Drugs for Bronchial Asthma, RA and Gout

Which of the following drugs is useful in asthma because it stabilizes mast cells?

• Salbutamol

• Cromolyn

• Ipratropium

• Theophylline

A 13-year-old boy with severe asthma has been treated for 6 months with good control of nocturnal wheezing. His parents now complain that he seems to be very fat around the face and shoulders, bruises easily, and has discolored streaks on his abdomen. Laboratory tests reveal moderate hyperglycemia. He has probably been receiving which of the following drugs?

• ipratropium

• prednisone

• salmeterol

• terbutaline

Answer explanation

This patient’s presentation is typical of glucocorticosteroid toxicity. Prednisone is an effective corticosteroid frequently used by mouth to control severe asthma that is not responsive to inhaled corticosteroids. High doses of prednisone, given chronically, very predictably cause signs and symptoms of hypercorticism. Ipratropium (choice A) is an antimuscarinic agent used in asthma by inhalation. Salmeterol (choice C) is a long-acting beta-2-selective agonist used by

inhalation. Terbutaline (choice D) is a short-acting beta-2-selective agonist, also used by inhalation.

Which of the following is the drug of choice to reverse bronchoconstriction in an acute asthma attack?

• Salbutamol

• Aminophylline

• Salmeterol

• Ipratropium

The most prominent and dose related side effect of

salbutamol is:

• Rise in blood pressure

• Muscle tremor

• Hyperglycaemia

• Central nervous system stimulation

Select the fastest-acting inhaled bronchodilator:

• Ipratropium bromide

• Formoterol

• Salbutamol

• Salmeterol

Select the correct statement about salmeterol:

• It is a long acting selective β2 agonist bronchodilator

• It is a bronchodilator with anti-inflammatory

  property

• It is a β blocker that can be safely given to

  asthmatics

• It is an antihistaminic with mast cell stabilizing

  property

Select the most appropriate drug for regular prophylactic therapy in a 10 year old child who suffers from exercise induced asthma:

• Oral salbutamol

• Oral theophylline

• Inhaled sodium cromoglycate

• Inhaled salmeterol

Select the drug that is neither bronchodilator nor anti-inflammatory, but has antihistaminic and mast cell stabilizing activity:

• Sodium cromoglycate

• Ketotifen

• Beclomethasone

• Montelukast

Leukotriene antagonists are used in bronchial asthma:

• For terminating acute attacks

• As monotherapy in place of β2 agonists

• As nebulized powder in refractory cases

• As adjuvants to β2 agonists for avoiding

  corticosteroids

Choose the correct statement about theophylline:

• Its use in asthma has declined because of

  narrow safety margin

• Its dose needs to be reduced in smokers

• It acts by increasing the formation of cAMP

• Its plasma halflife is longer in children compared

  to that in adults