Asthma

Question 1

Which class of drugs is best for the immediate-phase response of an asthma attack

Answer 1

bronchodilators

Question 2

Which class of drugs is best for the late phase response of an asthma attack

Answer 2

anti-inflammatory drugs

Question 3

Drugs that can trigger an asthma attack

Answer 3

cardioselective and nonselective beta blockers, calcium antagonists, dipyridamole, NSAIDs

Question 4

Long term control asthma medications

Answer 4

corticosteroids
LABA
leuktriene modifiers
methylxanthines
cromolyn
anti IgE

Question 5

Quick relief for asthma

Answer 5

SABA
anticholinergics
systemic corticosteroids

Question 6

This class of drug depresses the inflammatory response and edema in the respiratory tract and diminishes bronchial hyper-responsiveness

Answer 6

ICS

Question 7

This class is the most effective long term control therapy for persistent asthma and is the only therapy shown to reduce the risk of death from asthma

Answer 7

ICS

Question 8

CAUTION in growing children

Answer 8

ICS

Question 9

Local ADRs include thrush , dysphonia, reflex cough and bronchospasm

Answer 9

ICS

Question 10

Systemic effects could potentially include HPA axis suppression, impaired growth in children and dermal thinning (dose dependent)

Answer 10

ICS

Question 11

ICS messes with BMD, cataracts, and glaucoma in kids. T or F

Answer 11

FALSE! ICS at low to moderate dose is safe!

Question 12

This class is not a substitute for anti-inflam therapy and should not be used as monotherapy. Not for acute exacerbations

Answer 12

LABA

Question 13

This class causes loss of protection with methacholine, histamine, and exercise

Answer 13

LABA

Question 14

This class should not be used with CYP3A4 inhibitors- ketoconazole, ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir, telithromycin

Answer 14

LABA

Question 15

This class of drug competitively antagonizes leukotriene receptors D4 and E4 in the bronchiolar muscle, antagonizing endogenous molecules that cause bronchodilation

Answer 15

leukotriene receptor antagonists

Question 16

this class is an alternative treatment of mild persistent asthma

Answer 16

LRA

Question 17

CONTRAINDICATIONS in pregnancy, caution in elderly

Answer 17

LRA

Question 18

These two LRAs are associated with liver toxicity, contraindicated in pts with liver disease

Answer 18

Zileuton and Zafirlukast

Question 19

this class can cause GI disturbances, HA, respiratory infections

Answer 19

LRAs (zafirlukast and montelukast for resp infections)

Question 20

this LRA interacts with warfarin, increasing prothrombin time

Answer 20

zafirlukast

Question 21

this LRA doubles theophylline concentration, increases prothrombin time (warfarin), and doubles propranolol levels

Answer 21

zileuton

Question 22

this class increases cAMP levels in the bronchial smooth muscle cells inhibiting phosphodiesterase- causes smooth muscle relaxation and bronchodilation

Answer 22

Methylxanthines

Question 23

This class is indicated in refractory patients. It can be used as monotherapy or in combo with an ICS

Answer 23

methylxanthines

Question 24

Dont use this class if you are a child under 4, have cardiac disease, HTN, or hepatic impairment

Answer 24

methylxanthines

Question 25

This class has a narrow theraputic window, tons of drug-drug interactions, and safer alternatives

Answer 25

methylxanthines

Question 26

This class interacts with cimetidine, macrolides, quinolones and is a CYP1A2 and 3A4 substrate

Answer 26

methylxanthines

Question 27

this class can cause nausea, irritability, insomnia, HA, vomiting, tachyarrhythmias, ventricular arrhythmias, seizures

Answer 27

methylxanthines

Question 28

this class stabilizes mast cells preventing the release of inflammatory mediators

Answer 28

mast cell stabilizers

Question 29

indications for this class include patients less than 20 with severe allergic disease and moderate asthma OR pregnancy

Answer 29

mast cell stabilizers

Question 30

ADRs for this class include cough, transient bronchospasm, throat irritation

Answer 30

mast cell stabilizer

Question 31

this class is reserved for moderate to severe persistent asthma in patients 12 or older who are not controlled on other therapies (not first line therapy)

Answer 31

omalizumab

Question 32

this drug works bc it is a recombinant monoclonal antibody that binds IgE on mast cells and basophils, so it limits the release of mediators of allergic response

Answer 32

omalizumab

Question 33

this drug has a favorable safety profile, but a BBW for anaphylaxis

Answer 33

omalizumab

Question 34

this class decreases inflammation by suppression of migration of leukocytes and reversal of increased capillary permeability

Answer 34

systemic corticosteroids

Question 35

this class is used for control of chronic symptoms in people with severe asthma

Answer 35

systemic corticosteroids

Question 36

this class stimulates b2 adrenoceptors, leading to a rise in intracellular cAMP- subsequent smooth muscle relaxation and bronchodilation

Answer 36

SABA

Question 37

this class is indicated for relief of bronchospasm during acute exacerbations, and pretreatment for exercise induced bronchoconstriction

Answer 37

SABA

Question 38

ADRs include fine tremor, tachycardia, hypokalemia

Answer 38

SABA

Question 39

this class is indicated for relief of acute bronchospasm, can provide additive effects to B2 agonists in an acute setting

Answer 39

anticholinergics

Question 40

treatment of choice for bronchospasm due to B blockers

Answer 40

anticholinergics

Question 41

Contraindicated in glaucoma and pregnancy

Answer 41

anticholinergics

Question 42

this class is important in the treatment of severe acute asthma exacerbations

Answer 42

systemic corticosteroids

Question 43

mild intermittent asthma treatment

Answer 43

SABA

Question 44

mild persistent asthma treatment

Answer 44

low dose ICS, SABA

Question 45

moderate persistent asthma treatment

Answer 45

low dose ICS, LABA, SABA

Question 46

severe persistent asthma treatment

Answer 46

medium or high dose ICS, LABA, oral glucocorticosteroid (SABA)

Question 47

COPD pts get adequate relief from bronchodilators and anti-inflammatory agents. T or F

Answer 47

F

Question 48

primary therapy for COPD

Answer 48

oxygen

Question 49

Should I administer O2 to a pt with severe COPD who is retaining CO2

Answer 49

NOPE- depresses resp drive

Question 50

DOC in COPD patients

Answer 50

anticholinergic agents (beta 2 agonists should be combined)

Question 51

antibiotics can be used in a COPD patient when?

Answer 51

increased dyspnea, increased sputum volume, increased sputum purulence