Naplex - Asthma

Which of the following statements are correct regarding Pulmicort respules? (Select ALL that apply.) A. Pulmicort respules are given via nebulization. B. The generic name is budesonide. C. Pulmicort respules leave a metallic taste in the mouth. D. Pulmicort respules can be used as first-line therapy. E. Pulmicort respules need to be refrigerated.

A, B, D

Which of the following medications can increase theophylline levels and possibly result in theophylline toxicity? (Select ALL that apply.) A. Ciprofloxacin B. Bupropion C. Zafirlukast D. Ranitidine E. Clarithromycin

A, C, E

Most metered-dose inhalers need to be shaken well immediately before use. Which metered-dose inhaler does not have to be shaken before use? A. QVAR B. Symbicort C. Pulmicort Flexhaler D. Flovent HFA E. Asmanex HFA

A.

Which of the following medications is available as a dry powder inhaler? A. Pulmicort Flexhaler B. QVAR C. Xopenex D. Symbicort E. Bevespi Aerosphere

A.

Which of the following asthma medications works by blocking interleukin-5 receptors? A. Nucala B. Xolair C. Accolate D. Dulera E. Theo-24

A. Nacala is Mepolizumab

What is the generic name of Arnuity Ellipta? A. Mometasone B. Fluticasone C. Indacaterol D. Aclidinium E. Tiotropium

B

AG is a 17 year-old patient with moderate persistent asthma. The physician is considering adding zileuton. Unlike the other agents in its class, zileuton has a risk for which of the following toxicities? A. Hypersensitivity reactions, with trouble breathing B. Hepatotoxicity C. Acute renal failure D. Demyelinating disease E. Hemolytic anemia

B. Liver enzymes must be monitored each month for the first 3 months, then every 2-3 months for the rest of the year, and periodically thereafter.

Which of the following medications can decrease theophylline levels? (Select ALL that apply. A. Allopurinol B. Citalopram C. Carbamazepine D. Primidone E. Quinidine

C, D

CH is a 16 year-old teenager who has asthma and his only medication is Ventolin. He has been using his Ventolin inhaler for acute symptoms. When asked how many times he has used his Ventolin, he states he used it twice on Sunday, one time on Tuesday and one time on Wednesday. It is now Thursday. What would be an appropriate recommendation to make at this time? (Select ALL that apply.) A. Take Ventolin 2 inhalations Q4-6H starting today. B. Start Serevent Diskus 1 inhalation BID for better symptom control. C. Continue to take the Ventolin PRN for acute symptoms. D. Start Pulmicort Flexhaler 2 inhalations BID for better symptom control. E. Start Singulair 20 mg PO QHS.

C, D CH's asthma is not controlled as evidenced by his Ventolin usage. Ventolin should not be taken on a scheduled basis; he needs to be on maintenance therapy (a controller). LABAs should not be used as monotherapy.

Pulmicort respules are used primarily in this population group: A. Seniors B. Adults between 30 and 50 years old C. Children D. Patients who have failed theophylline E. Patients who have failed luekotriene modifying agents

C.

What is the therapeutic range for theophylline? A. 1-5 mcg/mL B. 2-10 mcg/mL C. 5-15 mcg/mL D. 10-20 mcg/mL E. 50-100 mcg/mL

C.

Which of the following statements concerning omalizumab is correct? A. Omalizumab is a mast-cell stabilizer. B. Omalizumab can be used as initial therapy in patients who have allergies and severe, persistent asthma. C. Omalizumab can cause anaphylaxis. D. Omalizumab can be administered at home in a nebulizer if an adult or parent has received training. E. Omalizumab is dosed based on IgG levels and body weight.

C.

A 70 year old patient has been prescribed Xopenex. Choose the correct statement concerning Xopenex: A. Xopenex causes more tachycardia than albuterol. B. Xopenex causes fewer headaches than albuterol. C. Xopenex is available as a SC injection given weekly. D. Xopenex is the R-isomer of albuterol. E. Xopenex is the L-isomer of albuterol

D.

DH has been using prednisone 10 mg PO daily for the past month post discharge from her recent asthma exacerbation. Her physician wants to taper her off the medication. What is the reason corticosteroids must be tapered? A. They can cause rebound hypertension if stopped abruptly. B. They can cause psychological dependence and withdrawal symptoms if stopped abruptly. C. They can cause seizures to occur if stopped abruptly. D. They can cause hypothalamic pituitary adrenal axis suppression. E. They can cause bizarre, psychiatric behavior if stopped abruptly.

D.

What are the ingredients in Symbicort? A. Salmeterol + fluticasone B. Formoterol + fluticasone C. Salmeterol + beclomethasone D. Formoterol + budesonide E. Mometasone + formoterol

D.

What is the correct dose of Advair HFA? A. 1 inhalation once daily. B. 1 inhalation BID. C. 2 inhalations once daily. D. 2 inhalations BID. E. Take PRN.

D.

SF is an 18 month old boy who has been prescribed montelukast granules. Counsel the parents on how to administer the granules to their son: A. Mix with 4 oz of applesauce and administer within 24 hours. B. The granule packet can be opened up to 8 hours prior to use. C. Mix with one tablespoon of warm water. D. Mix with a spoonful of cool, mashed carrots and administer within minutes. E. Mix with a tablespoon of breast milk or formula; the mixture can be stored up to 2 hours.

D. Instruct parents using the granules not to open the granule packet until they are ready to use it since granules mixed with foods or liquids cannot be stored. The granules can be mixed with 1 teaspoonful (5 mL) of baby formula or breast milk, or a spoonful of applesauce, mashed carrots, rice, or ice cream. Whatever the medicine is mixed with must be cold or at room temperature. Administer the mixutre immediately (within 15 minutes)

SC is a 4 year-old patient with moderate persistent asthma. He has been poorly controlled on an albuterol inhaler and a low-dose inhaled corticosteroid. The physician wants to add a leukotriene modifier to SC's regimen. Which agent can be recommended? A. Zileuton B. Theophylline C. Indacaterol D. Zafirlukast E. Montelukast

E. Two leukotriene receptor blockers are indicated for use in children with asthma. Montelukast is indicated for patients at least one year old and zafirlukast is indicated for patients 5 years and older.