Deck 8: Xanthines

Question 1

Which drug stimulates skeletal muscle and the central nervous system (CNS)the strongest?

A)Theophylline
B)Aminophylline
C)Caffeine
D)Ipratropium

Answer 1

Caffeine

Question 2

Which of the following will increase theophylline blood levels?
1)Pneumonia
2) $\beta$ agonists
3)Corticosteroids
4) $\beta$ blockers

A)2 only
B)1,3,and 4 only
C)1 and 3 only
D)1 only

Answer 2

1,3,and 4 only

Question 3

Which of the following are possible theories explaining how theophylline works?
1)Inhibits phosphodiesterase
2)Blocks acetylcholine
3)Blocks adenosine
4)Produces catecholamines
5)None of the above

A)1,2,and 3 only
B)1,3,and 4 only
C)1,2,3,and 4 only
D)5 only

Answer 3

1,3,and 4 only

Question 4

Which of the following physiologic effects is not produced by xanthines?

A)Cerebral vasodilation
B)Cardiac muscle stimulation
C)Bronchial smooth muscle relaxation
D)Central nervous system (CNS)stimulation

Question 5

It is difficult to determine therapeutic doses of theophylline because

A)individuals metabolize theophylline at different rates.
B)individuals may be allergic to theophylline.
C)all doses of theophylline and its derivatives are equivalent.
D)xanthines do not interact with other medications.

Question 6

Theophylline produces which of the following?

A)Increased $\beta$ ₂ stimulation causing bronchodilation
B)Increased respiratory muscle strength and endurance
C)Decreased pulmonary vascular resistance
D)Decreased ventilatory drive

Question 7

Disadvantages of theophylline therapy include which of the following?
1)Narrow therapeutic margin
2)Toxic effects
3)Unpredictable blood levels
4)Need for individual dosing
5)Numerous drug-drug and drug-condition interactions

A)4 only
B)1,3,and 5 only
C)1,3,and 4 only
D)1,2,3,4,and 5

Question 8

The currently recommended blood serum theophylline level for the management of asthma is

A)<5 µg/mL.
B)5 to 15 µg/mL.
C)10 to 20 µg/mL.
D)20 to 25 µg/mL.

Question 9

The mechanism of action of xanthines is

A)well defined.
B)understood by a few physicians but not public knowledge.
C)not published.
D)unclear.

Question 10

The recommended therapeutic blood serum range of theophylline for use in the treatment of chronic obstructive pulmonary disease (COPD)is

A)5 to 10 µg/mL.
B)10 to 12 µg/mL.
C)12 to 20 µg/mL.
D)>20 µg/mL.

Question 11

The xanthine of choice to treat apnea of prematurity is

A)theophylline.
B)dyphylline.
C)caffeine citrate.
D)aminophylline.

Question 12

Theophylline and caffeine are examples of

A)β agonists.
B)methylxanthines.
C)corticosteroids.
D)anticholinergics.

Question 13

Theophylline is classified as a bronchodilator because it

A)stimulates $\beta$ ₂-adrenergic sites.
B)stimulates $\alpha$ -adrenergic sites.
C)blocks cholinergic sites.
D)has a relaxing effect on bronchial smooth muscle.

Question 14

An increase in intracellular cyclic adenosine 3',5'-monophosphate (cAMP)causes which of the following?

A)Bronchial smooth muscle contraction
B)Bronchial smooth muscle relaxation
C)Skeletal muscle contraction
D)Cardiac muscle relaxation

Question 15

Theophylline should be used to treat

A)acute respiratory distress syndrome (ARDS).
B)pneumonia.
C)apnea of prematurity.
D)cystic fibrosis (CF).

Question 16

Dosage of theophylline is best monitored by

A)clinical reaction of the patient.
B)measuring urine drug levels.
C)monitoring for adverse drug effects.
D)measurement of serum drug levels.

Question 17

An increase in blood theophylline levels can be caused by

A)renal failure.
B)intravenous isoproterenol.
C)β agonists.
D)cigarette smoking.

Question 18

Common,less toxic side effects of theophylline therapy include which of the following?
1)Headache
2)Gastric upset
3)Anxiety
4)Nervousness
5)Diuresis

A)1 and 2 only
B)2,4,and 5 only
C)1,2,3,and 5 only
D)1,2,3,4,and 5

Question 19

You are working the night shift when a 68-year-old man with chronic obstructive pulmonary disease (COPD)is admitted through the emergency department.He has been given Combivent and inhaled corticosteroids.The intern on call asks for your recommendation for additional medication to give the patient.Which of the following would you recommend?

A)Formoterol
B)Levalbuterol
C)Albuterol
D)Theophylline

Question 20

A significant side effect of theophylline often seen in patients is

A)drowsiness.
B)bradycardia.
C)hypertension.
D)nausea.

Question 21

You are working in the emergency department when a 77-year-old man with viral hepatitis comes in complaining of nausea.His medications include Combivent,Advair,and theophylline.Which drug is likely the cause of his nausea?

A)Combivent
B)Theophylline
C)Advair
D)None of the above

Question 22

Which of the following factors will increase theophylline levels?
1)Alcohol
2) $\beta$ -blocking agents
3)Zileuton
4)Isoniazid
5)Loop diuretics
6)Rifampin
7)Calcium channel blockers
8)Influenza virus vaccine

A)1,2,7,and 8 only
B)1,2,3,7,and 8 only
C)2,3,6,7,and 8 only
D)1,2,3,and 4 only

Question 23

While working a shift in the neonatal intensive care unit (NICU),you observe a patient receiving caffeine citrate.What is the patient's likely diagnosis?

A)Supraventricular tachycardia
B)Hypotension
C)Apnea of prematurity
D)Infection

Question 24

Which of the following factors will decrease theophylline levels?
1)Alcohol
2 $\beta$ -blocking agents
3)Zileuton
4)Isoniazid
5)Loop diuretics
6)Rifampin
7)Calcium channel blockers
8)Influenza virus vaccine

A)4,5,and 6 only
B)5,6,7,and 8 only
C)3,4,and 6 only
D)5,6,and 7 only

Question 25

The antiinflammatory effects of theophylline include which of the following?
1)Decreased migration of activated eosinophils into bronchial mucosa
2)Increased T-cell proliferation and accumulation in atopic asthma
3)Inhibition of proinflammatory cytokines
4)Reduced airway responsiveness to stimuli such as histamine and methacholine

A)1 and 2 only
B)2 and 4 only
C)1,2,and 3 only
D)1,3,and 4 only