6. Respiratory Pharm.

Question 1

A 55 year old man complains of resent bronchospasm. He doesn’t smoke and has no know allergies. He does have a history of high blood pressure and has been using Propanol. What medication would be appropriate to give to this patient?

A.Tiotropium 
B. Terbutaline 
C. Theophylline 
D. Ipratropium 
E. Formoterol 

RFA

Answer 1

Ans. D Ipratropium-is the DOC for b-blocker induced bronchospasm

A. Tiotropium- added to ICS for long term control of serve persistent asthma

B. Terbutaline- is a SABA used for acute asthma and exercise induced brochospasms

C . Theophylline- is a phosphodiesterase inhibitor, is a alternative therapy for patients with persistent asthma

E. Formoterol- LABA used for long term control of asthma

Question 2

A 39 year women who has chronic pain pain that she self medicates with NSAIDS such as Motrin has been has started to notice she is having trouble breathing and shortness of breath. What drug is the DOC for this condition?

A. Pseudoephedrine 
B. Dextromethorphan 
C. N-Acetylcysteine 
D.Fluticasone 
E. Montelukast 

RFA

Answer 2

Ans. E Montelukast-is a LTRA and is used as an alternative therapy for exercise induced bronchospasm and NERDs

A. Pseudoephedrine- is an alpha agonist and used for nasal congestion

B Dextromethorphan- suppresses the cough reflex in the medulla and is used for treatment of cough

C N-Actylcystein- breaks disulfide linkages in mucus and lowers viscosity it is used in COPD

D. Fluticasone- is a corticosteroid used in longer term management of COPD

Question 3

Beta2 agonists mediate the relaxation of bronchiolar smooth muscle via increasing the intracellular content of what secondary messenger? (MG)

A. cGMP
B. cCAMP
C. Ca2+
D. IP3
E. DAG

Answer 3

B. cCAMP

Question 4

This drug inhibits the synthesis of cytokines via binding to a glucocorticoid receptor insides the cell and decreases interleukins, IFNgamma, TNFalpha, and GM-CSF (MG)

A. Albuterol
B. Salmeterol
C. Budesonide
D. Montelukast

Answer 4

C. Budesonide

this is the MOA for inhaled corticosteroids used in asthma and COPD treatment

Question 5

A 13 y/o boy is currently using his albuterol inhaler daily. He is also waking up from sleep SOB once every week. Which of the following could be added to his current treatment?

A. Low dose fluticosone + salmeterol
B. Formoterol
C. Medium dose budesonide
D. Nedocromil
E. Omalizumab

SZ

Answer 5

Ans. A Low dose fluticosone + salmeterol

OR C. Medium dose budesonide

The boy’s asthma is now moderate persistent. He can have a low dose ICS + LABA or can have a medium dose ICS.

Formoterol is a LABA and should not be given without a ICS.

Nedocromil is a release inhibitor which treats bronchospasm, it is not a bronchodilator.

Omalizumab is used for allergies.

Question 6

A 65 y/o male with a 40 pack year smoking history presents with c/o DOE and productive cough. He has been non-compliant with his therapies. Which of the following should he be taking for symptomatic relief?

A. Salmeterol
B. Pirbuterol
C. Tiotropium
D. Fluticasone
E. Budesonide 

SZ

Answer 6

Ans. B. Pirbuterol

SABAs and SAMAs are used for symptomatic relief and management of acute exacerbations.

LABAs (salmeterol) and LAMAs (tiotropium) are used for long term management.

Fluticasone and budesonide are long term management corticosteroids