Pharmacology - Pharmacology of the airways Flashcards

1
Q

stimulation of parasympathetic nerves by choline leads to what action in the airways?

a. bronchoconstriction, mucus secretion, and bronchial vasodilation
b. bronchodilation, mucus secretion and bronchial vasoconstriction
c. broncho constriction, mucus secretion and bronchial vasoconstriction

A

a. bronchoconstriction, mucus secretion, and bronchial vasodilation

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2
Q

what i the effect of circulating adrenaline on the airways?

a. bronchodilation
b. bronchoconstriction

A

a.bronchodilation

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3
Q

which nerves have the most significant role in control of smooth muscle tone in the airways?

a. parasympathetic
b. sympathetic

A

a.parasympathetic

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4
Q

what is the effect of stimulation of the NANC inhibitory nerves in the pulmonary circulation and airways?

a. bronchoconstriction and bronchial vasodilation
b. bronchodilation and bronchial vasoconstriction
c. bronchoconstriction and bronchial vasoconstriction

A

a. bronchoconstriction and bronchial vasodilation

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5
Q

what does release of NO by NANC nerves stimulate inside the cell?

a. acetyl kinase
b. guanylate cyclase
c. M1 receptors
d. protein kinase

A

b.guanylate cyclase

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6
Q

what receptors does Ach bind to in the airway smooth muscle?

a. M1 and M3
b. B1
c. Mu
d. a1
e. M1 and A1

A

a.M1 and M3

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7
Q

what condition is characterised by airway inflammation and an episodic reversible bronchospasm?

a. pulmonary fibrosis
b. pneuonia
c. asthma
d. emphysema

A

c.asthma

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8
Q

along with enzymes what else produces inflammation that leads to bronchial hypersensitivity?

a. prostaglandins
b. hormones
c. environmental stimuli
d. cytokines

A

d.cytokines

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9
Q

what happens to mucous glands in asthma?

a. hyposecretion
b. destruction of glands
c. hypersecretion

A

c.hypersecretion

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10
Q

what happens to the epithelium of the airway in asthma?

a. increased thickness
b. shedding
c. destruction of cells

A

b. shedding

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11
Q

what white blood cell will have an increased count in a patient with asthma?

a. macrophage
b. monocyte
c. basophils
d. eosinophils

A

d.eosinophils

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12
Q

what happens to blood vessels in asthma?

a. dilation
b. constriction
c. leaking

A

c.leaking

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13
Q

reducing exposure to an asthma causing antigen is known as?

a. stimulus reduction
b. avoidance
c. aversion

A

b.avoidance

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14
Q

which of these leads to bronchial hypereactivity in asthma?

a. late response - inflammation
b. early response - bronchoconstriction

A

a.late response - inflammation

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15
Q

which of these leads to acute symptoms in asthma?

a. late response - inflammation
b. early response - bronchoconstriction

A

b.early response - bronchoconstriction

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16
Q

Level of which antibody is increased in asthma?

a. IgM
b. IgA
c. IgE

A

c.IgE

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17
Q

IgE and antigens from dust/pollen act on which type of white blood cell?

a. macrophage
b. monocyte
c. basophils
d. eosinophils
e. mast cells

A

e.mast cells

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18
Q

epithelial shedding exposes which part of the cell?

a. blood vessels
c. mucous gland
d. nerves

A

d.nerves

sensitive to antigens

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19
Q

which of these b2 adrenoceptor agonists is short acting ?

a. salbutumol
b. salmeterol
c. formoterol
d. indacaterol

A

a.salbutumol

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20
Q

-terol

A

long acting B2 adrenoceptor agonist

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21
Q

what type of drug is ipratropium bromide?

a. long acting b2 agonist
b. short acting b2 agonist
c. anticholinergic

A

c.anticholinergic

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22
Q

which group of drugs is used for prophylaxis of inflammation and to resolve inflammation?

a. salbutamol , salmeterol,formoterol
b. ipratropium bromide,salmeterol,indaceterol
c. beclomethasone,fluticasone,budesonide

A

c. beclomethasone,fluticasone,budesonide

inhaled corticosteroids

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23
Q

which of these drug groups is used for symptomatic relief in asthma?

a. inhaled corticosteroids
b. b2 adrenoceptor antagonists
c. NSAIDS

A

b.b2 adrenoceptor antagonists

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24
Q

what type of receptor does a b2 adrenoceptor agonist work on in airway smooth muscle?

a. ligand gated ion channel
b. g protein coupled receptor
c. kinase linked receptor
d. nuclear receptor

A

b.g protein coupled receptor

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25
Q

b2 adrenoceptor agonists binding activates what enzyme to convert ATP to increased cAMP?

a. guanyl cyclase
b. phosphodiesterase
c. protien kinase A
d. adenylyl cyclase
e. myosin light chain kinase

A

d.adenylyl cyclase

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26
Q

b2 adrenoceptor agonists binding activates adenyl cyclase to convert ATP to increased cAMP what enzyme does this actiavte to produce 5AMP?

a. guanyl cyclase
b. phosphodiesterase
c. protien kinase A
d. adenylyl cyclase
e. myosin light chain kinase

A

b.phosphodiesterase

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27
Q

b2 adrenoceptor agonists binding activates adenyl cyclase to convert ATP to increased cAMP what enzyme does this activate to phosphorylate myosin light chain kinase and ca dependent K+ channels?

a. guanyl cyclase
b. phosphodiesterase
c. protien kinase A
d. adenylyl cyclase
e. myosin light chain kinase

A

c.protien kinase A

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28
Q

what effect does phosphorylation of myosin light chain kinase have on airway smooth muscle?

a. bronchodilation
b. bronchoconstriction

A

a.bronchodilation

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29
Q

how long do SABAa work for?

a. 12 hrs
b. 3 hrs

A

b.3 hrs

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30
Q

true or false salbutumol is selective to b2 adrenoceptors?

a. true
b. false

A

a.true

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31
Q

which of these causes bronchodilation?

a. smooth muscle relaxation
b. smooth muscle constriction

A

a.smooth muscle relaxation

32
Q

which of these is used as prophylaxis for asthma?

a. SABA
b. LABA

A

b.LABA

33
Q

which method of administration reduces systemic effects?

a. IV
b. oral
c. inhaled
d. IM

A

c.inhaled

34
Q

what is the main adverse effect of b2 adrenoceptor antagonists?

a. tremor
b. tachycardia/palpitations
c. arrhythmias
d. hypokalaemia

A

a.tremor

35
Q

which of these adverse effect of b2 adrenoceptor antagonists is dose dependent?

a. tremor
b. tachycardia/palpitations
c. arrhythmias
d. hypokalaemia

A

b.tachycardia/palpitations

36
Q

which of these is a short acting muscarinic antagonist?

a. salmeterol
b. tiotopium
c. umclidinium
d. ipratropium

A

d.ipratropium

37
Q

-ium

A

muscarinic antagonists

38
Q

what is the correct set of effects for muscarinic antagonists

a. bronchoconstriction, mucus secretion
b. antagonise bronchospasm and decrease mucus secretion

A

b.antagonise bronchospasm and decrease mucus secretion

39
Q

which type of asthma drug is better for irritant induced asthma and copd with episodes of bronchospasm than all asthma patients

a. lama
b. saba
c. muscarinic antagonists
d. b2 adrenoceptor agonists

A

c.muscarinic antagonists

40
Q

how long do muscarinic antagonists give bronchodilation for

a. 3hrs
b. 30 mins to 5 hrs
c. 12 hrs

A

b.30 mins to 5 hrs

41
Q

what is the main side effect of muscaranic antagonists?

a. tremor
b. tachycardia/palpitations
c. arrhythmias
d. hypokalaemia
e. dry mouth

A

e.dry mouth

42
Q

what is the effect of a1 adrenoceptor agonists?

a. vasodilation
b. vasoconstriction

A

b.vasoconstriction

43
Q

what is the effect of a1 adrenoceptor antagonists?

a. vasodilation
b. vasoconstriction

A

a.vasodilation

44
Q

-osin

A

selctive alpha 1 antagonists

45
Q

what type of receptors is found in the non vascular smooth muscle in the neck of the bladder and the prostate?

a. a1 adrenoceptors
b. b2 adrenoceptors
c. a1a adrenoceptors
d. m3 muscarinic cholinoceptors

A

c.a1a adrenoceptors

46
Q

what are agonists of a1a adrenoceptors?

a. vasoconstrictors
b. vasodilators
c. muscle concstrictors
d. muscle relaxants

A

c.muscle concstrictors

47
Q

what are antagonists of a1a adrenoceptors?

a. vasoconstrictors
b. vasodilators
c. muscle concstrictors
d. muscle relaxants

A

d.muscle relaxants

48
Q

what is the effect of antagonising M3 muscarinic receptors in airway smooth muscle ?

a. vasoconstrictors
b. vasodilators
c. bronchoconstrictors
d. bronchodilators

A

a. vasoconstrictors
b. vasodilators
c. muscle concstrictors
d. muscle relaxants

49
Q

what is the effect of agonising M3 muscarinic receptors in airway smooth muscle ?

a. vasoconstrictors
b. vasodilators
c. bronchoconstrictors
d. bronchodilators

A

c.bronchoconstrictors

50
Q

what do xanthines inhibit?

a. b2 adrenoceptors
b. m3 muscarinic receptors
c. phosphodiesterase and cAMP
d. adenyl cyclase

A

c.phosphodiesterase and cAMP

51
Q

what receptors are blocked by xanthines?

a. b2 adrenoceptors
b. m3 muscarinic receptors
c. phosphodiesterase and cAMP
d. adenyl cyclase
e. adenosine

A

e.adenosine

52
Q

how are xanthines taken

a. IV
b. IM
c. inhaled
d. oral

A

d.oral

53
Q

nausea,arrhythmias and convulsions are side effects of which asthma drug group?

a. b2 agonists
b. m3 antagonists
c. xanthines

A

c.xanthines

54
Q

what drug group is used in difficult to control asthma?

a. b2 agonists
b. m3 antagonists
c. xanthines

A

c.xanthines (theophyllines)

55
Q

the therapeutic window for xanthines is..

a. wide
b. narrow

A

b.narrow

between MEC and MTC

56
Q

which of these groups increase serum theophylline levels?

a. OCP, erythromycin, CCb, cimetidine
b. phenytoin, carbamazepine, rifampicin

A

a.OCP, erythromycin, CCb, cimetidine

57
Q

which asthma drugs are metabolised by p450 liver enzymes?

a. b2 agonists
b. m3 antagonists
c. xanthines

A

c.xanthines

58
Q

which of these groups decrease serum theophylline levels?

a. OCP, erythromycin, CCb, cimetidine
b. phenytoin, carbamazepine, rifampicin

A

b.phenytoin, carbamazepine, rifampicin

liver enzyme inducers

59
Q

what do inhaled corticosteroids inhibit?

a. b2 adrenoceptors
b. m3 muscarinic receptors
c. phosphodiesterase and cAMP
d. adenyl cyclase
e. phospholipase A2 and COX -2

A

e. phospholipase A2 and COX -2

60
Q

which of these drugs increase B2 responsiveness (bronchodilation)

a. b2 agonists
b. m3 antagonists
c. xanthines
d. inhaled corticosteroids

A

d.inhaled corticosteroids

61
Q

what are inhaled corticosteroids used for?

a. prophylaxis
b. acute symptom relief
c. long term symptom relief

A

a.prophylaxis

62
Q

oropharangeal candiasis and limited growth in children is associated with which asthma drug?

a. b2 agonists
b. m3 antagonists
c. xanthines
d. inhaled corticosteroids

A

d.inhaled corticosteroids

63
Q

which drugs are used for excercise and aspirin induced asthma?

a. b2 agonists
b. m3 antagonists
c. xanthines
d. inhaled corticosteroids
e. leukotriene receptor antagonists

A

e.leukotriene receptor antagonists

64
Q

-lukast

A

leukotriene receptor antagonists

65
Q

abdominal pain, headache and churg-strauss syndrome are associated with which asthma drug?

a. b2 agonists
b. m3 antagonists
c. xanthines
d. inhaled corticosteroids
e. leukotriene receptor antagonists

A

e.leukotriene receptor antagonists

66
Q

which asthma drug requires use of a spacing device/mouth rinse?

a. b2 agonists
b. m3 antagonists
c. xanthines
d. inhaled corticosteroids
e. leukotriene receptor antagonists

A

d.inhaled corticosteroids

67
Q

WHAT IS MEASURED IN ADULTS WITH ASTHMA to inform PAAP along with symptoms?

a. PEFR
b. vital capacity
c. residual capacity
e. resp rate

A

a.PEFR

68
Q

PAAP

A

personalised asthma action plan

for all patients

69
Q

what is the first lifestyle change for asthma

a. smoking cessation
b. nutrition
c. excercise

A

a.smoking cessation

70
Q

what values inform asthma control?

a. PEF and FVC
b. PEF and FEV1
c. FEV1 and FVC

A

b.PEF and FEV1

> 80% predicted

71
Q

SABA/LABA/SAMA/LAMA are..

a. preventers
b. relievers

A

b.relievers

72
Q

what should be prescribed to all with symptomatic asthma , to be used as reliever therapy when required?

a,SABA

b. LABA
c. SAMA
d. LAMA

A

a,SABA

73
Q

what should be prescribed to all with symptomatic asthma , to be used as prophylaxis (dose dependent on severity) ?

a,SABA

b. LABA
c. SAMA
d. LAMA
e. ICS

A

e.ICS

74
Q

what should be done if asthma is not adequately controlled with a low dose ICS?

a. add on therapy LTRA
b. dose increase

A

a.add on therapy LTRA

and review in 4-8 weeks

75
Q

if asthma is uncontrolled on a low dose ICS and LTRA what should be given next

a,SABA

b. LABA
c. SAMA
d. LAMA

A

b.LABA

76
Q

if asthma is uncontrolled on low dose ICS + LABA + LTRA ?

a. MART - maintainence and reliever therapy single inhaler ICS + fast acting LABA
b. increase ICS dose and add muscarinic antagonist/ xanthine

A

a.MART - maintainence and reliever therapy single inhaler ICS + fast acting LABA

77
Q
if asthma is uncontrolled on MART?
a,SABA
b.LABA
c.SAMA
d.LAMA
e.increase ICS dose and add muscarinic antagonist/ xanthine
A

e.increase ICS dose and add muscarinic antagonist/ xanthine