Question 1

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

Accepted Answer

Mepolizumab (Nucala)is administered subcutaneously every 4 weeks.Reslizumab (Cinquair)is administered intravenously every 4 weeks.The interleukin-5 antibody antagonists are administered by injection.Cinqair is administered in a health care setting due to the risk of anaphylaxis.

Question 2

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

Accepted Answer

Chlorofluorocarbons,which have ozone-depleting properties,have been phased out as propellants in metered-dose inhalers (MDIs).They have been replaced by the nonchlorinated HFA propellants that do not deplete the ozone layer.

Question 3

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

Accepted Answer

Patients with intermittent asthma have symptoms less than two times a month and the symptoms do not interfere with normal activity.Low-dose inhaled corticosteroid is recommended for moderate persistent asthma,and medium-dose inhaled corticosteroid is recommended for severe persistent asthma.A leukotriene modifier is recommended for mild persistent,moderate persistent,or severe persistent asthma.A long-actingβ₂-agonist is recommended for moderate persistent or severe persistent asthma.

Question 4

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

Accepted Answer

An intranasal anticholinergic such as ipratropium bromide should be used with caution in patients with glaucoma.Ipratropium bromide,a quaternary amine intranasal anticholinergic drug,can increase intraocular pressure if placed in the eye.

Question 5

Adrenergic agonists produce bronchodilation by stimulating which type of receptors?

Accepted Answer

With the development of selectiveβ₂-agonists,bronchodilation with fewer cardiac side effects can be achieved.Stimulation of alpha receptors causes peripheral vasoconstriction.Stimulation of b₁-receptors causes an increase in cardiac output.Stimulation of neuromuscular junction receptors causes muscle movement.

Question 6

Nasal decongestants are

Accepted Answer

They act by constricting blood vessels of the nasal mucous membranes.Alpha-adrenergic agonists cause peripheral vasoconstriction.Beta-1 agonists cause an increase in cardiac output.Beta-2 agonists cause relaxation of alveolar smooth muscle in the bronchioles.

Question 7

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

Accepted Answer

The spacer increases the amount of drug delivered to the lungs.

Question 8

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

Accepted Answer

An allergen triggers the response of the antibody immunoglobulin E (IgE),which binds to mast cells and basophils containing histamine.The release of histamine causes itchy,watery eyes and runny noses.Histamine is not released by the other types of white blood cells.

Question 9

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

Accepted Answer

A high-dose corticosteroid is recommended for treatment of severe persistent asthma.A short-actingβ₂-agonist is recommended for intermittent asthma.Low-dose inhaled corticosteroid is recommended for mild persistent asthma.Either low-dose inhaled corticosteroid and a long-actingβ₂-agonist or medium-dose inhaled corticosteroid is recommended for moderate persistent asthma.

Question 10

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

Accepted Answer

Rebound congestion is treated by discontinuing the intranasal decongestant and then having the patient use an intranasal corticosteroid or possibly a short course of oral steroids to help control symptoms.Intranasal decongestants should not be used for more than 3 to 5 days to avoid rebound congestion.

Question 11

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?

Accepted Answer

Long-actingβ₂-agonists improve lung function,decrease symptoms,and reduce exacerbations of asthma and rescue uses of short-actingβ₂-agonists.Inhaled corticosteroids are used with long-actingβ₂-agonists for patients with persistent asthma for whom the corticosteroids alone are not working well.

Question 12

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

Accepted Answer

Pseudoephedrine is one of the ingredients used to make methamphetamine.Phenylephrine,though less effective than pseudoephedrine,is not in many OTC oral decongestant products due to legal restrictions placed on the sale of pseudoephedrine.

Question 13

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

Accepted Answer

Seasonal allergic rhinitis is usually caused by pollen from trees,grass,and flowers and lasts for several weeks to months.The most effective method of treating allergic rhinitis is to eliminate the source of the allergen.It this is not possible then medication therapy is necessary.Perennial allergic rhinitis is a result of sensitivity to different allergens such as house dust or animal dander and lasts throughout the year.

Question 14

Which respiratory disease is characterized by destruction of lung alveoli?

Accepted Answer

Emphysema is characterized by alveolar destruction with air space enlargement and airway collapse.Asthma is characterized by inflammation and swelling in the bronchioles.Patients with upper respiratory tract infections have inflammation and swelling as well.Chronic bronchitis is a result of chronic inflammation of the airways and excessive sputum production.

Question 15

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.

Accepted Answer

Long-actingβ₂-agonists are used in conjunction with low-dose corticosteroids to treat patients with persistent asthma not well controlled with low-dose inhaled corticosteroids.Long-actingβ₂-agonists improve lung function and quality of life and lower exacerbation rates in patients with COPD.Long-actingβ₂-agonists are not recommended as monotherapy for asthma;however,they may be recommended as monotherapy for patients with COPD.

Question 16

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

Accepted Answer

Asthma is characterized by reversible airway obstruction and chronic bronchitis is characterized by irreversible airway obstruction.Asthma is characterized by reversible airway obstruction.There have been many famous Olympic champions who were asthmatic.Chronic bronchitis and emphysema are forms of chronic obstructive pulmonary disease that are characterized by irreversible airway obstruction.

Question 17

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

Accepted Answer

The most common adverse effects associated with oral decongestants include insomnia,excitability,headache,nervousness,anorexia,palpitations,and tachycardia.Other adverse effects include arrhythmias,hypertension,nausea,vomiting,and urinary retention.All of the above choices are correct.

Question 18

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

Accepted Answer

Other literature recommends that oxygen by nasal cannula be used during a dental appointment for patients with severe COPD,especially if pain or stress is anticipated.

Question 19

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.

Accepted Answer

Pseudoephedrine and phenylephrine are thought to stimulate alpha₁ adrenergic receptors on the venous sinusoids.Intranasal decongestants are alternatives to oral decongestants as they are less likely to cause systemic adverse effects.They can,however,cause stinging,burning,sneezing,and dry throat or nose.Oral decongestants are alpha-adrenergic agonists.Alpha effects cause peripheral vasoconstriction.

Question 20

Which is an interleukin-5 antibody antagonist?

Accepted Answer

Mepolizumab (Nucala)and reslizumab (Cinqair)are the first in a new class of drugs approved by the FDA to treat severe asthma in patients with elevated eosinophil levels.Montelukast (Singular)is a leukotriene modifier,albuterol (Proventil HFA)is a short-actingβ₂-adrenergic agonist,prednisone (Deltasone)is an oral corticosteroid,and omalizumab (Xolair)is an anti-IgE antibody.

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