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pharmacotherapy 2 > resp > Flashcards

resp Flashcards

1
Q

The following is a good choice for relieving headache in an asthmatic patient with aspirin hypersensitivity:
Aspirin Diclofenac Paracetamol ibuprofen prednisolone

A

Paracetamol

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2
Q 
the following is useful for prevention of exacerbations in a patient with severe chronic bronchitis:
• Methylprednisolone • Prednisolone
• Cromolyn
• salbutamol
• roflumilast
A

• roflumilast

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3
Q

. Which medication is best to recommended for a 10-year-old patient with asthma, in addition to salbutamol MDI 1 or 2puffs every 4-6 hours as needed?
• Oral
• No additional therapy needed.
• Budesonide/formoterol MDI 80/4.5 mcg per puff 2 puffs
twice daily.
• Mometasone DPI

A

• Mometasone DPI

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4
Q

A 52-year-old 172 cm tall Asian man, has: FEV1 of 1.53L and FVC of 2.72L. This patient is expected to have:
• Mild airflow obstruction as evidenced by the low FEV1 and normal EFV1 /FVC%
• Moderately severe airflow obstruction as evidenced by the low FEV1 and low EFV1 /FVC%
• Severe airflow obstruction as evidenced by the low FEV1 and low EFV 1 /FVC%
• Moderate airflow restriction as evidenced by the low FEV1 and high EFV 1 /FVC%
• Moderate airflow restriction as evidenced by the low FEV1 and normal EFV 1 /FVC%

A

• Moderately severe airflow obstruction as evidenced by the low FEV1 and low EFV1 /FVC%

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5
Q

How many seconds is optimal for breath holding after inhaling fromanMDI? 12 10 20 30

A

10

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6
Q

The underlying pathophysiology of asthma is best described by which of the following statements?
• Asthma is a psychosomatic disorder.
• Asthma is a disorder of the lung parenchyma.
• Asthma is caused by an aberrant response to
vaccinations.
asthma is a disease of airway inflammation

A

asthma is a disease of airway inflammation

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7
Q

Which objective measure for routine monitoring of asthma is available at home?
• PACO2 • FVC
• FEV1
• PEFR
• PD20
• Asthma is a disease of airway inflammation.

A

• PEFR

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8
Q
  1. Oral medication are popular for the treatment of asthma in children because young children may have difficulty with the proper use of aerosol inhalers. Which of the following is an orally active drug used for asthma?
    Ipratropium Cromolyn Salmeterol Montelukast
A

Montelukast

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9
Q

Which side effect of inhaled corticosteroids is reduced by spacer devices?
Cataracts Oropharyngeal candidiasis Thinning of skin Decreased bone density

A

Oropharyngeal candidiasis

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10
Q

The following class of drugs is indicated in severe COPD With frequent exacerbations is:
O Long-acting inhaled beta-2 agonists O Anticholinergics
O Inhaled corticosteroids
O Methylxanthines
O Short-acting inhaled beta-2 agonists

A

Inhaled corticosteroids

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11
Q 
Which of the following drugs combinations is preferred for long-term management of moderate persistent asthma?:
• Zafiukast + Ipratropium
• Budesonide + Ipratropium
• Budesonide + salmeterol
• Aminophylline + formoterol
A

Budesonide + salmeterol

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12
Q

A patient with COPD is expected to have:
O Increased TLC, decreased VC, increased FEVI /FVC ratio
O Increased TLC, decreased VC, decreased FEVI/FVC ratio
O Increased TLC, decreased VC, normal FEVI/FVC ratio
O Decreased TLC, increased VC, increased FEVI /FVC ratio

A

Increased TLC, decreased VC, decreased FEVI/FVC ratio

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13
Q 
Which objective measure for routine monitoring of asthma is available at home?
• PACO2 • FVC
• FEV1
• PEFR
• PD20
A

• PEFR

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14
Q

. For patients with asthma or COPD exacerbations who are not responding adequately to inhaled medications. what is the agent of choice to add to manage the acute exacerbations?
• Budesonide Cromolyn Theophylline Prednisolone

A

Theophylline

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15
Q

Which of the following drugs does not have a direct bronchodilators effect?
Ipratropium Epinephrine Theophylline Prednisolone

A

Prednisolone

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16
Q 
Which medications is best to recommended for 9-year-old girl with asthma, in addition to salbutamol MDI ?
• Oral theophylline
• No additional therapy is needed
• Mometasone DPI
• Budesonide/formoterol MDI
A

• Mometasone DPI

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17
Q

A 16-year-old male treated for bronchial asthma develops skeletal muscle tremors. Which of the following agents may be responsible for this finding?
Ipratropium zileuton salmeterol cromolyn Beclomethasone

A

salmeterol

18
Q

19.Which is the best asthma maintenance therapy for a 20-year- old patient using salbutamol inhaler throughout the day on a daily basis and sometimes at night?
• Zileuton.
• Fluticasone low dose.
• Fluticasone high dose.

A

Fluticasone low dose.

19
Q

A 20-year-old asthmatic patient needs salbutamol inhaler throughout the day on a daily basis and sometimes at night. Which of the following is the best maintenance therapy in this patient?
Beclomethasone low dose Beclomethasone high dose

A

eclomethasone low dose

20
Q

A 22-year-old man come back home from abroad, He has a history of asthma, and best the summarizes the efficacy or current status of this drug in such patients?
• IS, at best, a second or third-line agent for long term asthma control
• Dosing is Simple and convenient. rarely needs be adjusted
• Excellent alternative to an inhaled steroid for “rescue” therapy
• Possesses strong and clinically useful anti-inflammatory activity

A

• IS, at best, a second or third-line agent for long term asthma control

21
Q

A 23-year-old women is using salbutamol inhaler for frequent acute episodes of asthma and complains od symptoms that she ascribed to the salbutamol. Which of the following is not a recognized action of salbutamol?
Tachycardia Positive inotropic effect Diuretic effect Skeletal muscle tremor Smooth muscle relaxation

A

Diuretic effect

22
Q

A 25-year-old woman is seen for follow-up of persistent asthma symptoms despite treatment with inhaled fluticasone 88microg twice daily for the past 3months, According to the Asthma treatment guidelines, which of the following changes in therapy can be considered?
• Addition of a leukotriene antagonist Addition of a low-dose theophylline Addition of a long-acting beta-agonist
• Increase the dose of ICS or add leukotriene antagonist or a LABA or low-dose theophylline.

A

• Increase the dose of ICS or add leukotriene antagonist or a LABA or low-dose theophylline.

23
Q

A 40-year-old women with moderate persistent asthma has been under good control for 3 months (currently using salbutamol MDI once weekly). She awakens at night twice monthly with asthma symptoms but continues to exercise regularly without difficulties. Her other medications include fluticasone inhaled 88microg/puff twice daily and salmeterol 50 microg twice daily. Her FEV1 is currently at 83% of her personal best. Which action is most appropriate at the present time?
• Decrease the fluticasone to 44microg/puff twice daily
• Discontinue the fluticasone
• Do nothing, as the current salbutamol usage suggests poor
asthma control
• Discontinue the salmeterol
• Add Montelukast 10mg once daily, as the current
salbutamol usage suggests poor asthma control

A

Discontinue the salmetero

24
Q

A 43-year-old women with moderate persistent asthma has been under good control for 4 months (currently needing salbutamol MDI once weekly or less). He awakenes at night twice monthly with asthma continues to exercise regularly without difficulties. His medications are low dose fluticasone inhaler and salmeterol inhaler. His FEV1 83% of her personal best. Which action is most appropriate at the present time?
• Decrease the fluticasone dose
• Discontinue the fluticasone
Do nothing, as the current salbutamol usage suggests poor asthma control
Discontinue the salmeterol
• Add Montelukast as a replacement for salbutamol

A

Discontinue the salmeterol

25
Q

A 57-year-old woman with COPD was diagnosed with an upper respiratory tract infection. and erythromycin was prescribed. Her COPD was reasonably salbutamol. Which of the following would be an appropriate change in the patient s therapeutic regimen at this time?
• • • •
Add inhaled ipratropium to be used PRN. Add inhaled dexamethasone.
Decrease the dose of theophylline.
Add inhaled salmeterol.

A

Decrease the dose of theophylline.

26
Q

A62-year-oldmanwasrecentlydiagnosedwithCOPD.SpirometryrevealsEFV/1FVC60 % ofpredicated,pre-bronchodilators EFV 1 70% of predicated, and post-bronchodilator EFV1 72% of predicated. His symptoms are quite bothersome. He reports walking more slowly than others because of SoB and having to stop to catch his breath every so often when walking on level ground. He had 1 exacerbation last year that did not require hospitalization. Which is the most appropriate disease stage he is in according to guidelines? Stage1 stage 2 Stage3 Stage4

A

stage 2

27
Q

Mrs C is a 66-year-old former smoker with cardiac disease and severe COPD associated with frequent episodes of bronchoconstriction . which of the following is a bronchodilator useful in COPD and least likely to cause cardiac arrhythmia?
Epinephrine zileuton salbutamol cromolyn tiotropium

A

tiotropium

28
Q

A 71 man with COPD (FEV1 37%) and alfa 1-Antitrypsin deficiency can benefit from:
• Montelukast + Ipratropium
• Montelukast +Beclomethasone
• Biweekly transfusion of alfa 1-Antitrysin Augmentation therapy
• weekly transfusion of alfa 1-Antitrysin Augmentation therapy
• Budesonide + zileuton

A

weekly transfusion of alfa 1-Antitrysin Augmentation therapy

29
Q

A patient with asthma has moderate bronchospasm and wheezing about twice a week. Current medication are inhaler salbutamol used for prophylaxis and inhaled beclomethasone. If the physician chooses to use formoterol, which of the following is best way it should be used in the pateient management ?
• A replacement for Beclomethasone
• A replacement for salbutamol
• The preferred agent for acute symptom control (rescue agent)
• An add-on to current medications for additional prophylactic benefits
• Primary (Sole) therapy, replacing both salbutamol and Beclomethasone

A

• An add-on to current medications for additional prophylactic benefits

30
Q

A patient with chronic bronchitis is asking his local pharmacist for Dextromethorphan after an advice from a friend. Which information should the pharmacist teach the patient regarding this medications?
• Dextromethorphan should not be used for a long period at it can cause addiction
• Beta-2 agonist 2 should not be used while taking dextromethorphan
• The patient should not drive or operate machinery while taking dextromethorphan
• Dextromethorphan should not be used in case of chronic bronchitis as the coughing severs a good purpose by helping to clear

A

• Dextromethorphan should not be used in case of chronic bronchitis as the coughing severs a good purpose by helping to clear

31
Q

Q) the symptoms of allergen-mediated asthma result from which of the following

A
  • increased release of mediators from mast cells
32
Q

Q) which side effect of inhaled corticosteroids is reduced by spacer devices

A

oropharangeal candidiasis

33
Q

Q) A 16 y/o male treated for bronchial asthma develops skeletal muscle tremors. which of the following agents may be responsible for this finding

A

salmeterol

34
Q

Q) A 45-yearold male with a history of asthma has a PEFR of 65% predicted, nocturnal wheezing once a month, and daytime wheezing usually less than twice a week. which of the following is the best treatment option for this patient

A

inhaled budesonide + salbutamol MDI prn

35
Q

Q) which medication is best to recommend for a 9year old girl with asthma in addition to salbutamol MDI

A

mometasone DPI

36
Q

Q) all of the following are benefits of omalizumab except

A
  • can be used for treatment of patients with moderate to severe persistent asthma who have a component of copd
37
Q

Q) a patient with COPD is expected to have

A

increased TLC, Decreased VC and decreased FEV1/FVC ratio

38
Q

Q) a patient with asthma is expected to have

A

icreased TLC,decreased VC, increased RV, decrease in FEV1/FVC

39
Q

Q) the following should be administered to an otherwise healthy 27 year old mle with acute severe asthma

A

nebulized salbutamol

40
Q

Q) a 15 year old female is brought to the emergency department. she is breathing 30 times per minute, is unable to speak in full sentences and has PEFR < 50% predicted. the preferred first line therapy for her asthma exacerbation is

A

beta 2 agonist + corticosteroid

pharmacotherapy 2 (8 decks)

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