Asthma/ COPD Qs

10. A 32-year-old man with a history of opioid addiction presents with cough due to a viral upper respiratory system infection. Which is appropriate symptomatic treatment for cough in this patient?

Benzonatate

2. A 35-year-old man has all of his asthma medications with him today. Which of the following is duplication of therapy?

Budesonide/formoterol and salmeterol

4. Rochelle is an 8-year-old white female newly diagnosed with asthma of a moderate severity. Which of the following would be considered the most beneficial for the long-term control therapy of Rochelle's asthma?

Daily Inhaled beclomethasone

7. A 65-year-old woman with emphysema is seen in clinic today for a checkup. Her current COPD pharmacotherapy includes tiotropium 18 mcg once daily and albuterol MDI every 4 hours as needed. She is adherent with medications and uses her inhalers correctly. She reports increasing albuterol use over the last 3 months due to increased breathlessness; she denies any recent changes in sputum purulence or volume. Her CAT score today is 23 (compared to 18 three months ago) and she has not had any exacerbations in the last 3 years. Which of the following is the most appropriate change to her current treatment regimen?

Discontinue tiotropium and start umeclidinium/vilanterol 62.5 mcg/25 mcg, one inhalation daily

8. A 75-year-old man with severe COPD currently treated with tiotropium, formoterol/budesonide, and an albuterol MDI as needed presents to the clinic complaining of a more frequent cough, increased sputum production, and change in sputum color. The last time he had symptoms like these was 6 months ago, and at that time he was hospitalized for 3 days. After being diagnosed with a COPD exacerbation and continuing his current maintenance therapies, which of the following is the most appropriate initial treatment recommendation?

Doxycycline 100 mg orally every 12 hours

3. Which of the following drugs has been associated with hepatic toxicity as an adverse effect?

Leukotriene modifiers Zafirlukast & Zileuton

5. Which of the following medication classes has a boxed warning regarding an increased risk of asthma-related deaths when used as monotherapy?

Long-acting beta-2 agonists

4. Xanthines such as Theophylline:

May have an effect on airway inflammation mediated by increased Interleukin-10 release & phosphodiesterase inhibition

7. Which of the following inhaled agents is most likely to cause oral candidiasis?

Mometasone

9. Which one of the following medications treats both asthma and allergic rhinitis?

Montelukast

6. A 25-year-old known asthmatic presents with an exacerbation. Nebulizer treatment with albuterol is begun. Which test would be most useful to evaluate and monitor through treatment?

Peak expiratory flow rate

5. A mother contacts the outpatient clinic stating that her 8-year-old son is having an asthma attack. She has given him two treatments of 2.5 mg of albuterol by nebulizer 20 minutes apart without relief. He continues to sit very still, leaning forward slightly, and only gives one-word answers to her questions. Which of the following would be the most appropriate next step?

Send him to the emergency department or call 9-1-1 for transport and further evaluation

6. An 18-year-old patient complains of wheezing and chest tightness during basketball practice. She had asthma as a child but has "outgrown" it and does not report any day or nighttime symptoms consistent with asthma. Which of the following is the most appropriate?

She should be started on two inhalations of albuterol prior to basketball practice

1. A 23-year-old patient comes into clinic for asthma follow-up. Which of the following would be concerning about the patient's use of albuterol HFA MDI?

She uses 2 canisters of albuterol in 1 month

9. A 63-year-old man presents to clinic complaining of chronic cough and sputum production and shortness of breath with activity. PFTs completed prior to his visit show an FEV1/FVC ratio of 68% (0.68) and FEV1 65% of predicted. His CAT score is 12. He has not had any exacerbations. Which of the following would be most appropriate as the initial regimen for COPD?

Umeclidinium once a day

3. A 5-year-old boy is brought to the clinic by his parents who say that he often has trouble catching his breath when he has been playing hard outside. He is allergic to peanuts. At the moment, he is breathing fine. Which of the following drugs would be used to dilate his bronchioles in an acute asthma attack?

albuterol

2. Which of the following is an adverse effect of tiotropium?

dry mouth

10. Which of the following is the most likely adverse effect of indacaterol?

hypokalemia

1. Parasympathetic activation of the respiratory tract causes which of the following?

increased mucous secretions

8. Your 30-year-old patient has moderately severe new onset asthma, and you prescribe a highly selective β2 agonist inhaler to be used when needed. In considering the possible drug effects in this patient, you would note that β2 stimulants frequently cause:

skeletal muscle tremor