pharmacology: ch 17 drugs for treatment of respiratory disorders and allergic rhinitis
-Fluticasone/salmeterol (Advair HFA, Advair Diskus) -Budesonide/formoterol (Symbicort HFA) -Mometasone/formoterol (Dulera) a. inhaled corticosteroids/ long acting B2 agonists b. leukotrine modifiers c. long acting B2 agonist d. short acting B2 agonist
a
-albuterol (proair) -metaproterenol (alupent) -levalbuterol (xopenex HFA) a. short acting B2-adrenergic agonists (inhaler) b. long acting B2-adrenergic agonists c. inhaled corticosteroids d. oral corticosteroids
a
-diphenhydramine (Benadryl) -clemastine (Tavist) -chlorpheniramine (Chlor-Trimeton) -brompheniramine (Dimetane) a. 1st generation antihistamines b. 2nd generation antihistamines
a
All are effects of H1-agonists except: a. vasoconstrictor b. bronchconstriction c. increased capillary permeability d. sedation e. pain and itching in the nerve endings f. anti-cholinergic effects
a
Intranasal corticosteroids are considered first-line therapy for treatment of moderate to severe allergic rhinitis. The onset of action is within minutes of drug administration. a. first statement is true, second statement is false b. first statement is false, second statement is true c. both statements are true d. both statements are false
a
The primary group of drugs used to treat COPD is the __________, which cause __________. a. Anticholinergics, bronchodilation b. Cholinergics, bronchodilation c. Anticholinergics, bronchoconstriction d. Methylxanthines, bronchodilation
a
Which H1-blocker causes the most sedation and is used as an over-the-counter sleep aid? a. Diphenhydramine (Benadryl) b. Desloratadine (Clarinex) c. Loratadine (Claritin) d. Fexofenadine (Allegra)
a
Which actions of H1-blockers have the greatest potential adverse effect for the oral health of the patient? a. anticholingergic b. Antiserotonergic c. sedative d. antihistaminic
a
____________ produce bronchoconstriction, increased mucus secretion, mucosal edema, and increased bronchial hyper-reactivity which all constitute the slow reacting substance of anaphylaxis (SRS-A) a. leukotrienes b. mast cells c. histamine cells d. wbcs
a
by blocking histamine at the capillary permeability, what is occurring? a. causes less tissue edema b. block the dilation of the vascular smooth muscle that histamine produces c. suppress the itching and pain associated with histamine
a
in asthma, inflammation occurs later causing what? a. secretions in lungs and swelling in bronchioles b. secretions in lungs and swelling in epiglottis c. alveolar deconstruction with airway space enlargement and airway collapse d. none of the above
a
nasal decongestants are ________ that act by constricting the blood vessels of the nasal mucous a. alpha adrenergic agonists b. beta adrenergic agonist
a
what is the drug of choice for the emergency treatment of an acute asthma attack? a. short acting B2 agonist b. long acting B2 agonist c. inhaled corticosteroids d. leukotriene modifiers
a
what is the first line of therapy for mild occasional asthma? a. albuterol b. prednisone c. fluticasone d. budesonide
a
what is used primarily to treat mild allergic reactions? a. diphenhydramine (Benadryl) b. clemastine (Tavist) c. chlorpheniramine (Chlor-Trimeton) d. brompheniramine (Dimetane)
a
which of the following drugs is a leukotriene modifier that increases the effect of warfarin and is life threatening to hepatic injurt? a. Zafirlukast (Accolate) b. Montelukast (Singulair) c. Prednisone (Deltasone) d. Zileuton (Zyflo)
a
which of the following is a reversible airway obstruction? a. asthma b. COPD
a
which of the following is systemically as a decongestant, has an alpha agonist action? a. phenylpropanolamine b. pseudophedrine c. phenylephrine d. montelukast
a
which type of asthma will the patient experience asthma symptoms less than twice a month and the symptoms do not interfere with normal life? a. intermittent asthma b. persistent asthma
a
Which anticholinergic drugs are used in the management of COPD? a. Ipratropium bromide (Atrovent) b. Tiotropium bromide (Spiriva) c. Omalizumab (Xolair) d. Theophylline (Theo-Dur, Slo-Bid)
a, b
Which medications are used in the management of emphysema? a. anticholinergics b. B2-adrenergic agonists c. xanthines d. corticosteroids
a, b
which of the following should be avoided in asthma pts? a. aspirin b. NSAIDS c. tylenol d. nitrous
a, b
Antitussive agents that are commonly used today include a. Dextromethorphan b. Pseudoephedrine c. Codeine-containing compounds d. opioids
a, b, c
Chronic Obstructive Pulmonary Disease (COPD) is associated with which factors or conditions? a. smoking b. chronic bronchitis c. emphysema d. decreased sputum production e. asthma
a, b, c
The xanthines and methylxanthines include which medications? a. Theophylline b. Theobromine c. caffeine d. ipratoprium
a, b, c
first generation H1 antagonists have which effects? a. antihistaminic b. anticholingergic c. analgesic d. antiserotongeric e. sedative
a, b, d, e
Which drugs are categorized as leukotriene modifiers? a. Montelukast (Singulair) b. Zileuton (Zyflo) c. Beclomethasone (Beconase, Vancenase) d. Fluticasone (Flovent) e. Zafirlukast (Accolate)
a, b, e
prolonged use of oral corticosteroids can cause which of the following a. adrenal suppression b. candidiasis c. poor wound healing d. immunosuppression e. osteoporosis
a, c, d
Which are advantages of the metered-dose inhaler (MDI)? a. MDIs are compact, portable, and sterile, making them ideal for the ambulatory patient. b. Inhaler use is easy. c. Medication is delivered directly to bronchiole, reducing the total dose and systemic adverse effects. d. Onset of action is rapid and predictable compared with dose by mouth. e. The bronchodilator effect is greater than the comparable dose by mouth.
a, c, d, e
Adverse effects of the short-acting β2 agonists include: a. tachycardia b. CNS depression c. nervousness d. bradycardia e. insomnia
a, c, e
When cells produce leukotrienes in response to inflammation, which physiologic action occurs? a. bronchodilation b. decreased bronchial hyperreactivity c. bronchoconstriction d. increased mucus secretions and mucosal edema e. increased bronchial hyperreactivity
a, d, e
-salmeterol (serevent diskus) -formoterol (foradil aerolizer) a. short acting B2-adrenergic agonists (inhaler) b. long acting B2-adrenergic agonists c. inhaled corticosteroids d. oral corticosteroids
b
All of these medications are nonsedating H1-receptor antagonists except: a. Loratadine (Claritin) b. Diphenhydramine (Benadryl) c. Desloratadine (Clarinex) d. Fexofenadine (Allegra)
b
Antitussives are used in symptomatic relief of a. productive cough b. nonproductive cough c. cystic fibrosis d. COPD e. asthma
b
Management of normal breathing function is best achieved with treatment of short-acting β2 agonists, and no danger of overuse of these medications has been found. a. both parts of the statements are true b. both parts of the statements are false c. first part of statement is true, second part of statement is false d. first statement of statement is false, second part of statement is true
b
Nasal decongestants are α-adrenergic agonists whose primary action is a. bronchodilation b. Constriction of the blood vessels of the nasal mucous membranes c. Dilation of the blood vessels of the nasal mucous membranes d. sedation
b
The adverse reactions of leukotriene modifiers include irritation of the stomach mucosa, headache, and alteration of liver function tests. Fortunately, few drug interactions occur with these drugs. a. first statement is false, second statement is true b. first statement is true, second is false c. both statements are true d. both statements are false
b
What mechanism reduces sedation in the second generation of H1-blockers? a. adrenergic effects b. failure to penetrate the blood-brain barrier c. ability to penetrate the blood-brain barrier d. cholinergic effects
b
Which are the primary side effects associated with the methylxanthines? a. Hepatotoxicity, gastrointestinal motility, and tremors b. CNS stimulation, tachycardia, increased gastric secretion, and diuresis c. Bradycardia, sedation, central nervous system (CNS) depression, decreased gastric secretions, and urinary retention d. Renal toxicity, gastrointestinal upset, and ataxia
b
________ promote removal of exudate or mucous from resp passages a. decongestant b. expextorants c. mucolytics d. mast cell inhibitor
b
albuterol CANNOT cause insomnia a. true b. false
b
by blocking histamine at the vascular smooth muscle vessels, what is occuring? a. causes less tissue edema b. block the dilation of the vascular smooth muscle that histamine produces c. suppress the itching and pain associated with histamine
b
cromolyn (a mast cell inhibitor) is effective for a. acute asthmatic attack b. prophylaxis of asthma c. COPD d. long term asthma
b
inhaled corticosteroids _______ produce immediate benefit in an acute asthmatic attack a. do b. do not
b
leukotriene modifiers CANNOT be used to treat seasonal and perennial rhinitis a. true b. false
b
nitrous oxide is NOT a contraindication for COPD patients and can be used with ease a. true b. false- they shouldnt be used with COPD pts
b
selective B2-agonists produce bronchodilation with a. more cardiac side effect b. fewer cardiac side effect c. more lung side effect d. fewer lung side effect
b
short acting B2-agonists such as abuterol may be administered by a. topical b. inhalation/oral c. parenterally d. all above
b
what is allergic rhinitis? a. inflammation of the lungs b. inflammation of nasal airways c. irritation of nasal airways
b
which generation of antihistamines penetrate poorly into the CNS and are less likely to cause sedation? a. 1st generation b. 2nd generation
b
which of the following is a result of chronic inflammation of the airways and excessive sputum production? a. asthma b. chronic bronchitis c. emphysema d. upper resp infection
b
which of the following is an irreversible airway obstruction? a. asthma b. COPD
b
which of the following is approved for treatment of COPD? a. inhaled corticosteroid monotherapy b. inhaled corticosteroid combo w long acting beta 2 agonist
b
which of the following is used systemically as nasal decongestant, has both alpha adrenergic agonist and a beta adrenergic agonist? a. phenylpropanolamine b. pseudophedrine c. phenylephrine d. montelukast
b
which type of asthma can be mild, moderate or severe, with the severe division limiting a persons normal activities a. intermittent asthma b. persistent asthma
b
•acrivastine (Semprex) •cetirizine (Zyrtec) •desloratadine (Clarinex) •fexofenadine (Allegra) a. 1st generation antihistamines b. 2nd generation antihistamines
b
Which is the primary mechanism of action of inhaled corticosteroids in asthma treatment? a. immediate benefit in acute asthma attack b. reduction of hyperreactive airway c. reduction of inflammation, secretions and swelling d. bronchodilation
b, c
which of the following would be used to treat patients with more significant COPD? a. topical long acting anticholinergics b. inhaling long acting anticholinergics c. inhaled long acting B2 adrenergic blockers d. short acting anticholinergic
b, c
cromolyn can be used for which? a. acute asthmatic attack b. prophylaxis for chronic asthma pts c. taken before exercise induced asthma d. prophylaxis of asthma
b, c, d
Medications that are currently delivered by MDIs include: a. xanthines b. cromolyn c. B-adrenergic agonists, both specific and nonspecific d. corticosteroids e. anticholinergic drugs
b, c, d e,
Corticosteroids that are commonly used in inhaler devices include: a. prednisone b. beclomethasone c. triamcinolone d. fluticasone
b, d
Which components of asthma must be treated to control the disease? a. bronchodilation b. bronchoconstriction c. alveolar destruction d. inflammation
b, d
Which patients are most likely to have central nervous system excitation when taking antihistamines? a. Patients taking a smaller than usual dose b. Patients taking a larger than usual dose c. Adolescents and young adults d. Young children and the elderly
b, d
prolonged use of inhaled corticosteroids can cause which of the following a. adrenal suppression b. candidiasis c. poor wound healing d. immunosuppression e. osteoporosis
b, e
-beclomethasone (QVAR) -budesonide (pulmicort) -ciclesonide (alvescso) -flunisolide (aerospan HFA) -fluticasone propionate (flovent, HFA) -fluticasone furoate (arnuity ellipta) -mometasone furoate (asmanex HFA) a. short acting B2-adrenergic agonists (inhaler) b. long acting B2-adrenergic agonists c. inhaled corticosteroids d. oral corticosteroids
c
First-generation H1-blockers have all actions except: a. antihistaminic b. antiserotonergic c. cholinergic d. sedative
c
Intravenous aminophylline and rapidly absorbed oral liquid preparations are used to manage acute asthmatic attacks and status asthmaticus. Theophylline should be limited to patients whose asthma is not controlled with other agents. a. first statement is false, second statement is true b. first statement is true, second is false c. both statements are true d. both statements are false
c
Leukotrienes are made by the enzyme 5 lipoxygenase from arachidonic acid which also produces ________ a. histamine b. glucose c. prostaglandins d. platelets
c
Leukotrienes are used to a. decrease inflammation, swelling and secretions after an asthmatic attack b. dilate the bronchioles c. manage patients with asthma that is not controlled by B2 agonists and corticosteroid inhalers d. manage all asthma patients
c
Long-acting β2 agonists improve lung function, decrease symptoms, and reduce exacerbations and rescue use of short-acting β2 agonists. They are also recommended as monotherapy for asthma. a. both statements are true b. both statements are false c. first statement is true, second statement is false d. first statement is false, second statement is true
c
Non-sedating H1 receptor blocking drugs block histamine receptors in the __________ instead of the central nervous system, causing significantly less sedation than first generation H1 receptor blockers a. lungs b. tissues c. periphery d. brain
c
Oral adverse effects of chronic use of inhaled corticosteroids include: a. xerostomia b. herpetic lesions c. candidiasis d. aphthous stomatitis
c
Oral corticosteroids, such as prednisone, are sometimes indicated for severely asthmatic patients and even for patients with moderate asthma, especially during respiratory infections. Adverse reactions are similar to inhaled corticosteroids. a. both statements are true b. both statements are false c. first statement is true, second statement is false d. first statement is false, second statement is true
c
What is the action of sympathomimetic or adrenergic agonists in treatment of respiratory diseases? a. Vasoconstriction of arterioles b. Increased blood pressure in lungs c. Bronchodilation by β receptors of lungs d. Increased secretions
c
What is the mechanism of action used to treat asthma of the class of recombinant humanized monoclonal antibodies? a. Bronchodilation in conjunction with the β-adrenergic agonists b. Blockage of the effects of the release of leukotrienes c. Prevention of immunoglobulin E from binding to mast cells and basophils d. Prevention of immunoglobulin G from binding to T lymphocytes and macrophages
c
Which is the primary indication for used of leukotriene modifiers? a. emphysema b. chronic bronchitis c. Asthma that is not controlled by β2 agonists and corticosteroid inhalers d. mild asthma e. upper respiratory infections
c
______ destroy of dissolve mucous such as acetlycysteine a. decongestant b. expextorants c. mucolytics d. mast cell inhibitor
c
by blocking histamine at the nerve endings, what is occuring? a. causes less tissue edema b. block the dilation of the vascular smooth muscle that histamine produces c. suppress the itching and pain associated with histamine
c
how are respiratory drugs administered? a. orally b. IV c. topically via lungs d. IM
c
ipratropium bromide (atrovent) is an ________ available for oral inhalation for COPD pts a. short acting b2 agonist b. long acting b2 agonist c. short acting anticholinergic d. long acting anticholinergic
c
long acting B2 agonists are used in conjunction with ______ to treat patients with persistent asthma that is not well controlled on low dose inhaled corticosteroids a. B2 short acting agonist b. leukotriene modifiers c. corticosteroids d. mast cell inhibitors
c
low doses of ______ have reduced the need of emergency room visits and asthma related deaths as well as reducing hyperreactive airways a. short acting B2 agonists b. long acting B2 agonists c. inhaled corticosteroids
c
what is considered the first line of therapy for treating moderate/ severe allergic rhinitis? a. 1st generation antihistamines b. 2nd generation antihistamins c. intranasal cortiocosteroids d. mast cell stabilizers
c
what is most effective for long term treatment for control of symptoms in all patients with mild, moderate or severe persistant asthma? a. short acting B2 agonist b. long acting B2 agonist c. inhaled corticosteroids d. inhaled corticosteroids/long-acting B2 agonist
c
what is the most common side effect with a 1st generation antihistamine? a. dizziness b. blurred vision c. sedation d. tinnitus
c
what is usually the first line of therapy for patients with COPD? a. cholinergic drugs b. antihistamines c. anticholinergic and/or a B2 adrenergic agonist d. all of the above are considered the first lines of therapy
c
which of the following are signs of asthma? a. wheezing and filmy discharge from oral cavity b. hacking and wheezing c. shortness of breath and wheezing d. all of the above
c
which of the following can be used as an IV med to manage acute asthmatic attacks and status asthmaticus? a. albuterol b. cromolyn c. aminophylline d. theophylline
c
which of the following is characterized by alveolar deconstruction with airway space enlargement and airway collapse? a. asthma b. chronic bronchitis c. emphysema d. upper resp infection
c
which of the following is not one of the sites that antihistamine block histamine at? a. capillary permeability b. vascular smooth muscle vessels c. nerve beginnings d. nerve endings
c
which of the following is used topically as a nasal spray for a decongestant? a. phenylpropanolamine b. pseudophedrine c. phenylephrine d. montelukast
c
•Sympathomimetic/adrenergic agonists produce bronchodilation by stimulation of the a. a-receptors in the lungs b. b-receptors in the heat c. b-receptors in the lungs d. none of the above
c
-Zileuton (Zyflo) -Zafirlukast (Accolate) -Montelukast (Singulair) a. mast cell inhibitors b. corticosteroids c. methylxanthines d. leukotriene modifiers
d
-prednisone (deltasone) a. short acting B2-adrenergic agonists (inhaler) b. long acting B2-adrenergic agonists c. inhaled corticosteroids d. oral corticosteroids
d
Asthma is characterized by irreversible airway obstruction and is associated with a reduction in expiratory airflow. Chronic obstructive pulmonary disease (COPD) is characterized by reversible airway obstruction, such as in chronic bronchitis or emphysema. a. first statement is true, second statement is false b. first statement is false, second statement is true c. both statements are true d. both statements are false
d
Expectorants are drugs that destroy or dissolve mucus from the respiratory passages. Mucolytics promote the removal of exudate or mucus. a. first statement is false, second statement is true b. first statement is true, second is false c. both statements are true d. both statements are false
d
H1-receptors are primarily responsible for stimulating gastric acid secretion, and the H2-receptors are primarily related to vasodilation, increased capillary permeability, bronchoconstriction, and pain or itching at the nerve endings. a. the first part of the statement is true, second part is false b. first part of statement is false, second part is true c. both parts of statement are true d. both parts of statement are false
d
In __________, patients have persistent life-threatening bronchospasm despite drug therapy. a. emphysema b. chronic bronchitis c. intermittent asthma d. status asthmaticus
d
Inhaled corticosteroids are the most effective long-term treatment for control of symptoms in all patients with which conditions? a. moderate asthma b. mild asthma c. severe persistent asthma d. all of the above
d
Intranasal administration of antihistamines is preferable to oral administration. This is because antihistamines administered intranasally have few adverse effects. a. first statement is true, second statement is false b. first statement is false, second statement is true c. both statements are true d. both statements are false
d
Patients with few symptoms of COPD but with high risk for exacerbations...or a patient with many symptoms of COPD and with high risk for exacerbations, they will use all of the following except which? a. Inhaled corticosteroid combined with a long acting B2 adrenergic agonist b. Fluticasone propionate/salmeterol (Advair Diskus) c. Fluticasone furoate/vilanterol (Breo Ellipta) d. Ipratropium (atrovent HFA)e. Budesonide/formoterol (Symbicort)
d
The ventilation drive for breathing in normal persons is stimulated by elevated levels of the partial pressure of oxygen, and the partial pressure of carbon dioxide can vary widely. In patients with COPD, a gradual rise in the partial pressure oxygen over time causes the ventilation drive to be triggered by an increase in carbon dioxide. a. first statement is true, second statement is false b. first statement is false, second statement is true c. both statements are true d. both statements are false
d
What is the first line of defense for an intermittent asthma attack? a. mucolytics b. long acting B2 agonists c. corticosteroids d. short-acting B2 agonists
d
Which group of medications is often combined with H1 antihistamines? a. Mast cell stabilizers (cromolyn sodium) b. Intranasal anticholinergic agents c. Leukotriene modifers (montelukast/Singulair) d. Decongestants (adrenergic agents)
d
_____ may alter the metabolism of theophylline leading to toxicity a. aspirin b. NSAIDS c. tylenol d. erythromycin
d
_______________ is used to treat chronic asthma and bronchospasm associated with COPD by inhibiting breakdown of sensitized mast cells that stimulate the release of histamine/serotonin and slow reacting substance of anaphylaxis a. albuterol b. cromolyn c. aminophylline d. theophylline
d
in a patient with a few symptoms of COPD, which of the following should be used? a. topical long acting anticholinergics b. inhaling long acting anticholinergics c. inhaled long acting B2 adrenergic blockers d. short acting anticholinergic
d
inhaled corticosteroids are great at all of the following EXCEPT one that occur within the lungs after an asthma attack. which is the exception? a. reducing inflammation b. reducing swelling c. reducing secretions d. increasing lung space
d
tiotroprium bromide (spiriva) is an ___________ used to treat COPD a. short acting b2 agonist b. long acting b2 agonist c. short acting anticholinergic d. long acting anticholinergic
d
which of the following drugs would be used to treat a patient with few symptoms of COPD? a. tiotropium (spiriva) b. salmeterol (serevent diskus) c. indacterol (arcapta) d. ipratropium (atrovent HFA)
d
which of the following is an action of the mast cell inhibitor, cromolyn (intal)? a. bronchodilator b. antihistamine c. antiinflammatory d. prevention of release of histamine from mast cells
d
which of the following is not one of the diseases that are treated with respiratory drugs? a. asthma b. COPD c. upper respiratory tract infections d. sinus infections
d
which of the following is not something that can precipitate asthma? a. allergens b. exercise c. stress d. depression e. upper resp. infection f. environmental pollutionn
d
which of the following is the least toxic drug group for asthma? a. short acting B2 agonist b. inhaled corticosteroids c. long acting B2 agonist d. mast cell inhibitors e. leukotrine modifiers
d
Which agent approved for treatment of seasonal and perennial allergic rhinitis has the mechanism of action of serving as a leukotriene receptor antagonist? a. Loratadine (Claritin) b. Diphenhydramine (Benadryl) c. Fexofenadine (Allegra) d. Desloratadine (Clarinex) e. Montelukast (Singular)
e
Which treatment considerations should the dental health care worker make for patients with asthma? a. Patients should be asked to bring their fast-acting β2-agonist inhalers with them to the appointments. b. Observe and question the patient before the appointment to prevent an acute asthma attack. c. Minimal stress is induced during the appointment. d. Advise the patient to reduce environmental pollution, such as strong perfumes. e. all of the above
e
__________ is used only for the prophylaxis of asthma and not for treatment of an acute attack by preventing the antigen-induced release of histamine, leukotrienes, and other substances from sensitized mast cells. a. zileuton (zyflo) b. beclomethasone (beconase, vancenase) c. Zafirlukast (Accolate) d. Fluticasone (Flovent) e. Cromolyn (Intal, Nasalcrom)
e
All of these medication groups are used in treatment of asthma except: a. β-adrenergic agonists b. corticosteroids c. xanthines d. Leukotriene-altering agents e. cromolyn f. cholinergic agents
f