Asthma Flashcards
Which of the following medications can increase theophylline levels and possibly result in theophylline toxicity? (Select ALL that apply.)
Answer
A Ciprofloxacin B Bupropion C Zafirlukast D Ranitidine E Clarithromycin
Cipro, zafirlukast, clarithromycin
A patient with severe, persistent asthma has been using prednisone 20 mg daily for at least three years. Which side effects are likely to be due to long-term prednisone use? (Select ALL that apply.)
Answer
A Reduced bone density and osteoporosis B Elevated blood glucose and diabetes C Poor wound healing D Alopecia E Hearing loss
A Reduced bone density and osteoporosis B Elevated blood glucose and diabetes C Poor wound healing
SF is an 18 month old boy who has been prescribed montelukast granules. Counsel the parents on how to administer the granules to their son:
Answer
A
Mix with 4 oz of applesauce and administer within 24 hours.
B
The granule packet can be opened up to 8 hours prior to use.
C
Mix with one tablespoon of warm water.
D
Mix with a spoonful of cool, mashed carrots and administer within minutes.
E
Mix with a tablespoon of breast milk or formula; the mixture can be stored up to 2 hours.
D
Mix with a spoonful of cool, mashed carrots and administer within minutes.
Instruct parents using the granules not to open the granule packet until they are ready to use it since granules mixed with foods or liquids cannot be stored. The granules can be mixed with 1 teaspoonful (5 mL) of baby formula or breast milk, or a spoonful of applesauce, mashed carrots, rice, or ice cream. Whatever the medicine is mixed with must be cold or at room temperature. Instruct the parents not to mix the granules with extra amounts of milk or food; they need to make sure the entire dose has been consumed. Administer the mixutre immediately (within 15 minutes).
RL is a pharmacist in a busy store. CK is a mother who came in with her eight year old daughter. The child had a new prescription for an albuterol inhaler. RL quickly instructed the mother how to use the MDI. When she got home, CK had no idea how to instruct her daughter properly. The child, like many patients, had poor technique and did not obtain proper relief from the medication. What is the most important thing that RL should have done to ensure that the parent and child understood how to use the inhaler?
Answer
A
Have the mother repeat back the instructions to him in a slow and deliberate manner.
B
The pharmacist should have repeated the instructions twice and asked the mother if she understood everything that was explained.
C
The pharmacist should have given the mother written instructions.
D
The pharmacist should have demonstrated how to use the inhaler and then watched the patient demonstrate proper technique.
E
The pharmacist should have had the technician, who may have had more time, demonstrate proper technique to the mother.
D
The pharmacist should have demonstrated how to use the inhaler and then watched the patient demonstrate proper technique.
JW is well-controlled on his asthma medications which include Flovent HFA 220 mcg BID, Serevent Diskus 1 inhalations BID, and Proventil HFA PRN symptoms. He is picking up his refills and asks if anything can help with his sore throat. When inspected, the pharmacist recognizes the throat is sore due to thrush. What are some counseling points the pharmacist can provide that will help reduce JW’s risk of thrush in the future? (Select ALL that apply.)
Answer
A
Mr. Wallach should drink 8 oz of water after taking his medications.
B
Mr. Wallach should gargle with warm warm and spit out the rinse after using his medications.
C
Mr. Wallach should purchase a spacer device and use with his Serevent Diskus.
D
Mr. Wallach should purchase a spacer device and use with his Flovent HFA.
E
Mr. Wallach should not kiss others as this infection is contagious.
B
Mr. Wallach should gargle with warm warm and spit out the rinse after using his medications.
D
Mr. Wallach should purchase a spacer device and use with his Flovent HFA.
HL has had asthma for a number of years and has been in denial about her disease. At the age of 22 years, she wants to better manage her condition. Her doctor tells her that she is a Step 4 asthmatic and explains to her how to use a peak flow meter. HL’s personal best is 300 mL. Now she is in the pharmacy and she has selected a peak flow meter to purchase but admits to forgetting the steps for using it. Which of the following statements are correct in counseling HL on the appropriate use of a peak flow meter? (Select ALL that apply.)
Answer
A
Use the peak flow meter in the morning, before she takes her medications.
B
Record the highest number of each day in a log book.
C
It is best to perform the assessment in a supine position with legs not elevated higher than the lungs.
D
Coughing during the assessment invalidates the reading.
E
If the value recorded is < 150 mL, she should go to the hospital immediately, regardless of symptoms.
A
Use the peak flow meter in the morning, before she takes her medications.
B
Record the highest number of each day in a log book.
D
Coughing during the assessment invalidates the reading.
E
If the value recorded is < 150 mL, she should go to the hospital immediately, regardless of symptoms.
A 70 year old patient has been prescribed Xopenex. Choose the correct statement concerning Xopenex:
Answer
A
Xopenex causes more tachycardia than albuterol.
B
Xopenex causes fewer headaches than albuterol.
C
Xopenex is available as a SC injection given weekly.
D
Xopenex is the R-isomer of albuterol.
E
Xopenex is the L-isomer of albuterol.
Xopenex is the R-isomer of the beta-2 adrenergic agonist albuterol. Like albuterol, it is available in a metered-dose inhaler (Xopenex HFA) and for use in a nebulizer. The frequency of systemic effects (tachycardia, headache, nervousness) is reported to be similar to albuterol.`
Which of the following medications can decrease theophylline levels? (Select ALL that apply.)
Answer
A Allopurinol B Citalopram C Carbamazepine D Primidone E Quinidine
C
Carbamazepine
D
Primidone
A 55 year-old male patient has continuous asthma symptoms, even with high dose inhaled corticosteroid therapy. He also has NYHA Class III heart failure. The physician will initiate theophylline. Choose the correct statement:
Answer
A
The patient will require a higher dose of theophylline due to his heart failure.
B
The patient will have to limit the amount of protein in his diet to < 5% of total calories.
C
The therapeutic range of theophylline is 2-10 mcg/mL.
D
Signs of theophylline toxicity include liver failure.
E
Theophylline should be dosed on the patient’s ideal body weight.
E
Theophylline should be dosed on the patient’s ideal body weight.
Most metered-dose inhalers need to be shaken well immediately before use. Which metered-dose inhaler does not have to be shaken before use?
Answer
A QVAR B Symbicort C Pulmicort Flexhaler D Flovent HFA E Asmanex HFA
A
QVAR
(And Alvesco)
