia (B) Signup and view all the answers

What is a benefit of using corticosteroids over β2 agonists?

They do not cause tremor or arrhythmias (A) Signup and view all the answers

What is the main advantage of inhaled corticosteroids?

They are relatively safe and have fewer side effects (D) Signup and view all the answers

What is the role of phospholipase A2 in asthma?

It increases the release of arachidonic acid from membrane lipids (D) Signup and view all the answers

What is the effect of corticosteroids on prostaglandins and leukotrienes?

They reduce their concentrations (A) Signup and view all the answers

What is the mechanism of action of corticosteroids in asthma?

They inhibit the expression of COX-2 (C) Signup and view all the answers

Why are inhaled glucocorticoids now considered appropriate for most cases of moderate asthma?

Early use may prevent severe, progressive inflammatory changes (A) Signup and view all the answers

What is the effect of corticosteroids on β adrenoceptors in the airway?

They increase their responsiveness (C) Signup and view all the answers

What is the shift in thinking regarding the use of corticosteroids in asthma?

They should be used early in moderate asthma to prevent severe, progressive inflammatory changes (D) Signup and view all the answers