Download Pharm - 11-30

ASTHMA AND COPD
BY ALAINA DARBY
Which of the following is an anti-inflammatory drug?
a. Omalizumab
b.Montelukast
c. Salmeterol
d.Epinephrine
Which of the following acts on mast cells?
a. Budesonide
b.Fluticasone
c. Cromolyn
d.Montelukast
What is the purpose of methacholine?
a. Muscarinic antagonist used to test for asthma
b.Muscarinic agonist used to test for asthma
c. Muscarinic antagonist used to treat asthma
d.Muscarinic agonist used to treat asthma
Which of the following is not a trigger for asthma?
a. Environmental exposure
b.Food and additives
c. Diseases
d.Warm air
Which is true about the development of asthma?
a. Its progression is primarily determined by genetics
b.Viral infection during infancy increases incidence of
asthma
c. Environmental factors are most influential after
immune development
d.It may further develop into allergies
Which of the following is true of asthma attack?
a. Bronchospasm occurs late in the attack
b.Inflammation is mediated by histamine release by
mast cells
c. Inflammation is a delayed response
d.Bronchospasm is mediated by cytokine signaling
Which of the following is true of the progression of asthma?
a. Bronchospasm directly causes mucus hypersecretion through
smooth muscle constriction
b.Tissue edema and shedding of the surface epithelium is due to
chronic inflammation
c. Chronic inflammation causes remodeling of pulmonary tissue
d.Bronchospasm is caused by the activation of adrenergic
nerves
Which of the following is true of bronchoconstriction?
a. Non-asthmatics experience no bronchoconstriction at
normal methacholine doses
b.Hypersensitivity is an exaggerated response to normal
stimulus dose
c. Hyperreactivity is an exaggerated response to a high
stimulus dose
d.A positive reaction is considered to be a 20% rise in
FEV1
Which of following is a reason that asthma inhalers
are so expensive in the US?
a. They no longer use CFC’s as a propellant
b.They are no longer under patent
c. They have a longer than usual patent
d.They are fairly recent medications
Which of the following is described by daily inhaler use,
two nighttime attacks per week, and a PEF of 75%?
a. Intermittent
b.Severe
c. Mild persistent
d.Moderate persistent
Which of the following does not promote bronchodilation?
a. Adenosine
b.Theophylline
c. Muscarinic antagonists
d.cAMP
What is the mechanism of methylxanthines?
a. Phosphodiesterase analog
b.Promote adenosine
c. Inhibit conversion of cAMP to AMP
d.Binding adenosine directly
Which of the following is true?
a. Muscarinic receptors are found in the large bronchioles, beta 2
receptors are found in the small bronchioles
b.Muscarinic receptors are found in the large bronchioles, beta 2
receptors are found in the large bronchioles
c. Muscarinic receptors are found in the small bronchioles, beta 2
receptors are found in the large bronchioles
d.Muscarinic receptors are found in the small bronchioles, beta 2
receptors are found in the small bronchioles
Which of the following is true of the location of
muscarinic receptors?
a. M1 is found in the bronchioles
b.M2 is found in the submucosal glands
c. M2 is found in the autonomic ganglia
d.M3 is found in the submucosal glands
Which is not a benefit of using tiotropium over ipratropium?
a. It has a shorter onset of action
b.It has a longer duration of action
c. It is selective for M1 and M3, preventing endogenous Ach
release
d.It has greater muscarinic receptor affinity
Which group of individuals should be cautioned about using
ipratropium?
a. Those with cancer
b.Those with bleeding risk
c. Those with BPH
d.Those with kidney failure
Which of the following is true about drug interactions
with beta 2 agonists?
a. Saquinavir and diruetics can prolong the effects
b.Beta blockers are physiological opposites
c. MAOIs and TCAs exacerbate hypokalemia
d.Beta blockers can prevent acute bronchospasm
treatment
Which of the following is a “reliever”?
a. Salmeterol
b.Albuterol
c. Formoterol
d.Indacaterol
Which of the following is a therapeutic action of
albuterol?
a. Stabilize mast cells
b.Contract smooth muscle
c. Block beta receptors
d.Reverse hypokalemia
Why are glucocorticoids often used in combination with beta
agonists?
a. They cause additional bronchodilation
b.They can also bind to and block the M3 receptors
c. They cause upregulation of beta receptors
d.They enhance delivery of the beta agonist to its site of
action
Beta agonists do not work well as bronchodilators in some
patients, which of the following is not a reason for this?
a. Prolonged use has led to uncoupling from the receptor
b.Binding of beta-arrestin has led to internalization of the
receptors
c. Some patient exhibit SNPs causing diminished activity of the
receptor
d.Prolonged use has let to damage in the DNA encoding the
receptor
Which of the following does not stabilize mast cells?
a. Albuterol
b.Theophylline
c. Cromolyn sodium
d.Obuzamab
Which of the following is a reason continued use of LABAs?
a. They cause glucocorticoid receptor upregulation
b.They enhance the effects of glucocorticoids
c. Bronchoconstriction causes tissue remodeling
d.Inflammation can often be prevented by LABA’s
Which of the following is a reason for combining SABAs and
anticholinergics?
a. SABAs cause bronchodilation but anticholinergics do not
b.Their receptors are located in different parts of the
bronchioles
c. They cause synergistic effects when given together
d.They are not effective on their own
Which of the following is not a potential anti-inflammatory
target?
a. Nucleus of cytokine producing cells
b.The antibodies themselves
c. The target cell
d.Cytokines themselves
Which of the following act directly on the cytokines?
a. Cytokine synthesis inhibitors
b.Signal transduction inhibitors
c. Monoclonal antibodies
d.Receptor antagonists
How do methylxanthines enhance the effects of beta-2
activation?
a. Maintenance of cAMP levels
b.Inhibition of adenosine action
c. Upregulation of beta-2 receptors
d.Enhanced cAMP synthesis
Which of the following is not true of cromolyn sodium?
a. It stabilizes mast cells
b.It produces systemic side-effects
c. It has no bronchodilator activity
d.It is only for prophylactic use
Which of the following is an inhaled steroid?
a. Methylprednisone
b.Prednisone
c. Beclomethasone dipropionate
d.Prednisolone
Which of the following is not a mechanism through which
corticosteroids produce their effects?
a. Occupancy of importin alpha
b.Increased mucus secretion
c. Repression of transcription factors
d.Increased anti-inflammatory lipocortins
Which of the following produce most of corticosteroid
side effects?
a. Trans activation
b.Lipocortins
c. Inflammatory proteins
d.GATA-3
Which of the following is true of asthma?
a. Neutrophilic asthma is steroid sensitive
b.Neutrophilic asthma leads to severe asthma
c. Eosinophilic asthma is steroid resistant
d.Eosinophilic asthma leads to severe asthma
Which of the following would not be a reason for the
ineffectiveness of steroids in COPD?
a. Changes in binding affinity
b.Overexpression of the other form of glucocorticoid
receptor
c. Decreased cytokine signaling
d.Downregulation of histone deacetylase 2
Which of the following is the primary reason for inhaling
corticosteroids rather than taking them orally?
a. Deliver it directly to the site of action
b.Prevent oropharyngeal candidiasis
c. Prevent systemic effects
d.Avoid first pass metabolism
Which of the following would not be a beneficial
attribute when developing a steroid?
a. Inactive prodrugs
b.Reduced excretion
c. Dissociated drugs
d.Controlled particle size
Which of the following is true of the synergism of beta-2
agonists and their effects on corticosteroids?
a. They stimulate Gs
b.They stimulate Gq
c. They stimulate Gi
d.They stimulate Gt
Which of the following is not a routine test that is
necessary for someone taking a combined
corticosteroid/LABA?
a. Blood glucose
b.Serum potassium
c. Pulmonary function
d.Liver function
Which of the following pairs is responsible for
leukotriene synthesis?
a. COX1/ COX2
b.Phospholipase A2/ thromboxane
c. 5 lipoxygenase/ C4 synthetase
d.5 lipoxygenase/ thromboxane
Which of the following would be a method of treating an
individual who is unresponsive to corticosteroids who is
experiencing inflammation and bronchospasm?
a. Target leukotriene formation as an alternative therapy
b.Add beta agonists to enhance corticosteroid response
c. Target cyclooxygenase enzyme as an alternative therapy
d.Target the neutrophils and eosinophils that mediate the
asthmatic response
Which is not an indication for members of the “kast”
family?
a. Asthma
b.Exercise-induced bronchospasm
c. COPD
d.Allergic rhinitis
Which of the following is true of the “kast” family?
a. They all inhibit CYP2C9 and CYP3A4
b.They cause frequent side effects
c. They are a bronchodilator
d.They can be given by mouth
Which of the following would not be an advantage of
antileukotrienes?
a. Greater symptom improvement in severe asthma
b.Better adherence
c. Beneficial benefits in neuronal regulation
d.When a beta-2 agonist is contraindicated
Which of the following is a leukotriene synthesis blocker?
a. Montelukast
b.Zileuton
c. Theophylline
d.Omalizumab
Which of the following can cause anaphylaxis and is
therefore only administered in a clinical setting?
a. Montelukast
b.Zileuton
c. Theophylline
d.Omalizumab
Which of the following treatment regimens is the first
choice of treatment for intermittent asthma?
a. SABA
b.LABA
c. ICS
d.Cromolyn
Which of the following is not a treatment for acute
asthma?
a. Norepinephrine
b.Short-acting anticholinergics
c. Systemic or inhaled steroids
d.MgSO4
Which of the following are the common forms of COPD?
a. Asthma and emphysema
b.Pneumonia and bronchitis
c. Bronchitis and emphysema
d.Asthma and pneumonia
Which of the following is true of the profile for COPD?
a. Younger (children)
b.Progressive dyspnea
c. Good response to corticosteroids
d.Airflow normalizes after episode
Which of the following is a drug that is labeled for
smoking cessation?
a. Varenicline
b.Clonidine
c. Mecamylamin
d.Naltrexone
Which of the following is true of nicotine addiction?
a. Cigarette smoke only binds to nicotinic receptors in the VTA
b.Nicotine initially signals the dopaminergic pathway
c. The dopaminergic pathway is quickly desensitized
d.Dopamine signaling gives rise to the withdrawal symptoms
Which of the following is the mechanism for nicotine
replacement therapy?
a. Attaining of high levels of nicotine to mimic cigarette
response
b.Produce sustained plasma nicotine level that is tapered
c. Quick accumulation of peak levels
d.Induction of the GABA response
Which of the following is true of Varenicline?
a. Agonist of the α4β2 nicotinic receptor
b.Causes the release of mesolimbic dopamine
c. Is solely responsible for depressive effects
d.One of the most effective single drugs
Which of the following is true of Buproprion?
a. More effective than varenicline
b.Less effective than nicotine replacement
c. May cause sedation and depression
d.Is a norepinephrine and dopamine reuptake inhibitor
Which of the following can be used in conjunction with
methylxantines to loosen phlegm and bronchiole secretions?
a. Theophylline
b.Guaifenesin
c. Varenicline
d.Roflumilast
Which of the following is used only for individuals with severe
disease symptoms, reduces the requirement for
corticosteroids, and inhibits the PDE enzyme?
a. Theophylline
b.Guaifenesin
c. Varenicline
d.Roflumilast
Which of the following would not be contraindicated in
COPD?
a. Sedatives
b.Beta-blockers
c. Glucocorticoids
d.Aspirin
e.ACE-inhibitors