Deck 20: Pharmacology

Question 1

Which of the following statements accurately describes levalbuterol?

A)It is composed of both (R)- and (S)-albuterol.
B)The d-isomer is the most active compound.
C)A dose of 0.63 mg is equipotent to 1.25 mg of racemic albuterol.
D)The d-isomer possesses a longer duration of action.

Answer 1

B
Albuterol is composed of both (R)- and (S)-isomers of albuterol.Levalbuterol is the active isomer of albuterol (R-albuterol)and is indicated for the treatment or prevention of bronchospasms in adults and children.In studies of asthma treatment in the pediatric patient,levalbuterol has been compared with both racemic albuterol and placebo.In doses of 0.31 and 0.63 mg,levalbuterol produced an equipotent degree of bronchodilation,as measured by percent change from predose forced expiratory volume at 1 second (FEV₁),as did comparable doses of 1.25 and 2.5 mg of racemic albuterol.This same study found that 0.63 mg of levalbuterol was equipotent to 1.25 mg of racemic albuterol,and 1.25 mg of levalbuterol was equipotent to 2.5 mg of racemic albuterol.Therefore,there is no demonstrable difference in terms of safety or effectiveness between levalbuterol and albuterol.

Question 2

A patient with status asthmaticus has been admitted to the emergency department.The physician would like to try a b₂-agonist that can be administered parenterally.Which of the following drugs should the therapist suggest?

A)Terbutaline
B)Levalbuterol
C)Epinephrine
D)Pirbuterol

Answer 2

A
Terbutaline is the only selective b₂-agonist available in parenteral form for the emergency treatment of status asthmaticus in critically ill children.

Question 3

Nebulized pentamidine should be administered in a negative pressure room and through which of the following nebulizer systems?

A)Pari LC Plus
B)Nebutech
C)Respirgard II
D)SPAG

Answer 3

C
Nebulized pentamidine should be administered in a negative pressure room and through a Respigard II,which routes exhaled breaths through a micro filter to avoid potential adverse events to health care workers in the immediate treatment area.

Question 4

When should the therapist administer short-acting bronchodilators to improve penetration of inhaled antibiotics?

A)Immediately after the antibiotic
B)No more than 4 hours after administration of the antibiotic
C)15 minutes to 4 hours before each dose
D)At the same time as the administration of the antibiotic

Question 5

To reduce the adverse effects of inhaled corticosteroids,what should the therapist recommend?

A)Decrease the dosage
B)Use a dry powder inhaler
C)Use a holding chamber device
D)Brush teeth after each inhalation

Question 6

Which of the following medications is the only drug that inhibits 5-lipoxygenase?

A)Montelukast
B)Omalizumab
C)Zafirlukast
D)Zileuton

Question 7

While working at the bedside of a small child who has myasthenia gravis,the therapist notices a new medication order prescribing glycopyrrolate for the control of secretions.What should the therapist do at this time?

A)Inform the nurse that this medication is contraindicated for patients with myasthenia gravis.
B)Inform the nurse that the dose is incorrect.
C)Inform the nurse that this medication is contraindicated in children.
D)Mention nothing because the prescription is correct.

Question 8

Which of the following medications works to maintain the integrity of the mast cell?

A)Ipratropium bromide
B)Magnesium sulfate
C)Cromolyn sodium
D)Methylprednisolone

Question 9

Which of the following side effects are consistent with chronic administration of theophylline?
I)Nausea
II)Vomiting
III)Tachycardia
IV)Central nervous system stimulation

A)I and II only
B)II and III only
C)III and IV only
D)I,II,III,and IV

Question 10

How long should a patient wait to receive the maximal benefit of inhaled corticosteroids?

A)48 hours
B)5 days
C)1 to 2 weeks
D)1 month

Question 11

Which of the following adverse effects is likely to be experienced by patients who use nonselective b₂-adrenergic agonists?

A)Tremor
B)Tachypnea
C)Bradycardia
D)Blurred vision

Question 12

Which of the following medications is most suited for the treatment of postextubation edema?

A)Racemic epinephrine
B)Ephedrine
C)Norepinephrine
D)Fluticasone

Question 13

Which of the following medications is an effective adjunctive therapy in relieving bronchospasm in patients with acute bronchospasm when combined with albuterol?

A)Pirbuterol
B)Salmeterol
C)Metaproterenol
D)Ipratropium bromide

Question 14

The physician asks the therapist to recommend a long-acting b-agonist for a patient.Which of the following medications should the therapist recommend?

A)Levalbuterol
B)Formoterol
C)Metaproterenol
D)Terbutaline

Question 15

Which of the following responses are considered adverse effects of inhaled corticosteroids?
I)Oropharyngeal candidiasis
II)Dry mouth
III)Wheezing
IV)Dysphonia

A)I and II only
B)II and III only
C)II and IV only
D)I,III,and IV only

Question 16

Which of the following medications is a recombinant humanized monoclonal anti-IgE antibody use for the treatment of severe persistent asthma?

A)rhDNase
B)RespiGam
C)Omalizumab
D)Palivizumab

Question 17

Which of the following benefits has been associated with the use of inhaled tobramycin?
I)Improvement of FEV₁
II)Eradication of Pseudomona aeruginosa
III)Reduction in hospitalization
IV)Reduction in parenteral use of antibiotics

A)I and IV only
B)I,II,and III only
C)I,III,and IV only
D)I,II,III,and IV

Question 18

Which of the following effects constitute adverse reactions to dornase alfa (recombinant human deoxyribonuclease I (rhDNase))?
I)Chest pain
II)Pharyngitis
III)Rash
IV)Hypovolemia

A)I and IV only
B)I,II,and III only
C)I,III,and IV only
D)II,III,and IV only

Question 19

Which of the following agents should be considered in the rapid-sequence intubation of patients with status asthmaticus?

A)Atropine
B)Magnesium sulfate
C)Halothane
D)Ketamine

Question 20

Which of the following effects is related to activation of b-adrenergic receptor sites?

A)Activation of guanyl cyclase
B)Skeletal muscle contraction
C)Bronchial smooth muscle relaxation
D)Release of inflammatory mediators