Pulmonology

Question 1

Nasal decongestant

Answer 1

Alpha1 agonist = vasoconstriction
✔️ Phenylephrine
✔️ Oxymetazoline

Question 2

WOF: nasal decongestant

Answer 2

Rhinitis medica mendosa - Rebound congestion
⬆️ BP

Question 3

Use of intranasal steroids

Answer 3

If severe (Acute rhinits/common cold)
vs. inflammation

Question 4

WOF: Intranasal steroids

Answer 4

Drying of the nasal mucosa

Question 5

Drug that facilitate nasal drainage

Answer 5

Sodium chloride solution (Salinase)

Question 6

Drugs used for acute rhinitis/common cold

Answer 6

✔️ Nasal decongestant
✔️ Intranasal steroids
✔️ Sodium chloride solution (Salinase)
✔️ Hydration - oral fluid intake

Question 7

IgE mediated

Answer 7

Allergic rhinitis
(+) trigger (allergen)

Question 8

WTD during allergic rhinitis

Answer 8

1. Avoid allergen
2. H1 receptor antagonist
3. Intranasal steroids - Fluticasone
4. Alpha1 agonist - decongestant
5. Anticholinergic - ⬇️⬇️ secretion - Ipratropium

Question 9

Acute cough

Answer 9

• infection
• occupational
• chemical

Question 10

Chronic cough

Answer 10

• # 1 drug in the world - ACEis
• 🇵🇭 TB
• Malignancy

Question 11

Mucoregulators

Answer 11

✔️ Ambroxol = mucokinetic - normalize viscosity
✔️ Bromhexine
✔️ Carbocistein (Sulmox)
✔️ Macrolide
eg. Azithromyin = Anti-inflammatory for COPD patients

Question 12

Mucolytic

Answer 12

MOA: break disulfide bonds
⬇️⬇️ viscocity of mucus
Antioxidant
e.g. N-acetylcysteine (Fluimucil)
Erdosteine

Question 13

Expectorant

Answer 13

Expel mucus
✔️hypertonic saline = ⬆️cilliary motility ⬇️mucus viscosity
✔️Iodine
e.g. Domiodol
WOF: toxic
✔️Guaifenesin (Robitussin)
MOA: irritate the vagus nerve = cough
Use: chronic bronchitis

Question 14

Hemoptysis

Answer 14

blood in sputum

Question 15

Codeine is metabolized into morphine using what enyme?

Answer 15

CYP2D6

Question 16

Derivative of Levorphanol

Answer 16

Dexthrometorphan

Question 17

Drug that has the addition of Dexthrometorphan in Robitussin DM

Answer 17

Guaifenesin

Question 18

Dexthrometorphan is avoided in children due to what?

Answer 18

(+) seizures
(+) hallucination

Question 19

Peripherally acting antitussive drug

Answer 19

Levodropizine (Levoprost)

Question 20

mixed acting antitussive drug

Answer 20

Butamirate

Question 21

Glycerol derivative of Butamirate

Answer 21

Benzonatate

Question 22

Diagnosis for Bronchial Asthma

Answer 22

Spirometry

Question 23

Formula for Pack years

Answer 23

no. sticks per day x 1pack/20 sticks x no. of years

Question 24

Guidelines for COPD

Answer 24

GOLD
Global initiative for Ostructive Lung Disease

Question 25

SABA meds

Answer 25

✔️ Salbutamol/Albuterol ✔️ Terbutaline

Question 26

LABA medications

Answer 26

"BIFS" Bambuterol Indacaterol Formoterol Salmeterol

Question 27

1st line reliever for BA

Answer 27

Salbutamol

Question 28

WOF with salbutamol

Answer 28

Tremors Tachycardia Hypokalemia

Question 29

Anti-inflammatory drug usually combined with LABA

Answer 29

Inhaled corticosteroids (ICS)

Question 30

Budesonide + Formoterol

Answer 30

Symbicort

Question 31

Salmeterol + Fluticasone

Answer 31

Seretide

Question 32

MOA of Methylxanthines

Answer 32

(-) adenosine (-) PDE = ⬆️cAMP: Bronchodilation

Question 33

Uses of Methylxanthines

Answer 33

✔️ alternative controllers for COPD ✔️ respiratory stimulant vs. apnea or prematurity

Question 34

WOF with Methylxanthines

Answer 34

Narrow therapeutic index (+) headache (+) palpitations (+) nausea and vomiting WTD? Therapeutic Drug Monitoring

Question 35

Methylxanthines

Answer 35

Aminophylline Theophylline

Question 36

Anticholinergic SAMA

Answer 36

Ipatropium

Question 37

LAMA

Answer 37

"UGAT" Umeclinidium Glycopycronium Aclinidium Tiotropium -controller for COPD

Question 38

WOF when using SAMA and LAMA

Answer 38

drying of secretions

Question 39

MOA of mast cell stabilizer

Answer 39

(-)Cl influx =stabilize mast cell

Question 40

Uses of Mast cell stabilizers

Answer 40

✔️ prophylaxis vs mild asthma ✔️ adjuct in AR

Question 41

Mast cell stabilizers

Answer 41

✔️ Cromolyn ✔️ Nedocromil ✔️ Cromoglycate

Question 42

Mast cell stabilizers WOF:

Answer 42

No bronchodilation

Question 43

5-LOX inhibitor

Answer 43

Zilueton vs. excersize induced asthma WOF: CYP inhibitor

Question 44

LT antagonist

Answer 44

Montelukast Zafirlukast

Question 45

MOA of corticosteroids

Answer 45

(+) lipoprotein

Question 46

combined with LABA = controller

Answer 46

Inhaled corticosteroids

Question 47

Oral corticosteroid

Answer 47

Prednisone

Question 48

Parenteral corticosteroids

Answer 48

Methylprednisone Hydrocortisone

Question 49

(-) PDE adjunt in COPD

Answer 49

Roflumilast

Question 50

anti-IgE vs uncontrolled BA

Answer 50

Omalizumab