Asthma & COPD Drugs

Question 1

Asthma, chronic obstructive pulmonary disease (COPD) Drug of choice in acute asthmatic bronchospasm what drug does this MOA?

Answer 1

Albuterol Terbutaline
Selective β2 agonist

Question 2

What is the MOA for Salmeterol, Formoterol?

Answer 2

Bronchodilation Prevention of asthma exacerbations

Question 3

What is the toxicity and overdose for Beta agonist in Asthma?COPD

Answer 3

Toxicity:Tremors
Tachycardia
Overdose: arrhythmia

Question 4

What is MOA of Ipratropium and Tioptropium, S/E,receptor?

Answer 4

Prevents bronchoconstriction
Anticholinergic adverse efffects
M3

Question 5

phosphodiesterase inhibition adenosine receptor antagonist what drug is this? S/E?

Answer 5

Theophylline
Inc CO
Inc PVR
Arrhythmias

Question 6

This drug works on the PDE4 receptor? MOA

Answer 6

Roflumilast
Reduce inflammation

Question 7

MOA of corticosteroids? name four of the corticosteroids inhaled?

Answer 7

Alters gene expression inhibit Nf-KB
Reduces mediators of inflammation
Prophylaxis of exacerbations
Beclomethasone
Budesonide
Triamcinolone
Flunisolide
Mometasone
Fluticasone

Question 8

What are systemic corticosteroids MOA? Drug Name?

Answer 8

Alters gene expression Reduces mediators of inflammation powerful prophylaxis of exacerbations
Prednisone
Methylprednisolone
Hydrocortisone

Question 9

Name the drug that blocks Leukotrienes d4 receptors? Use for ASA induced asthma and use as a prophylaxis of asthma especially in children

Answer 9

Montelukast
Zafirlukas

Question 10

What is the MOA, receptor, use, s/e of Zileuton?

Answer 10

Inhibits lipoxygenas e ⇨ reduces leukotriene synthesis
Slightly more effective than montelukast
Prophylaxis of asthma, especially in children Aspirin- induced asthma
Needs liver function test monitoring

Question 11

Name the Mast cell stabilizers/? MOA

Answer 11

Nedocromil
Cromolyn
Inhibits mast cell degranulation

Question 12

Omalizumab MOA, s/e, use,

Answer 12

Anti monoclonal antibody IgE

Reduces frequency of
asthma exacerbations
Moderate to severe asthma inadequately controlled by other agents
Parenteral duration 2–4 weeks Toxicity:
Injection site reactions Anaphylaxis

Question 13

1. A 10-year-old boy is brought into Emergency Department by his parents for constantly coughing and having trouble breathing for the past 3 days. The boy recently recovered from an upper respiratory infection and has had multiple bouts of bronchitis in the past year. His physical exam reveals moderate to severe respiratory distress with bilateral expiratory wheezing. His respiratory rate is 32/min, BP=120/83 mm Hg, heart rate = 135/min, temperature 37.8 C. HIs pO2 is 93%. What drug should be given to the boy to rapidly relieve his symptoms?
   A. Aminophylline orally
   B. Cromolyn sodium
   C. Ipratropium by nebulizer
   D. Levalbuterol by nebulizer
   E. Salmeterol by MDI

Answer 13

D. Levalbuterol by nebulizer

Question 14

2. The boy’s clinical status does not improve despite aggressive conventional therapy with a short acting beta-2 agonist and systemic corticosteroids. He is admitted to the hospital, and placed in the intensive care unit. It is decided to try a trial dose of theophylline, which has a narrow therapeutic window of 10-20 ug/ml. What toxic effects should you be looking for if this boy’s theophylline levels rises too high?
   A. hyperkalemia
   B. bradycardia
   C. sedation
   D. seizures & arrhythmias

Answer 14

D. seizures & arrhythmias

Question 15

3. His condition improves after several days of treatment, and he is eventually discharged. His asthma severity is classified as moderate & persistent. What daily long-term therapy should be prescribed?
   A. albuterol
   B. budesonide (inhaled) C. montelukast
   D. salmeterol
   E. theophylline

Answer 15

B. budesonide (inhaled)

Question 16

4.A 19-year-old boy presents to the emergency department with shortness of breath. He was playing outside earlier in the day, but when he came back inside, his mother noticed that he had difficulty breathing. He also said that his chest felt “tight.” He has not had a fever or rash. He has a history of type 1 diabetes and asthma for which he takes insulin and albuterol as needed. He has needed his rescue inhaler multiple times over the past 2 weeks. The patient’s temperature is 98.6°F (37.0°C), blood pressure is 110/70 mmHg, pulse is 90/min, and respirations are 24/min. Diffuse wheezing is auscultated in all lung fields. He is treated appropriately for his condition, including an oral and inhaled medication. Which of the following is the mechanism of action of the oral medication?
A. Agonism of beta-2 adrenergic receptors
B. Antagonism of muscarinic acetylcholine receptors
C. Inhibition of calcium influx into smooth muscle cells
D. Inhibitionofcyclooxygenaseactivity
E. Inhibition of nuclear factor kappa B activity

Answer 16

E. Inhibition of nuclear factor kappa B activity

Question 17

5.A 27-year-old veterinarian has been struggling with periodic allergies caused by exposure to cat dander, that has recently been getting worse. The drug regimen that she has been taking for several years (daily fluticasone and salmeterol or Advair ®, with albuterol as needed) is no longer sufficient to control her almost daily asthma attacks. A skin test is positive for cat dander, and her IgE levels are elevated. Considering her occupation, what additional form of prophylactic treatment would be the best choice to add to her therapy, and would require treatment only once or twice a month?
A. Beclomethasone B. Formoterol
C. Montelukast
D. Omalizumab
E. Salmeterol

Answer 17

D. Omalizumab

Question 18

6.Your asthma patient requires a “step up” in their daily control medication. When discussing therapeutic options, your patient mentions hearing about an asthma drug having a “Black Box” warning related to causing potentially life-threatening anaphylactic reactions. Which drug is this?
A. Formoterol
B. Omalizumab
C. Salmeterol
D. Zafirlukast
E. Zileuton

Answer 18

B. Omalizumab

Question 19

7.Your asthma patient requires the addition of a daily control medication after beginning to need the use of an albuterol rescue inhaler over 4 times a week for the past 3 weeks. You discuss the various therapeutic options for asthma control medications and rank their advantages and disadvantages. Which of the options listed below would have the greatest potential for producing the most significant systemic side effects?
A. Albuterol MDI
B. Levalbuterol MDI C. Montelukast oral D. Prednisone, oral E. Zileuton, oral

Answer 19

D. Prednisone, oral

Question 20

8. A 27-year-old woman with a history of persistent asthma presents to the Emergency Department with complaints of agitation, muscle tremors and a “racing heart”. During her history, she mentions having recently increased the number of asthma medications being taken, as well as the frequency of use of her rescue inhaler. Which of the following is most likely responsible for her current symptoms?
   A. Albuterol
   B. Beclomethasone C. Ipratropium
   D. Montelukast
   E. Omalizumab

Answer 20

A. Albuterol

Question 21

9. A patient on an asthma medication arrives in your Emergency Department with a severe asthmatic attack . His lips have a blue color, and pulse oximetry indicates a pO2 level of 80%. Which treatment should you apply FIRST?
   A. Albuterol nebulizer
   B. Epinephrine. s.c.
   C. Levoalbuterol nebulizer D. Oxygen face mask
   E. Pirbuterol nebulizer

Answer 21

D. Oxygen face mask