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Advanced Pharmacology Final Exam Questions and Complete Solutions Graded A+
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Advanced Pharmacology Final Exam Questions and Complete Solutions Graded A+
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Advanced PharmacologyFinal Exam Questions
and Complete Solutions
Graded A+
Denning [Date] [Course title]
,Albuterol - Answer: Class: Short acting B2 agonist with minor B1
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS excitation effects (tremors,
dizziness), HA, tachycardia, palpitations
Comments: Safe for children and pregnancy; may combine with ipratropium; least expensive
Terbutaline - Answer: Class: Short acting B2 agonist with minor B1
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS excitation effects (tremors,
dizziness), HA, tachycardia, palpitations
X: Pregnancy category B or C
Salmeterol - Answer: Class: Long acting B2 agonist, more selective
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS excitation effects (tremors,
dizziness), HA, tachycardia, palpitations
Comments: Do not use alone for persistent asthma, combine with an inhaled corticosteroid; don't wash
it, powder can get clogged
What are some things you can educate your patients on regarding beta agonist inhalers? - Answer: 1.
Demonstrate and have patient do return demonstration
2. Check correct inhaler use if patient says it's not working
3. Encourage use of spacer
Fluticasone - Answer: Class: Inhaled corticosteroid
Used for: 1st line treatment for persistent asthma
MOA: Anti-inflammatory, minimal systemic exposure
Budesonide - Answer: Class: Inhaled corticosteroid
Used for: 1st line treatment for persistent asthma
,MOA: Anti-inflammatory, minimal systemic exposure
Zafirlukast - Answer: Class: Leukotriene modifier/antagonist
Used for: 2nd line to decrease bronchoconstriction, edema
MOA: Works similar to prostaglandins in r/t to inflammation, blocks lipoxygenase
Theophylline - Answer: Class: Xanthine; stimulant
Used for: Asthma
MOA: Bronchial smooth muscle relaxation
ADR: cardiovascular effects, increased gastric acid production, CNS effects (irritability, restlessness,
seizures, insomnia), GI effects (reflux, worsens heartburn), cardiac effects (palpitations, tachycardia,
hypotension, life-threatening arrhythmias)
X: GERD, HTN, ischemic heart dx, coronary insufficiency, CHF, history of stroke, cardiac arrhythmias;
smoking increases clearance
Comments: Stay away from charcoal-broiled foods (accelerates the hepatic metabolism), avoid large
amounts of caffeine containing beverages; elimination is influenced by diet
What are the signs of Theophylline toxicity? - Answer: Vomiting, insomnia, jitteriness, HA, severe GI
pain, irregular heartbeat
Ipratropium Bromide - Answer: Class: Inhaled anticholinergic
Used for: NOT 1st line, supplemental use in acute bronchospasm
MOA: Blocks the muscarinic cholinergic receptors, causes bronchial smooth muscle relaxation; uses
alternate pathway, effects additive with beta receptors
What is asthma? - Answer: Chronic inflammatory disorder of the airways, recurrent episodes of
wheezing, breathlessness and chest tightness, airflow obstruction is reversible - recommendations by
Expert Panel III is to take an aggressive approach to gain quick control
What would you treat mild intermittent asthma with? - Answer: Step 1 therapy:
1. Use short acting B2 agonists PRN for symptoms - patients may have symptoms when exposed to
triggers (URI, allergens, chemical inhalents, exercise)
, 2. Educate on annual flu shot
What would you treat mild persistent asthma with? - Answer: Step 2 therapy:
1. Long-term/low dose inhaled corticosteroids such as Fluticasone or Budesonide
2. Use short acting B2 agonist PRN, if using more than 2 days/week, then step up therapy
What would you treat moderate persistent asthma with? - Answer: Step 3 therapy:
1. Treat with medium dose inhaled corticosteroids (Fluticasone or Budesonide) OR
1. Low dose inhaled steroid (Fluticasone or Budesonide) plus long acting B2 agonist (Advair or
Salmeterol) OR
1. Medium dose inhaled steroid (Fluticasone or Budesonide) plus leukotriene receptor antagonist
(Zafirlukast)
2. May use short acting B2 agonists (Albuterol or Terbutaline)
What would you treat severe persistent asthma with? - Answer: Step 4 therapy:
1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND long-acting B2 agonist
(Salmeterol) OR
1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND a leukotriene modifier
(Zafirlukast) OR Theophylline
Step 5 therapy:
1. High dose inhaled corticosteroid AND long acting B2 agonist
Step 6 therapy:
1. High dose inhaled corticosteroid AND long acting B2 agonist AND oral corticosteroid
**Severe persistent asthma requires consultation with asthma specialist
What drugs would you consider for pregnant patients who have asthma? - Answer: Inhaled beta
agonists are acute drug of choice; inhaled corticosteroids are the long term drug of choice
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