Deck 32: Respiratory Pharmacology, treatment of Asthma and Copd

Question 1

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

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

Answer 1

All of these are correct.

Question 2

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

Answer 2

All of these

Question 3

Caffeine,theophylline,and theobromine are compounds found in nature and these compounds are classified as methylxanthines.Identify the type of compound being exemplified in this question.

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

Answer 3

Plant compounds

Question 4

Determine the statement that is true regarding systemic steroid use in the treatment of asthma.

A) Systemic steroid use leads to decreased susceptibility to infection.
B) Systemic steroid use increases the release of inflammatory mediators from mast cells.
C) Systemic steroid use leads to increased susceptibility to infection.
D) Systemic steroid use leads to dehydration.

Question 5

Which of the following is an expectorant available over the counter and is used for the relief of an unproductive cough?

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

Question 6

A patient complains of hoarseness and changes in his voice after using anti-inflammatory steroids.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) chew a throat lozenge immediately after inhaling the medication.
D) All of these are correct.

Question 7

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

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

Question 8

What causes chronic obstructive pulmonary disease?

A) Arthritis and chronic fatigue syndrome
B) Emphysema and chronic bronchitis
C) Nephritis and chronic viral hepatitis
D) Synovitis and chronic esophagitis

Question 9

Considering the onset of action as the primary factor,determine the preferred therapy for the treatment of any sudden onset of asthma symptoms for patients who experience less than two asthmatic episodes per week.

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

Question 10

Which of the following effects are associated with the use of the leukotriene inhibiting drug zileuton (Zyflo)?

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

Question 11

Implementing a treatment plan for asthma that includes cromolyn sodium involves educating the patient on proper use of the medication.Which of the following is a valid instruction for its use?

A) Cromolyn sodium should be administered prophylactically by oral inhalation three to four times per day.
B) Cromolyn sodium should be administered an hour after exposure to the allergen.
C) Cromolyn sodium should be administered prophylactically by oral inhalation once a week.
D) None of these are correct.

Question 12

Which of the following occurs in the respiratory tract due to the release of histamine?

A) It causes bronchoconstriction, increased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes.
B) It causes bronchodilation, decreased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes.
C) It causes bronchodilation and inhibits the release of mediators from mast cells.
D) None of these are correct.

Question 13

Identify the factor that can trigger an asthmatic attack.

A) Humidity
B) Warm air
C) Exercise
D) Deep breathing

Question 14

Which of the following best describes the primary mechanism of action of the mucolytics?

A) Liquefaction of the bronchial mucus
B) Production of cough for the removal of the thickened mucus from the lungs
C) Increase in the viscosity of bronchial secretions
D) All of these

Question 15

Select the drug class that can cause stimulation of the central nervous system,increase respiratory muscle contractility,and mucociliary clearance.

A) Theophylline
B) Ipratropium
C) Albuterol
D) Pirbuterol

Question 16

Identify 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 to the inhalation mixture will decrease irritation and bronchospasm.
D) None of these are correct.

Question 17

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

A) Theophylline may cause vasoconstriction.
B) Theophylline may cause excessive cardiac stimulation.
C) Theophylline may cause angioedema.
D) None of these are correct.

Question 18

Identify 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 19

What is the significant therapeutic aim in treating COPD?

A) To inhibit the production of mucus
B) To improve lung function
C) To liquefy mucus and thus eliminate mucus from the lungs
D) All of these

Question 20

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

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

Question 21

Select the mechanism of action of omalizumab (Xolair).

A) Omalizumab destroys 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 22

Dr.Martha has prescribed pirbuterol to a patient who is having an asthmatic attack.Which of the following statements best explains her reason for choosing this drug?

A) It is considered a rescue drug.
B) The onset of action with the use of this drug is 1 hour from the time it is inhaled.
C) The duration of action for this drug is 12-14 hours.
D) It is a nonselective beta drug; therefore it is more effective.

Question 23

Under which of the following categories are salmeterol and formoterol typically classified?

A) Rescue drugs
B) Reliever drugs
C) Antihelminthic drugs
D) Antithyroid drugs

Question 24

Select the correct statement related to the mechanism of action of steroids.

A) Steroids work as anti-inflammatory 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 25

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 26

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 27

Kevin suffers from occasional asthmatic episodes caused due to various allergic reactions.His doctor prescribes cromolyn sodium for his treatment.During a subsequent visit,his doctor informs him that he could use a substitute drug that is similar in mechanism and pharmacological effect to cromolyn.Which of the following drugs is being referred to in this scenario?

A) Formoterol (Foradil)
B) Tiotropium (Spiriva)
C) Dyphylline (Lufyllin)
D) Nedocromil (Tilade)

Question 28

Select the mechanism of action of the bronchodilator drug 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 29

Which of the following statements is true of ipratropium bromide (Atrovent)?

A) It has a quick onset and prolonged duration of action.
B) It is a quaternary derivative of atropine.
C) It causes several adverse effects.
D) It is a nonselective beta drug.

Question 30

Select the correct statement related to the bronchodilators salmeterol and formoterol.

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 31

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 32

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

A) Albuterol (Proventil), Salmeterol/fluticasone (Advair), Tiotropium (Spiriva)
B) Salmeterol/fluticasone (Advair), Albuterol (Proventil), Tiotropium (Spiriva)
C) Albuterol (Proventil), Tiotropium (Spiriva), Salmeterol/fluticasone (Advair)
D) Tiotropium (Spiriva), Albuterol (Proventil), Salmeterol/fluticasone (Advair)

Question 33

Which of the following statements is true of prostaglandins?

A) Aspirin inhibits the formation of prostaglandins.
B) Prostaglandins cause bronchodilation.
C) Prostaglandins are derived from eosinophils.
D) Whenever there is injury to body tissue, prostaglandins are rapidly released from mast cells.

Question 34

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

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

Question 35

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.