Question 1

A pediatric patient is admitted to the emergency department from a physician's office with the suspected diagnosis of croup.An inspiratory stridor is heard.Which aerosolized sympathomimetic would you recommend to decrease the stridor?

Accepted Answer

Racemic epinephrine (Vaponephrine)is a sympathomimetic drug.However,its alpha effects are strong and it is commonly used to relieve croup and epiglottitis symptoms in children.

Question 2

Which of the following is caused by histamine release from the mast cells?
I.Bronchodilation
II.Increased bronchial gland secretion
III.Increased amount of mucus present in the airways

Accepted Answer

Histamine is also a potent bronchoconstrictor.In addition to its bronchoconstrictive activity,histamine II)increases bronchial gland secretion,causing III)an increase in the amount of mucus present in the airways.Histamine may also have an effect on vascular permeability similar to the effect of-SRS-A.

Question 3

Salmeterol and Fluticasone are combined into a DPI preparation.What is the purpose of these two drugs combined?

Accepted Answer

Fluticasone propionate (Flovent)and salmeterol (Serevent)have been combined into a DPI preparation containing 100 mcg of fluticasone propionate and 50 mcg of salmeterol.By taking both drugs together,the long-term effects of both d)maintenance bronchodilation and anti-inflamation can be achieved.

Question 4

Stimulation of the sympathetic nervous system causes _________________

Accepted Answer

Sympathetic nervous system stimulation causes bronchodilation.

Question 5

Acetylcholine stimulates ____________________

Accepted Answer

Acetylcholine stimulates the cholinergic receptors.

Question 6

Release of acetylcholine will cause ___________________

Accepted Answer

Cholinergic receptors are cells that respond when stimulated by acetylcholine.Cholinergic receptors cause profound bronchospasm in the lungs when stimulated.Cholinergic receptors are found in the parasympathetic nervous system.

Question 7

What is the name of the receptor sites that are located in the peripheral vasculature,the heart,bronchial muscle,and bronchial blood vessels?

Accepted Answer

Alpha receptors are located in the peripheral vasculature,the heart,bronchial muscle,and bronchial blood vessels.

Question 8

Which of the following is NOT an example of a sympathomimetic drug?

Accepted Answer

Atropine sulfate is a anti-cholinergic bronchodilator.Salmeterol,formoterol,and pirbuterol are all sympathomimetic bronchodilators.

Question 9

Which of the following drugs cause bronchodilation by inhibiting the effects of the parasympathetic nervous system?
I.Atropine sulfate
II.Ipratropium bromide
III.Tiotropium bromide
IV.Terbutaline sulfate

Accepted Answer

I)Atropine,II)ipratropium,and III)tiotropium are all examples of antocholinergic bronchodilators (bronchodilators that work by blocking the parasympathetic nervous system).Anticholinergic drugs block the cholinergic receptor sites,preventing that route of bronchospasm.

Question 10

Place the following intracellular events of the Beta 2 receptor stimulation in order.
I.Phosphodiesterase breaks down cyclic 3',5'-AMP into 5'-AMP
II.Adenylate cyclase combines with magnesium and ATP to form cyclic 3',5'-AMP
III.Cyclic 3',5'-AMP results in bronchial smooth muscle relaxation
IV.Beta-2 stimulation causes the formation of adenylate cyclase

Accepted Answer

The following order is correct: IV)Beta-2 stimulation causes the formation of adenylate cyclase.II)Adenylate cyclase combines with magnesium and ATP (adenosine triphosphate)to form cyclic 3',5'-AMP (adenosine monophosphate).III)Cyclic 3',5'-AMP results in bronchial smooth muscle relaxation and hence bronchodilation.Cyclic 3',5'-AMP is not a long-lived agent.It is readily broken down by another enzyme present in the lungs called phosphodiesterase.I)Phosphodiesterase breaks 3',5'-AMP down into 5'-AMP,which no longer causes bronchodilation.

Question 11

Inhibition of the sympathetic nervous system would cause _________________

Accepted Answer

If the sympathetic nervous system is inhibited,it would cause bronchoconstriction.

Question 12

A patient is ready to be discharged to her home.At home the patient has a compressor and a small volume nebulizer.Which of the following corticosteroids is in solution and is intended to be administered via a small volume nebulizer?

Accepted Answer

Budesonide (Pulmocort)is available as both an inhalant solution (0.25 mg/ mL once daily)and a dry powder formulation (200 mcg/dose twice daily).In aerosol form,this anti-inflammatory medication targets the lungs specifically with fewer side effects.

Question 13

Corticosteroids:

Accepted Answer

Corticosteroids are widely used in the management of the inflammatory process associated with asthma,reactive airways disease,and other pulmonary disorders.

Question 14

Which of the following would NOT cause a bronchospasm or bronchoconstriction?

Accepted Answer

Beta-1 receptors would not cause a bronchospasm or bronchoconstriction.Leukotrienes are one of many chemical mediators released by the mast cells.Leukotrienes cause a direct,strong bronchoconstriction.Histamine is also a potent bronchoconstrictor.Prostaglandins cause a strong bronchospasm,especially in asthmatic patients.

Question 15

A sympathomimetic drug would cause ________________

Accepted Answer

A sympathomimetic drug would cause bronchodilation.Sympathomimetic agents are the drugs most commonly used to reverse bronchospasm.

Question 16

Stimulation of the beta 2 receptors causes ___________________

Accepted Answer

Stimulation of the beta-2 receptors in the lungs causes bronchodilation.

Question 17

Which receptor site results in tachycardia,an increased potential for arrhythmias,and an increased cardiac output?

Accepted Answer

Stimulation of the beta-1 receptors results in tachycardia,an increased potential for arrhythmias,and an increased cardiac output.In administering drugs to the pulmonary system,stimulation of the beta-1 sites is not desired.However,most respiratory pharmacologic agents have some beta-1 stimulatory effect.

Question 18

Aminophylline causes bronchodilation by ___________________

Accepted Answer

Aminophylline is a phosphodiesterase inhibitor.It is an example of drugs in the xanthine group.Common phosphodiesterase drugs are found in the methylxanthine group.Cyclic 3',5'-AMP is broken down into 5'-AMP by the enzyme phosphodiesterase.If the action of phosphodiesterase can be blocked or inhibited,more 3',5'-AMP will remain in the lungs,resulting in better bronchodilation.Phosphodiesterase inhibitors act in this way.

Question 19

What immunoglobulin antibody sensitizes the mast cell?

Accepted Answer

The IgE (reagin)antibodies sensitize the mast cell.Repeated exposure to the antigen causes the degranulation of the mast cell.

Question 20

Which of the following sympathomimetic drugs are intended for maintenance therapy only?
I.Levalbuterol
II.Salmeterol
III.Formoterol
IV.Pirbuterol

Accepted Answer

II)Salmeterol and III)Formoterol are intended for maintenance therapy only.

Quiz 14: Introduction to Respiratory Care Pharmacology