Pulmonary Therapeutics

Up to what percent of people use their inhalers incorrectly?

• 25%

• 40%

• 60%

• 80%

Which of the following beta blockers are B1 selective?

• metoprolol

• carvedilol

• labetalol

• propranolol

DB is a 25 yo M Hawaiian that comes to talk with you when filling a prescription for albuterol. “I have been coughing for the last 2 weeks and my wife says she can hear me wheeze when I go to sleep. My doctor had me take a breathing test. Here’s my results:"

Avg FEV₁ 69% of predicted normal

With albuterol: FEV₁ 400 mL increase, 12.1% increase

What values indicated that the patient has asthma?

• FEV₁ or FVC increase by > 200 mL

• FEV₁ or FVC increase by > 10% from baseline

• both answers

• neither answers

Formoterol has the onset of a ___ acting beta agonist with the duration of a ___ acting beta agonist.

• short; short

• short; intermediate

• short; long

• long; long

WS is 65 yo M diagnosed with mild asthma. Current symptoms of SOB occur once a month, does not have any limitations of activity & no history of hospitalization due to asthma exacerbation or other risk factors for poor outcomes. Not on any medications for asthma. What is the preferred medication for this patient?

• SABA daily

• low dose ICS + formoterol PRN for symptoms

• LAMA

• LABA

Which class do we not use as monotherapy due to increased risk of asthma related deaths?

• LABA

• LAMA

• SABA

• immunotherapies

AR comes for a 3 months follow up on asthma. He is using his albuterol daily for SOB and for wheezing he has about once a week while sleeping at night. He called in sick to work at least twice this month because of his symptoms. He has never been to the hospital for asthma exacerbation.

Medications: budesonide/formoterol HFA (Symbicort HFA) 80/4.5 mcg 2 puffs BID

He is adherent and uses his inhaler properly.

What is the preferred therapy?

• change to medium dose ICS-LABA

• change to high dose ICS-LABA

• mometasone/formoterol HFA (Dulera HFA) 200/5 mcg 2 puffs BID

WC is 50 yo F with moderate asthma. Patient has not seen a doctor in years and is wheezing 3-4 times a week and wakes up once a week coughing. WC used to use an inhaler when had symptoms & would like to get it again as she would have used it if he had it. Has not been to the ER for exacerbations or had limitations in activity. Patient feels asthma is not controlled. What would be the preferred medication for this patient?

• montelukast

• budesonide/ formoterol 160/4.5 mcg PRN asthma symptoms

• budesonide/ formoterol 160/4.5 mcg PRN and 1 inh BID

• mometasone/ formoterol 200/5 mcg 1 inh BID

Patients are instructed to use a peak flow meter ___ times and record the ___ score on their asthma action plan.

• two; best

• two; worst

• three; best

• three; worst

When utilizing both MDIs and DPIs, patients are instructed to hold their breath for ___ seconds.

• five

• ten

• fifteen

• as long as possible