Deck 32: Respiratory Pharmacology, treatment of Asthma, and Copd

Question 1

Explain the reason why theophylline may be contraindicated in patients with existing cardiovascular disease.

A) Theophylline may cause muscle wasting of the myocardium layer of the heart.
B) Theophylline may cause excessive cardiac stimulation.
C) Theophylline may cause angioedema.
D) None of these are correct.

Answer 1

Theophylline may cause excessive cardiac stimulation.

Question 2

Implementing a treatment plan that includes cromolyn sodium includes educating the patient on proper use of the medication.The instructions for use are:

A) Cromolyn sodium is administered prophylactically by oral inhalation three to four times per day.
B) Cromolyn sodium is administered immediately after exposure to the allergen.
C) Cromolyn sodium is administered prophylactically by oral inhalation once daily.
D) None of these are correct.

Answer 2

Cromolyn sodium is administered prophylactically by oral inhalation three to four times per day.

Question 3

Summarize the preferred therapy for the relief of moderate or persistent asthma.

A) Treatment with low-to-moderate-dose inhaled antiinflammatory corticosteroids and inhaled selective beta-2 adrenergic bronchodilators at the onset of the asthma symptoms.
B) Daily treatment with low-to-moderate-dose inhaled antiinflammatory corticosteroids and inhaled selective beta-2 adrenergic bronchodilators.
C) Daily treatment with low-dose inhaled antiinflammatory corticosteroids and inhaled selective beta-2 adrenergic bronchodilators.
D) Daily treatment with high-dose inhaled corticosteroids and long-acting beta adrenergic bronchodilators.

Answer 3

Daily treatment with low-to-moderate-dose inhaled antiinflammatory corticosteroids and inhaled selective beta-2 adrenergic bronchodilators.

Question 4

Differentiate between the methylxanthine,selective beta-2,and anticholinergic drug agents,and select the drug class that produces mild stimulation of the central nervous system,heart,and kidneys and relaxation of smooth muscle.

A) Theophylline
B) Atrovent
C) Albuterol
D) Maxair

Question 5

Use the adverse-effect profile of the systemic steroids to determine the statement that is true regarding the use of these steroids in the treatment of asthma.

A) Systemic steroid use leads to decreased susceptibility to infection.
B) Systemic steroid use leads to hyperglycemic events.
C) Systemic steroid use leads to increased susceptibility to infection.
D) Systemic steroid use leads to dehydration.

Question 6

Use the mechanism of action of the corticosteroids to determine the physiologic action that results from their administration.

A) Corticosteroids inhibit the production of allergic antibodies.
B) Corticosteroids inhibit the release of inflammatory mediators from the mast cells.
C) Corticosteroids inhibit the production and secretion of mucus.
D) All of these are correct.

Question 7

Describe the proper method of administration of acetylcysteine (Mucosil) to decrease the possibility of irritation and bronchospasm.

A) Addition of a bronchodilator to the inhalation mixture will decrease irritation and bronchospasm.
B) Addition of a bronchoconstrictor to the inhalation mixture will decrease irritation and bronchospasm.
C) Addition of a leukotriene inhibitor to the inhalation mixture will decrease irritation and bronchospasm.
D) None of these are correct.

Question 8

Summarize the role that the autonomic nervous system plays in the development of asthma.

A) Parasympathetic stimulation by epinephrine (beta-2 receptor) produces the bronchodilation that is characteristic of asthma.
B) Parasympathetic activation through the release of acetylcholine produces bronchoconstriction and increased secretion of mucus.
C) Sympathetic activation through the release of acetylcholine produces bronchoconstriction and increased secretion of mucus.
D) Sympathetic activation through the release of epinephrine produces bronchoconstriction and increased secretion of mucus.

Question 9

Compare the mucolytic and expectorant drug agents,and determine the primary mechanism of action of the mucolytic agents.

A) Increase in liquification of the bronchial mucus
B) Production of cough for the removal of the thickened mucus from the lungs
C) Facilitation of removal of thickened mucus secretions from the lungs
D) All of these are correct.

Question 10

Explain the mechanism of action of the anticholinergic drug agents used to treat asthma.

A) By blocking the actions of acetylcholine, anticholinergic drugs produce
B) bronchodilation and also reduce the volume of respiratory secretions.
C) By blocking the actions of acetylcholine, anticholinergic drugs produce bronchoconstriction and also increase the volume of respiratory secretions.
D) By blocking the actions of acetylcholine, anticholinergic drugs produce bronchodilation and also increase the volume of respiratory secretions.
E) None of these are correct.

Question 11

A patient complains of hoarseness and changes in his voice.Using your knowledge of steroids and leukotriene inhibitors,you advise the patient that the best way to avoid these adverse effects is to:

A) Switch to an intravenously administered steroid or leukotriene inhibitor.
B) Rinse his mouth with water after inhaling the medication to reduce the amount of steroid that remains in his mouth and throat.
C) Suck on a throat lozenge immediately after inhaling the medication.
D) All of these are correct.

Question 12

Differentiate between the chemical mediators that are formed and released from injured tissue,mast cells,and leukocytes in the respiratory tract,and select the function of histamine as it relates to asthma.

A) Histamine causes bronchoconstriction, increased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes.
B) Histamine causes bronchodilation, decreased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes.
C) Histamine is released from eosinophils and mast cells and functions to attract
D) eosinophils to the site of cell injury or irritation.
E) None of these are correct.

Question 13

Implementing a treatment plan that includes zileuton (Zyflo) requires monitoring the patient for:

A) Nausea and diarrhea
B) Fever, rash, and headache
C) Dark urine, jaundice, and clay-colored stools
D) All of these are correct.

Question 14

Use the clinical manifestations of asthma and COPD to determine the significant therapeutic aim in treating COPD.

A) Inhibit the production of mucus.
B) Maximize the exchange of the respiratory gases.
C) Liquefy mucus to help eliminate the mucus from the lungs.
D) All of these are correct.

Question 15

Using the onset of action as the primary factor,determine the preferred therapy for the treatment of the sudden onset of asthma symptoms.

A) Cromolyn sodium
B) Advair
C) Singulair
D) Albuterol

Question 16

Identify the symptoms associated with chronic bronchitis.

A) Dry cough, difficulty breathing, and increased respiratory infections
B) Productive cough, difficulty breathing, and increased respiratory infections
C) Dry cough, increased respiratory infections, and restriction of physical activity
D) Productive cough, increased respiratory infections, and restriction of physical activity

Question 17

Caffeine,theophylline,and theobromine are classified as methylxanthines and are found in nature.Methylxanthines can be described as:

A) Mineral compounds
B) Plant compounds
C) Synthetic compounds
D) None of these are correct.

Question 18

Identify the factors that can trigger an asthmatic attack.

A) Allergens, air pollutants, humidity, infections, and exercise
B) Air pollutants, hot air, certain drugs, infections, and exercise
C) Allergens, air pollutants, cold air, infections, and exercise

Question 19

Identify the physical manifestations associated with emphysema.

A) Difficulty expelling air from the lungs
B) Reduced respiratory exchange
C) Shortness of breath
D) All of these correct.

Question 20

Compare the expectorant and the mucolytic agent,and select the product that is available over the counter without a prescription for the relief of an unproductive cough.

A) Mucinex
B) Mucosil
C) Potassium citrate
D) Ammonium chloride

Question 21

Select the primary reason why the preferred route of administration for the corticosteroids in the treatment of chronic asthma and COPD is oral inhalation with metered-dose inhalers.

A) The advantage of inhalation is that lower dosages of steroid are delivered directly into the respiratory tract, therefore limiting systemic absorption and the adverse effects associated with steroid use.
B) The advantage of inhalation is that it prevents the abnormal increase in liver enzymes and the development of fever, dark urine, clay-colored stools, or jaundice.
C) The advantage of inhalation is that it prevents sleep disorders and suicidal ideation.
D) None of these are correct.

Question 22

Select the correct statement related to the preferred therapy for the treatment of asthma and COPD.

A) The aim of therapy is to administer leukotriene drugs that inhibit leukotriene-1 receptors.
B) The aim of therapy is to administer methylxanthine drugs to inhibit the action of beta-2 adrenergic receptors or anticholinergic drugs that decrease parasympathetic activity.
C) The aim of therapy is to administer sympathomimetic drugs to stimulate beta-2 adrenergic receptors or anticholinergic drugs that decrease parasympathetic activity.
D) None of these are correct.

Question 23

Select the mechanism of action of omalizumab (Xolair).

A) Omalizumab potentiates the IgE antibody and decreases the circulating levels of IgE, which reduces the severity and frequency of asthmatic attacks.
B) Omalizumab binds up the IgE antibody and increases the circulating levels of IgE, which reduces the severity and frequency of asthmatic attacks.
C) Omalizumab binds up the IgE antibody and decreases the circulating levels of IgE, which reduces the severity and frequency of asthmatic attacks.
D) None of these are correct.

Question 24

Select the mechanism of action of the bronchodilator drug known as theophylline.

A) Theophylline antagonizes adenosine, a bronchoconstrictor.
B) Theophylline inhibits the enzyme phosphodiesterase (PDE), which slows the metabolism of cAMP.
C) Theophylline inhibits the enzyme phosphodiesterase (PDE), which slows the inactivation of cAMP.
D) All of these are correct.

Question 25

Select the correct statement related to the bronchodilators,salmeterol,and formoterol when differentiating between salmeterol,formoterol,albuterol,and pirbuterol.

A) Salmeterol and formoterol are administered as oral tablets, have an immediate onset of action, and have a duration of action of 12 hours.
B) Salmeterol and formoterol are administered by nebulization, have an immediate onset of action, and have a duration of action of 4 to 6 hours.
C) Salmeterol and formoterol are administered by inhalation, have an onset of action of 10 to 20 minutes, and have a duration of action of 12 hours.
D) None of these are correct.

Question 26

Differentiate between the corticosteroids and the bronchodilator drug agents,and select the correct statement related to the mechanism of action of the corticosteroids.

A) Steroids work as antiinflammatory agents to inhibit the activation of arachidonic acid.
B) The major effect of steroids in the treatment of asthma is to inhibit the inflammatory process.
C) Steroids act to decrease the formation of prostaglandins and leukotrienes.
D) All of these are correct.

Question 27

Differentiate between the chemical mediators that are formed and released from injured tissue,mast cells,and leukocytes in the respiratory tract,and select the function of the eosinophilic chemotactic factor of anaphylaxis as it relates to asthma.

A) Eosinophilic chemotactic factor (ECF-A) is released from eosinophils and mast cells and functions to stimulate the action of arachidonic acid.
B) Eosinophilic chemotactic factor (ECF-A) is released from eosinophils and mast cells and functions to attract eosinophils to the site of cell injury or irritation in the lining of the respiratory tract in asthma.
C) Eosinophilic chemotactic factor (ECF-A) is released from eosinophils and mast cells and functions to stimulate the action of the prostaglandins.
D) None of these are correct.

Question 28

Select the group of drug agents that are listed in increasing order of their duration of action.

A) Albuterol, Advair, Spiriva
B) Advair, albuterol, Spiriva
C) Albuterol, Spiriva, Advair
D) Spiriva, albuterol, Advair

Question 29

Select the statement that correctly outlines the synthesis process of prostaglandins and leukotrienes.

A) During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Cyclooxygenase converts arachidonic acid into several different prostaglandins. At the same time, lipoxygenase converts arachidonic acid into the leukotrienes.
B) During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Lipoxygenase converts arachidonic acid into several different prostaglandins. At the same time, cyclooxygenase converts arachidonic acid into the leukotrienes.
C) During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Cyclooxygenase converts arachidonic acid into several different prostaglandins and leukotrienes.
D) During inflammation, phospholipase A stimulates the release of arachidonic acid from the cell membrane. Lipoxygenase converts arachidonic acid into several different prostaglandins and leukotrienes.

Question 30

Select the drug agent that is used to treat allergic rhinitis from the corticosteroids that are administered by oral inhalation or by nasal spray.

A) Aerobid
B) Pulmicort
C) Azmacort
D) Flonase