12/18

Question 1

What are two long-term effects of oral or intravenous steroid use? What are the adverse effects of inhaled corticosteroids?

Answer 1

Oral or IV cortiocosteroids put people at risk for avascular necrosis of the femoral head (hip pain and limp) and Cushing’s syndrome.
Inhaled corticosteroids put people at risk of oral thrush

Question 2

What are the side effects of the leukotriene receptor antagonists like Montelukast?

Answer 2

GI distress, hypersensitivity reaction and sleep disturbances

Question 3

Which antibiotic requires oxygen for uptake into the host cell, and is therefore ineffective against anerobes?

Answer 3

aminoglycosides

Question 4

Which asthma medication blocks acetylcholine at muscarinic receptors?

Answer 4

ipratropium

Question 5

Which asthma medication inhibits phosphodiesterase resulting in increased cAMP levels?

Answer 5

theophylline

Question 6

Which asthma medication inhibits the degranulation of mast cells?

Answer 6

cromolyn

Question 7

Which asthma medication inhibits the synthesis of cytokines?

Answer 7

corticosteroids like beclomethasone and prednisone

Question 8

Which asthma medication stimulates adenylyl cyclase resulting in increased cAMP levels?

Answer 8

Riociguat and beta-agonists such as salmeterol and albuterol

Question 9

What drug should you give to patients who need prophylaxis for pneumocystis jiroveci pneumonia but are allergic to sulfa drugs?

Answer 9

inhaled pentamidine

Question 10

Which antiTB drug has the adverse effect of loss of vision acuity and red-green color blindness?

Answer 10

ethambutol

Question 11

Which antiTB drug has the adverse effect of hepatotoxicity, neurotoxicity and drug-induced lupus?

Answer 11

isoniazid

Question 12

Which antiTB drug has the adverse effect of hepatotoxicity, hyperuricemia and gout?

Answer 12

pyrazinamide

Question 13

Which antiTB drug has the adverse effect of red-orange body fluids and significant hepatotoxicity?

Answer 13

rifampin

Question 14

What is the indication for amiodarone? What are it’s side effects?

Answer 14

amiodarone is a class III antiarrhythmic; side effects include pulmonary fibrosis, photosensitivity and thyroid disorders

Question 15

What are the drugs of choice to treat an acute asthma attack?

Answer 15

short acting B2 agonist, methylxanthine (theophylline), muscarinic antagonist, steroids

Question 16

Which anti-asthma drug can elevate liver enzymes, requiring liver function tests before start of therapy?

Answer 16

zileuton

Question 17

What drug used to treat rheumatoid arthritis will increase the risk of reactivation TB? Why?

Answer 17

etanercept, infliximab and adalimumab can lead to reactivation TB because they are TNF inhibitors and TNF is the cytokine that recruits monocytes to form the epithelioid histiocytes that wall off the infection.
At very high doses (higher than the doses used to treat RA) methotrexate will suppress bone marrow formation of monocytes which can lead to reactivation TB

Question 18

What is Samter’s triad?

Answer 18

aspirin-sensitive asthma: nasal polyps, asthma and aspirin sensitivity