Deck 17: Drugs for the Treatment of Respiratory Disorders and Allergic Rhinitis

Question 1

Which of the following statements represents the primary advantage of the use of metered-dose inhalers (MDIs)?

A)The inhaled dose can be accurately measured.
B)They are difficult to use properly,and they can be abused.
C)The onset of action is unpredictable.
D)The bronchodilator effect is less than that of a comparable oral dose.

Answer 1

The inhaled dose can be accurately measured.

Question 2

Patients with _____ asthma experience symptoms less than two times a month,and the symptoms do not interfere with normal activity.

A)intermittent
B)mild persistent
C)moderate persistent
D)severe persistent

Answer 2

intermittent

Question 3

If a patient with COPD is given oxygen and the PaO₂ rises,the stimulant to breathing is

A)markedly stimulated.
B)slightly stimulated.
C)slightly depressed.
D)removed.

Answer 3

removed.

Question 4

The ventilation of a patient with COPD is driven by a(n)

A)increase in PaO₂ .
B)decrease in PaO₂ .
C)increase in PaCO₂ .
D)decrease in PaCO₂ .

Question 5

Which one of the following recommendations would you not make to your patients with asthma?

A)Bring your inhaler (albuterol)to the dental appointment.
B)Rinse after using your corticosteroid inhaler.
C)Avoid erythromycin.
D)Avoid aspirin.
E)Avoid acetaminophen.

Question 6

Which of the following drugs used to treat respiratory diseases carries a black box warning about a higher risk of asthma-related deaths as a result of a high number of asthma-related deaths reported with salmeterol therapy during a clinical trial?

A)Mast cell degranulation inhibitors
B)Anti-immunoglobulin E (IgE)antibodies
C)Short-acting β₂ -agonist
D)Long-acting β₂ -agonist

Question 7

Albuterol is a bronchodilator that can be administered via a metered-dose inhaler (MDI).It is recommended in prophylactically treating (preventing)chronic asthma.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true;the second statement is false.
D)The first statement is false;the second statement is true.

Question 8

Asthma may be precipitated by (1)allergens, (2)exercise, (3)stress.

A)1,2,3
B)1,2
C)1,3
D)2,3

Question 9

Which of the following agents prevents the antigen-induced release of histamine from sensitized mast cells?

A)Leukotriene (LT)modifiers
B)Corticosteroids
C)Cromolyn
D)Methylxanthines
E)Anti-IgE antibodies

Question 10

Patients with asthma should bring their fast-acting _____ inhaler to be used prophylactically or in the management of an acute asthmatic attack in the dental office.

A)m-agonist
B)B₁-agonist
C)B₁-antagonist
D)β₂ -agonist
E)β₂ -antagonist

Question 11

Which of the following groups of medications are considered first-line treatment for chronic obstructive pulmonary disease (COPD)?

A)b-adrenergic agonists
B)Anticholinergics
C)Methylxanthines
D)Leukotriene (LT)antagonists

Question 12

The drive for ventilation is stimulated by a(n)_____ in the partial pressure of _____ in the normal person.

A)depression;carbon dioxide (PaCO₂ )
B)elevation;carbon dioxide (PaCO₂ )
C)depression;oxygen (PaO₂ )
D)elevation;oxygen (PaO₂ )

Question 13

Leukotriene modifiers are used to manage patients with _____ that is not controlled byβ₂-agonists and corticosteroid inhibitors.

A)emphysema
B)asthma
C)chronic bronchitis
D)acute bronchitis

Question 14

Which one of the following drugs can result in oral candidiasis?

A)Fluticasone
B)Phenytoin
C)Acetaminophen
D)Metoprolol
E)Omeprazole

Question 15

The first line of treatment for intermittent asthma is a

A)short-acting β₂ -adrenergic agonist.
B)long-acting β₂ -adrenergic agonist.
C)corticosteroid.
D)mast cell degranulation inhibitor.
E)methylxanthine.

Question 16

In status asthmaticus,patients have persistent life-threatening

A)tachycardia.
B)stomach ulcers.
C)bronchospasm.
D)electrolyte imbalance.

Question 17

Which of the following drugs is the most effective long-term treatment for control of symptoms in all patients with mild,moderate,or severe persistent asthma?

A)LT modifiers
B)Cromolyn
C)Long-acting β₂ -agonists
D)Theophylline
E)Corticosteroids

Question 18

Asthma is characterized by _____ airway obstruction and is associated with reduction in _____ airflow.

A)reversible;inspiratory
B)reversible;expiratory
C)irreversible;inspiratory
D)irreversible;expiratory

Question 19

Which of the following statements is true of leukotrienes (LTs)?

A)LTs produce bronchodilation and decreased bronchial hyperreactivity.
B)LTs are produced by cells of inflammation.
C)LTs produce increased secretion of mucus and mucosal edema.
D)Both A and B are true.
E)Both B and C are true.

Question 20

Which of the following respiratory diseases is associated with irreversible airway obstruction?

A)Asthma
B)Chronic bronchitis
C)Emphysema
D)Both A and B
E)Both B and C

Question 21

Which of the following medications is used to treat persistent asthma and the bronchospasm associated with chronic bronchitis and emphysema?

A)Theophylline
B)Ipratropium
C)Omalizumab
D)Cromolyn

Question 22

Montelukast is generally well tolerated.It is more effective than H₁-antihistamines and intranasal corticosteroids.

A)Both parts of the statement are true.
B)Both parts of the statement are false.
C)The first part of the statement is true;the second part is false.
D)The first part of the statement is false;the second part is true.

Question 23

Pseudoephedrine,_____ agonist,is used systemically as a nasal decongestant.

A)an a-adrenergic
B)a b-adrenergic
C)an a-adrenergic and b-adrenergic
D)neither an a-adrenergic nor a b-adrenergic

Question 24

Which of the following symptoms is the most common side effect associated with the older antihistamines? (Please note: all are associated,but one is most common)

A)Nausea
B)Xerostomia
C)Sedation
D)Constipation

Question 25

The primary advantage of second-generation H₁ agents is that they are less likely to have which of the following pharmacologic effects of first-generation H₁ antihistamines?

A)Antihistaminic
B)Antiserotonergic
C)Anticholinergic
D)Sedative

Question 26

Which of the following types of medication are considered first-line therapy for the treatment of moderate to severe allergic rhinitis?

A)Leukotriene modifiers
B)Intranasal corticosteroids
C)Mast cell stabilizers
D)Intranasal decongestants

Question 27

Which of the following classes of antibodies is triggered when an allergen is inhaled in an individual with a sensitized immune system?

A)IgA
B)IgD
C)IgE
D)IgG
E)IgM

Question 28

_____ is the least toxic of all asthma medications.

A)Omalizumab
B)Cromolyn
C)Theophylline
D)Fluticasone
E)Zileuton

Question 29

_____ is a concern when administering local anesthetics with sulfiting agents as a preservative for the vasoconstrictor.

A)Tardive dyskinesia
B)Bronchoconstriction
C)Tachycardia
D)Emesis

Question 30

Antihistamines such as loratadine (Claritin)are nonsedating because they

A)stimulate the CNS.
B)bind only to H₂-receptors.
C)are combined with decongestants that have CNS stimulant activity.
D)do not cross the blood-brain barrier.

Question 31

Which of the following statements is true of omalizumab (Xolair)?

A)It is a recombinant humanized monoclonal antibody.
B)It prevents IgE from binding to mast cells and basophils.
C)It is administered by inhalation.
D)Both A and B are true.
E)Both B and C are true.

Question 32

The drug of first choice for emphysema is

A)albuterol.
B)zileuton.
C)theophylline.
D)beclomethasone.
E)ipratropium.

Question 33

Ipratropium bromide (Atrovent)is an intranasal _____ drug.

A)adrenergic
B)cholinergic
C)antiadrenergic
D)anticholinergic

Question 34

The term _______ refers to agents that are H₁-blockers.

A)histamine
B)antihistamine
C)adrenergic
D)cholinergic

Question 35

Antihistamines that are H₁-antagonists are least effective at competitively blocking the effect of histamine at which of the following sites?

A)Nonvascular smooth muscle (bronchial)
B)Vascular smooth muscle (vessels)
C)Capillary permeability
D)Nerve endings

Question 36

Montelukast (Singulair)is a(n)

A)intranasal corticosteroid.
B)leukotriene modifier.
C)intranasal anticholinergic drug.
D)mast cell stabilizer.
E)oral decongestant.

Question 37

Which of the following is the mechanism of action of cromolyn sodium (Nasalcrom)?

A)Inhibits mast cell degranulation
B)Blocks acetylcholine receptors
C)Stimulates alphA₁ adrenergic receptors
D)Stimulates cholinergic receptors

Question 38

Which of the following common antihistamines produces the most sedation?

A)Brompheniramine (Dimetane)
B)Chlorpheniramine (Chlor-Trimeton)
C)Diphenhydramine (Benadryl)
D)Fexofenadine (Allegra)
E)Loratadine (Claritin)

Question 39

Which of the following drugs is a mast cell stabilizer?

A)Ipratropium bromide (Atrovent)
B)Montelukast (Singulair)
C)Cromolyn sodium (Nasalcrom)
D)Azelastine (Astelin)

Question 40

A significant drug interaction occurs between theophylline and _____ that can result in toxic serum levels of theophylline.

A)aspirin
B)erythromycin
C)nifedipine
D)clomiphene

Question 41

How are the interleukin-5 antibody antagonists administered to the patient?

A)Inhaler
B)Injection
C)Oral administration with a tablet
D)Oral administration with a liquid

Question 42

Nonchlorinated hydrofluoroalkane (HFA)propellants do not deplete the ozone layer.

Question 43

Which type of medication is recommended for the treatment of intermittent asthma?

A)Inhaled corticosteroid
B)Leukotriene modifier
C)Short-acting β₂ -agonist
D)Long-acting β₂ -agonist

Question 44

Which of the following types of drugs is known to increase intraocular pressure if inadvertently placed in the eye?

A)Mast cell stabilizer
B)Antihistamine
C)Intranasal anticholinergic
D)Leukotriene modifier

Question 45

Adrenergic agonists produce bronchodilation by stimulating which type of receptors?

A)Alpha
B)Beta-1
C)Beta-2
D)Neuromuscular junction

Question 46

Nasal decongestants are

A)alpha-adrenergic agonists.
B)alpha-adrenergic antagonists.
C)beta-adrenergic agonists.
D)beta-adrenergic antagonists.

Question 47

A spacer is often placed between the metered-dose inhaler and the mouth to decrease the amount of drug delivered to the lungs.

Question 48

Histamine is released by which of the following types of white blood cells? (Select all that apply. )

A)Polymorphonuclear leukocytes (PMNs)
B)Mast cells
C)Basophils
D)Macrophages

Question 49

A high-dose inhaled corticosteroid is recommended for which form of asthma?

A)Intermittent
B)Mild persistent
C)Moderate persistent
D)Severe persistent

Question 50

Why should intranasal decongestants only be used for 3 to 5 days?

A)They produce systemic toxicity.
B)They can cause rebound congestion.
C)They will start to cause systemic autocoid effects.
D)They will produce xerostomia.

Question 51

Which type of drug is used in conjunction with low-dose corticosteroids to treat patients with persistent asthma that is not well controlled with low-dose inhaled corticosteroids?

A)Corticosteroids
B)Leukotriene modifiers
C)Long-acting β₂ -agonists
D)Mast cell degranulation inhibitors
E)Anti-interleukin-5 antibodies

Question 52

Why is phenylephrine being used in many over-the-counter (OTC)oral decongestant products instead of pseudoephedrine?

A)Phenylephrine is much less costly than pseudoephedrine.
B)Pseudoephedrine is used to make methamphetamine.
C)Pseudoephedrine is derived from morphine and is a narcotic.
D)Phenylephrine is more effective than pseudoephedrine.

Question 53

Which of the following are sources of seasonal allergic rhinitis rather than perennial allergic rhinitis? (Select all that apply. )

A)Pollen from flowers
B)Pollen from trees
C)House dust
D)Animal dander

Question 54

Which respiratory disease is characterized by destruction of lung alveoli?

A)Asthma
B)Upper respiratory tract infection
C)Chronic bronchitis
D)Emphysema

Question 55

Long-actingβ₂-agonists are recommended as monotherapy for asthma.Long-actingβ₂-agonists may be recommended as monotherapy for patients with chronic obstructive pulmonary disease (COPD)who have moderate to severe airflow obstruction.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true,the second is false.
D)The first statement is false,the second is true.

Question 56

Asthma is characterized by __________ airway obstruction,and chronic bronchitis by __________ airway obstruction.

A)reversible;reversible
B)reversible;irreversible
C)irreversible;reversible
D)irreversible;irreversible

Question 57

Oral decongestants should be used with caution in patients with (Select all that apply. )

A)cardiovascular disease.
B)hypertension.
C)diabetes.
D)hyperthyroidism.
E)closed-angle glaucoma.
F)None of above

Question 58

Researchers have suggested that oxygen be limited to less than 3 L/min for patients with severe COPD.

Question 59

Oral decongestants are alpha-adrenergic antagonists that cause a vasoconstriction of the nasal mucosa.Intranasal decongestants are an alternative to oral decongestants that are less likely to cause systemic adverse effects.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true;the second statement is false.
D)The first statement is false;the second statement is true.

Question 60

Which is an interleukin-5 antibody antagonist?

A)Montelukast (Singulair)
B)Mepolizumab (Nucala)
C)Albuterol (Proventil HFA)
D)Prednisone (Deltasone)
E)Omalizumab (Xolair)

Question 61

Montelukast (Singulair)has been associated with postmarketing reports of psychiatric symptoms.

Question 62

Intranasal corticosteroids are considered first-line therapy for treating moderate to severe allergic rhinitis.

Question 63

The H₁-receptor antagonists have varying cholinergic effects.

Question 64

Ipratropium bromide should be used with caution in patients with glaucoma.

Question 65

Second-generation antihistamines are more likely to cause sedation than first-generation antihistamines.

Question 66

Allergic rhinitis is primarily associated with immunoglobulin A.

Question 67

One common mistake that many asthmatics make is to rely on their albuterol inhaler and omit using their steroid inhaler.

Question 68

Orally inhaled corticosteroids produce an immediate benefit in an acute asthma attack.

Question 69

Antihistamines may be used to treat a mild allergic reaction.

Question 70

Sedation with antihistamines is additive with that caused by other CNS depressant drugs.

Question 71

Cromolyn sodium works by blocking acetylcholine receptors.