Asthma/COPD Deck 2

Question 1

Cromolyn Class

Answer 1

mast cell stabalizer

Question 2

Cromolyn is for

Answer 2

prevention, inhaled, prevention. Not quickl relief!!

Question 3

Cromolyn MOA

Answer 3

Stabilizes cytoplasmic membrane of mast
cells, thereby preventing release of histamine and
other mediators; in addition, inhibits eosinophils,
macrophages, and other inflammatory cells

Question 4

Cromolyn uses and route

Answer 4

Route: nebulizer
• Uses: chronic asthma, exercise-induced
bronchospasm (EIB)

Question 5

Cromolyn AE

Answer 5

cough or bronchospasm.

Question 6

Omalizumab [Xolair] MOA

Answer 6

– Antagonism of immunoglobulin E (IgE)

Question 7

Omalizumab [Xolair] USE

Answer 7

– Patients age 12 years or older with moderate to
severe asthma that (1) is allergy related and (2)
cannot be controlled with an inhaled glucocorticoid

Question 8

Omalizumab [Xolair] ADR

Answer 8

injection-site reactions, viral infection, URI,

sinusitis, HA, pharyngitis, CV events, malignancy

Question 9

Omalizumab [Xolair] Black Box

Answer 9

• life-threatening anaphylaxis
  (most likely with first dose, period of observation in
  office).

Question 10

Omalizumab [Xolair] is used in a

Answer 10

allergists office

Question 11

Bronchodilators use

Answer 11

Symptomatic relief, do not alter underlying
disease process (inflammation)

Question 12

Beta 2 agonist MOA

Answer 12

• Through activation of beta2 receptors in the smooth
muscle of the lung, these drugs promote
bronchodilation, relieving bronchospasm

• Beta2 agonists have a limited role in suppressing
histamine release in the lung and increasing ciliary
motility

Question 13

SABA take

Answer 13

PRN

Question 14

Exercize endused take SABA

Answer 14

before exercise

Question 15

SABA ADR

Answer 15

– tachycardia, angina, tremor

Question 16

Inhaled long-acting beta2-agonists (LABA) when are they given

Answer 16

Long-term control in patients who experience frequent attacks

Question 17

LABA dosing is

Answer 17

is on a fixed schedule, not PRN

Question 18

LABA effective in treating

Answer 18

COPD

Question 19

LABA when used to treat asthma must always be combined with

Answer 19

glucocorticoid

Question 20

Use of what alone in asthma is contraindicated

Answer 20

LABA

Question 21

LABA ADR

Answer 21

tachycardia, agina, tremor

Question 22

LABA black box warning

Answer 22

risk for asthma-related deaths.

– Salmeterol [Serevent Diskus], formoterol [Foradil Aerolizer], and arformoterol [Brovana)

Question 23

Vilanterol – available in

Answer 23

combination – flucticasone/vilanterol

[Breo Ellipta] and umeclidinium/vilanterol [Anoro Ellipta]

Question 24

Rule of Two (5 items) Should know this for the exam

Answer 24

• No symptoms more than twice per
week.
• Should not use a short-acting beta agonist no more than twice per week.
• No interference with normal activity.
• No more than one to two flare-up in the
past year.
• Peak flow levels should be higher than

80% of the predicted or personal bests.

Question 25

Theophylline produces

Answer 25

brochodialtion by relaxing smooth muscle from the bronki

Question 26

Theophylline has a

Answer 26

narrow therapeutic indix

Question 27

Theophylline plasma levels should be between

Answer 27

10 to 20 mcg

Question 28

Theophylline Toxcicity is related to

Answer 28

levels

Question 29

Theophylline the drug is usually

Answer 29

administered by mouth, but may be given IV

Question 30

Theophylline is uesed for

Answer 30

maintenic therapy of chronic stable asthma

Question 31

Theophylline plasma levels below 20 mcg

Answer 31

adverse effects uncommon

Question 32

Theophylline plasma 20 to 25 mcg

Answer 32

n/v diarrhea, insomnia, restless ness

Question 33

Theophylline plasma above 30 mcg

Answer 33

severe dysrhymias and convulions

death may occr from cardio respiroarty collapse

Question 34

Theophylline no (methylxanthines) no longer recommended for

Answer 34

COPD

Question 35

Theophylline toxicity treatment

Answer 35

– Stop theophylline
– Activated charcoal together with a cathartic
– Dysrhythmias respond to lidocaine
– Intravenous diazepam may help control seizures

Question 36

Theophylline interactions

Answer 36

– Caffeine
– Tobacco and marijuana
– Cimetidine
– Fluoroquinolone antibiotics

Question 37

Anti-Cholinergics improve lung functions

Answer 37

by blocking muscarinic receptors in the bronchi

Question 38

Anti-Cholinergics approved fro only

Answer 38

COPD. Off label for asthma

Question 39

Ipratropium and tiotropium have a

Answer 39

longer duration of action

Question 40

Ipratropium action and use

Answer 40

– Administered by inhalation to relieve bronchospasm
– Therapeutic effects begin within 30 seconds, reach 50% of
maximum in 3 minutes, and persist about 6 hours

Question 41

Ipratropium ADR

Answer 41

– Dry mouth and irritation of the pharynx
– Glaucoma
– Cardiovascular events