Respiratory Pharmacology Quiz
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Questions and Answers

What is the primary action of anticholinergics on M3 receptors?

  • Stimulate secretion of mucus
  • Enhance respiratory rate
  • Promote bronchoconstriction
  • Inhibit contraction of airway smooth muscle (correct)

    • Which of the following agents is an example of an anticholinergic used in respiratory therapy?

  • Albuterol
  • Aminophylline
  • Salmeterol
  • Ipratropium bromide (correct)

    • How does the onset of action for anticholinergics compare to adrenergic agents?

  • Anticholinergic action is more intense
  • Anticholinergics act more quickly
  • Anticholinergics develop slowly and are usually less intense (correct)
  • There is no difference in onset times

    • Which of the following describes the mechanism of action for ipratropium bromide?

    <p>It inhibits mucus secretion in the respiratory tract</p> Signup and view all the answers

    What is a common characteristic of the bronchial response when using anticholinergics?

    <p>Decreased production of airway secretions</p> Signup and view all the answers

    What is the primary action of B agonists on airway smooth muscle?

    <p>Promote airway relaxation</p> Signup and view all the answers

    What side effect is associated with the use of B agonists?

    <p>Lachycardia</p> Signup and view all the answers

    How do B agonists affect intracellular cAMP levels?

    <p>Stimulate the increase of cAMP formation</p> Signup and view all the answers

    What physiological effect results from increased ciliary activities due to B agonist administration?

    <p>Decreased microvascular leakages</p> Signup and view all the answers

    What is the best route of administration for B agonists to achieve local effects on airway muscles?

    <p>Inhalation route</p> Signup and view all the answers

    What role do corticosteroids play in the treatment of asthma?

    <p>They stabilize the condition long-term.</p> Signup and view all the answers

    Which of the following is NOT a characteristic of bronchodilators?

    <p>They are used to manage long-term asthma control.</p> Signup and view all the answers

    Which alternative therapy is classified as a leukotriene modulator?

    <p>Nedocromil sodium</p> Signup and view all the answers

    What is a necessary component of asthma management alongside drug treatment?

    <p>Behavioral changes and education</p> Signup and view all the answers

    Which of the following medications is NOT included among the recommended bronchodilators?

    <p>Cromolyn sodium</p> Signup and view all the answers

    In asthma treatment, which agent is specifically recommended for maintaining long-term airway patency?

    <p>Corticosteroids</p> Signup and view all the answers

    Which medication is considered a short-acting bronchodilator?

    <p>Salbutamol</p> Signup and view all the answers

    What is a misconception about corticosteroids in asthma management?

    <p>They can be used alone for asthma control.</p> Signup and view all the answers

    What is a characteristic feature of new generation B2-selective agonists?

    <p>They can last up to 12 hours due to high solubility.</p> Signup and view all the answers

    Which statement is true regarding the R-isomer and S-isomer of selective agonists?

    <p>The R-isomer promotes inflammation while the S-isomer activates against the receptor.</p> Signup and view all the answers

    What is the primary source of methylxanthines like theophylline?

    <p>Plant alkaloids.</p> Signup and view all the answers

    Why are new generation B2-selective agonists not recommended as monotherapy?

    <p>They have no anti-inflammatory activity.</p> Signup and view all the answers

    What condition is commonly treated with theophylline?

    <p>Asthma.</p> Signup and view all the answers

    What is a significant risk associated with theophylline therapy?

    <p>Narrow therapeutic windows requiring monitoring.</p> Signup and view all the answers

    How do new generation B2-selective agonists improve asthma symptoms?

    <p>By interacting with inhaled steroids.</p> Signup and view all the answers

    What type of side effect is commonly associated with methylxanthines?

    <p>Cardiac arrhythmia.</p> Signup and view all the answers

    What is a common side effect associated with systemic glucocorticoids?

    <p>Suppression of the hypothalamo-pituitary axis</p> Signup and view all the answers

    What dosage range is typically recommended for children experiencing acute asthma exacerbation with glucocorticoids?

    <p>1-2 mg/kg/day</p> Signup and view all the answers

    Which adverse effect is more prevalent with inhaled glucocorticoids?

    <p>Candidiasis</p> Signup and view all the answers

    In chronic use, systemic glucocorticoids can lead to which metabolic disorder?

    <p>CHO and lipid metabolism disorder</p> Signup and view all the answers

    What is a potential toxicity effect of inhaled glucocorticoids regarding bone health?

    <p>Bone resorption</p> Signup and view all the answers

    Which of the following is NOT a side effect associated with systemic glucocorticoids?

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

    Which of the following factors most significantly increases the risk of side effects from glucocorticoid therapy in women?

    <p>Higher doses</p> Signup and view all the answers

    Which of the following side effects is associated with glucocorticoids but not vaporizers or inhalants?

    <p>Growth retardation</p> Signup and view all the answers

    What is the primary mechanism by which leukotrienes contribute to asthma symptoms?

    <p>Bronchoconstriction and mucus hypersecretion</p> Signup and view all the answers

    Which inflammatory cells are primarily involved in the production of leukotrienes?

    <p>Mast cells and macrophages</p> Signup and view all the answers

    What role does leukotriene B4 (LTB4) play in the context of asthma?

    <p>It acts as a neutrophil chemoattractant</p> Signup and view all the answers

    Which response is NOT associated with the action of leukotrienes in the airways?

    <p>Decreased mucus production</p> Signup and view all the answers

    How do leukotriene pathway inhibitors function in asthma management?

    <p>By blocking the effects of leukotrienes</p> Signup and view all the answers

    What potentially harmful effects are associated with leukotrienes in asthma pathology?

    <p>Airway inflammation and increased secretions</p> Signup and view all the answers

    What is a key characteristic of leukotriene D4 (LTD4) in the context of airway pathology?

    <p>It increases airway permeability and mucosal edema</p> Signup and view all the answers

    What triggers the release of leukotrienes in the airway inflammation associated with asthma?

    <p>Activation of inflammatory cells</p> Signup and view all the answers

    Study Notes

    Asthma

    • Asthma is a respiratory condition characterized by difficulty breathing.
    • Clinically, it's marked by recurrent shortness of breath, chest tightness, coughing, and wheezing.
    • Physiologically, asthma involves reversible narrowing of the bronchial airways and a marked increase in bronchial responsiveness to stimuli.
    • Pathologically, asthma features lymphocytic and eosinophilic inflammation of the bronchial mucosa.
    • There's remodeling of the bronchial mucosa, thickening of the lamina reticularis, and hyperplasia of cells in the bronchial structure (smooth muscle, secretory glands, goblet cells).

    Asthma Triggers

    • Genetic predisposition
    • Upper respiratory tract infections
    • Allergens (dust, dander, pollen, mold)
    • Cold air
    • Exercise

    Asthma Status

    • A life-threatening condition requiring aggressive treatment
    • Defined by unresponsiveness to standard therapy.

    Asthma Treatment Strategies

    • Returning lung function to near normal
    • Preventing exacerbations (flare-ups)

    Drug Classification for Asthma

    • Three major classes of anti-asthma drugs:
      • Bronchodilators:
        • β-adrenergic agonists (e.g., epinephrine, terbutaline, salmeterol, albuterol)
        • Methylxanthines (e.g., theophylline)
        • Anticholinergics (e.g., ipratropium bromide)
      • Anti-inflammatory agents:
        • Corticosteroids (e.g., inhaled corticosteroids like fluticasone, budesonide)
      • Alternative therapies:
        • Leukotriene modifiers
        • Cromolyn sodium
        • Nedocromil

    Bronchodilators (β-adrenergic agonists)

    • Used to relieve acute asthma attacks.
    • Examples:
      • Epinephrine
      • Terbutaline
      • Salmeterol
      • Albuterol
    • These agents relax bronchial smooth muscle and help improve breathing.
    • Potential side effects: tachycardia, skeletal muscle tremors.

    Anti-inflammatory Agents (Corticosteroids)

    • Used to control inflammation, which is a key component of persistent asthma.
    • Examples:
      • Fluticasone
      • Budesonide
    • Systemic corticosteroids (oral) are used for severe acute exacerbations.
    • Inhaled corticosteroids are preferred for long-term management.
    • Side effects (potential):
      • Increased mood disturbance
      • Increased appetite
      • Candidiasis
      • Loss of glucose control in diabetics
      • Bone resorption or osteoporosis (with systemic use)

    Alternative Therapies (Leukotriene modifiers)

    • Examples
      • Montelukast
      • Zafirlukast
    • Block the production or action of leukotrienes.
    • This helps reduce airway inflammation and bronchoconstriction.

    Alternative Therapies (Cromolyn Sodium & Nedocromil)

    • Used to prevent acute exacerbations
    • Inhibits the release of inflammatory molecules from mast cells.

    Anti- IgE Monoclonal Antibodies

    • For severe asthma
    • E.g. Omalizumab

    Methylxanthines 

    • Theophylline.
    • Effective as bronchodilators
    • Requires close monitoring due to narrow therapeutic window

    Anticholinergics

    • Ipratropium bromide.
    • Not as effective or rapid as beta agonists.
    • Added to beta agonist for synergistic effect.
    • Often given via MDI for quick administration

    Leukotriene Pathway Inhibitors

    • (Montelukast, Zafirlukast)
    • Inhibit the inflammatory action of leukotrienes
    • Particularly useful for exercise-induced asthma

    Route of Adminstration

    • Inhaler is the preferred route.

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    Description

    Test your knowledge on the pharmacological actions of anticholinergics and beta agonists in respiratory therapy. This quiz covers mechanisms of action, therapeutic uses, and comparisons between different classes of respiratory drugs. Perfect for students and professionals in healthcare.

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