Exam 1 - Asthma (chronic)

Question 1

What is the MOA for short-acting beta-2 agonists (SABAs)?

Answer 1

stimulate beta-2 receptors in lungs causing bronchial smooth muscle relaxation

Question 2

What are AEs of SABAs? (6)

Answer 2

tremor, lightheadedness, cough, tachycardia, hypokalemia, hyperglycemia

Question 3

What are the SABAs? (2)

Answer 3

albuterol and levalbuterol

Question 4

What are the inhaled corticosteroids (ICSs)?

Answer 4

budesonide, ciclesonide, fluticasone, beclomethasone, mometasone

Question 5

With what things do ICSs aid? (5)

Answer 5

reduce chronic airway inflammation, reduce risk of exacerbations, improve lung function, reduce symptoms, and improve QoL

Question 6

What are AEs of ICSs? (4)

Answer 6

growth concerns, hyperglycemia, increased risk of fractures, oral candidiasis (thrush)

Question 7

Which dosage form should be shaken? Which should not?

Answer 7

metered-dose inhaler (MDI); dry powder inhaler (DPI)

Question 8

When should DPIs be avoided?

Answer 8

milk protein allergies

Question 9

What is important regarding ciclesonide (Alvesco)?

Answer 9

not recommended in children <12

Question 10

What is important regarding fluticasone (Flovent, Arnuity, ArmonAir)?

Answer 10

higher risk of sore throat/hoarseness

Question 11

What is important regarding beclomethasone (Qvar RediHaler)?

Answer 11

not recommended in children <5

Question 12

What is important regarding mometasone (Asmanex)? (2)

Answer 12

not recommended in children <4, administer in evening

Question 13

What is important regarding budesonide (Pulmicort)?

Answer 13

not recommended in children <6

Question 14

What are the long-acting beta agonists (LABAs)? (3)

Answer 14

salmeterol, formoterol, vilanterol

Question 15

What is a boxed warning for LABAs?

Answer 15

increased risk of asthma-related death when treated with LABA alone

Question 16

What is important regarding fluticasone propionate/salmeterol (Advair/Wixela)?

Answer 16

not recommended in children <4

Question 17

What is important regarding fluticasone propionate/salmeterol (AirDuo Respiclick)?

Answer 17

not recommended in children <12

Question 18

What is the long-acting muscarinic antagonist (LAMA)?

Answer 18

tiotropium

Question 19

What is the MOA for methylxanthines?

Answer 19

block phosphodiesterase and increase cAMP levels

Question 20

What are AEs of theophylline? (5)

Answer 20

tremor, diarrhea, HA, tachycardia, CYP3A4 substrate

Question 21

What are the biologic therapies for asthma? (6)

Answer 21

omalizumab (Xolair), mepolizumab (Nucala), reslizumab (Cinqair), benralizumab (Fasenra), dupilumab (Dupixent), tezepelumab (Tezpire)

Question 22

What are environmental risk factors for asthma? (7)

Answer 22

SE status, secondhand exposure, allergen exposure, urbanization, RSV infection, family size, decreased exposure to common infectious agents during childhood

Question 23

What are symptoms of asthma?

Answer 23

dyspnea, chest tightness, coughing, wheezing/whistling, in association with exercise/laugh/cold air

Question 24

What are signs of asthma?

Answer 24

expiratory wheezing on auscultation, dry/hacking cough, atopy, reduced O2 saturation

Question 25

What is a normal airflow for adults?

Answer 25

> 0.75 - 0.8

Question 26

What steps do mild, moderate, and severe asthma correlate to?

Answer 26

mild = steps 1 or 2, moderate = steps 3 or 4, severe = step 5

Question 27

What comorbidities are risk factors for asthma exacerbations? (7)

Answer 27

obesity, chronic rhinosinusitis, GERD, confirmed food allergy, anxiety, depression, pregnancy

Question 28

What are risk factors for developing fixed-airflow limitation? (6)

Answer 28

preterm/low birth weight, lakc of ICS treatment, exposure to tobacco or other smokes, low FEV1, chronic mucus hypersecretion, sputum or blood eosinophilia