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ASTHMA/COPD THERAPEUTICS DR. ANDREWS

Total questions: 45

Worksheet time: 4hrs 17mins

Name
Class
Date
1.

Which of the following is for Preventive treatment prior to exercise for exercise-induced bronchospasm (EIB) for a short period of time?

a)

LAMA

b)

SABA

c)

LABA

d)

SAMA

2.

Which of the following effects will have Short-Acting β2-Agonists (SABA)? Select all that apply

a)

Hypokalemia and changes in blood glucose may occur (long-term use)

b)

Cardiovascular effects

c)

Hyperkalemia

3.

Which of the following are the ADRs for Short-Acting β2-Agonists (SABA)? Select all that apply

a)

Headache.

pain

b)

pharyngitis and rhinitis

c)

tachycardia

d)

dizziness, tremor

e)

changes in cardiac rythm

4.

Which of the following is good for Prevention of exercise-induced bronchospasm (EIB) for a long time?

a)

SABA

b)

LABA

c)

SAMA

d)

LAMA

5.

Which of the following is the BLACK BOX WARNING related to LABAs?

a)

Increase the risk of embryonic related death when used alone.

b)

Increase the risk of Heart failure related death when used alone.

c)

Increase the risk of asthma related death when used alone.

d)

Increase the risk of fetus related death when used alone.

6.

LABA should not be used alone in patients with ASTHMA. It can be used adding an ICS.

a)

True

b)

False

7.

Which of the following are the ADRs for Long-Acting β2-Agonists (LABA)? Select all that apply

a)

Tachycardia, tremor

b)

hyperglycemia

c)

Changes in cardiac rhythm

d)

palpitations and nervousness

e)

hypokalemia

8.

Which of the following are the Long-Acting β2-Agonists (LABA) approved for Both Asthma and COPD twice daily (q 12 hrs)? Select all that apply

a)

Arformoterol

b)

Salmeterol

c)

Formoterol

d)

Indacaterol

e)

Vilanterol

9.

Which of the following are the Long-Acting β2-Agonists (LABA) approved Only for COPD? Select all that apply

a)

Arformoterol

b)

Salmeterol

c)

Formoterol

d)

Indacaterol

e)

Olodaterol

10.

Which of the following drugs are considered Short-Acting Muscarinic Antagonist (SAMA)?

a)

Tiotropium Bromide (Spiriva®) Q24H

b)

Ipratropium (Atrovent)

c)

Formoterol

d)

Aclidinium (Tudorza Pressair)

e)

Revefenacin (Yupelri) Q24H by nebulizer

11.

Which of the following is an adverse effect for Short-Acting Muscarinic Antagonist (SAMA)?

a)

changes in cardiac rythm

b)

dry mouth

c)

metallic taste

d)

glaucoma

12.

Which of the following are specific adverse effects for Long-Acting Muscarinic Antagonist (LAMA)? Select all that apply

a)

upper respiratory infections

b)

metallic taste

c)

changes in cardiac rythm

d)

glaucoma

13.

A patient has been hospitalized. This patient is currently taking Aminophylline 200mg oral daily tablet , and Dr. Ritz decide to switch to Theophylline IV. What is it going to be the new dose of Theophylline for this patient in IV formulation?

Hint: ATM

a)

250 mg IV

b)

160 mg IV

c)

40 mg IV

d)

800 mg IV

14.

A female has been discharged from the hospital. This patient was being administered Theophylline IV 300mg based on weight. Dr. Ritz decides to switch from Theophylline IV to Aminophylline oral daily tablet. What is going to be the new dose of Aminophylline for this patient?

TBW: 60 KG

IBW: 62 kg

a)

240 mg oral

b)

375 mg oral

c)

1500 mg oral

d)

60 mg oral

15.

A female patient goes to see her doctor. The physician decides to start oral loading dose of Methylxanthine. What would be the total loading dose for this patient that the physician must prescribe?

TBW: 65 KG

IBW: 54 kg

**Note: If IBW is not given we must calculate it, using formula based on female or male:

Female IBW = 45.5 kg + 2.3 × each inch over 60"

Male IBW = 50 kg + 2.3 × each inch over 60"

a)

325 mg oral

b)

270 mg oral

c)

43.2 mg oral

d)

67.5 mg oral

16.

Which of the following are TRUE about Methylxanthine (Theophylline)? Select all that apply

a)

Oral loading dose: 5 mg/Kg IBW (or TBW if < IBW)

b)

Therapeutic Range: 5-15 mcg/mL

c)

Monitoring: Theophylline levels, HR, CNS effects (insomnia, irritability), use of rescue inhaler

d)

Aminophylline to theophylline: Multiply by 0.8

e)

Theophylline to Aminophylline: Divide by 0.8

17.

Which of the following are the potential side effects for Methylxanthine (Theophylline)? Select all that apply

a)

tachycardia

b)

tachyarrhythmias

c)

CNS stimulation

d)

hyperglycemia

e)

hypokalemia

18.

Which of the following will DECREASE Methylxanthine (Theophylline) concentration? Select all that apply

a)

Phenobarbital

b)

Phenytoin

c)

Carbamazepine

d)

Rifampin

e)

Smoking

19.

Which of the following is the first line of treatment for Asthma that will help with suppression, control, and reversal of inflammation?

a)

LAMA

b)

LABA

c)

ICS

d)

Methylxanthine (Theophylline)

20.

Dr. Andrews said to know these brand and generic only, NOT THE DOSING.

a)

Yes

b)

No

21.

Which of the following adverse effects is the most common one when using ICS?

a)

tachyarrhythmias

b)

tachycardia

c)

Oral thrush

d)

CNS stimulation

e)

glaucoma

22.

Which of the following should be a counselling point when dispensing an ICS?

a)

Use mouthwash before using an ICS

b)

Rinse and spit after administration

c)

Always brush your teeth before using an ICS

d)

Rinse and swallow after administration for systemic effects

23.

Which of the following are ADEs for SYSTEMIC CORTICOSTEROIDS? Select all that apply

a)

weight gain

b)

increase in blood glucose

c)

fluid retention

d)

cataracts

e)

diabetes

24.

The LEUKOTRIENES MODIFIERS indication is for EIB (Exercise-induced bronchospasm).

a)

True

b)

False

25.

Which of the following Leukotriene Modifiers (Leukotriene receptor antagonist (LTRA):) must be dispensed in original container?

a)

Zafirlukast (Accolate)

b)

Montelukast (Singulair)

26.

What should we counsel with the patient when dispensing Montelukast (Singulair®) 4mg granules?

a)

Use within 5 hours min of opening the packet

b)

Dissolve in small amount (5 mL) of breast milk or formula or mixed with applesauce, carrots, rice or ice cream.

c)

Use within 115 min of opening the packet

d)

May administer directly in the mouth

e)

Take in the evening

27.

Which of the following drugs has the greatest risk for serious behavior, and mood related changes, including suicidal thoughts or actions)?

a)

Formoterol

b)

Mometasone

c)

Montelukast

d)

Salmeterol

e)

Vilanterol

28.

Which of the following drugs has a BOX WARNING about risk of serious neuropsychiatric events, including suicidality?

a)

Zileuton

b)

Singulair

c)

Mometasone

d)

Folmoterol

e)

Salmeterol

29.

Which of the following is TRUE about the Immunomodulators? Select all that apply

a)

Increase dose of corticosteroids

b)

Decrease dose of corticosteroids

c)

Has no effect in the dose of corticosteroids

d)

Target specific cells/pathways to decrease symptoms associated with asthma

30.

Which of the following Immunomodulators has to be administered in a healthcare setting and the dose is going to be dependent upon weight and IgE?

a)

Reslizumab

(Cinqair)

b)

Omalizumab (Xolair)

c)

Dupilumab (Dupixent)

d)

Mepolizumab

(Nucala)

31.

Which of the following Immunomodulators is administered IV infusion only?

a)

Omalizumab

(Xolair)

b)

Mepolizumab

(Nucala)

c)

Reslizumab

(Cinqair)

d)

Dupilumab

(Dupixent)

32.

Which of the following Immunomodulators is for patients ≥ 6 y/o with a positive skin test to perennial aeroallergen and inadequately controlled with inhaled corticosteroids?

a)

Omalizumab

b)

Mepolizumab

c)

Reslizumab

d)

Dupilumab

33.

Which of the following is an anti-IgE monoclonal antibody that binds to IgE and blocks binding to receptor on mast cells and basophils –limits release of mediators of allergic response?

a)

Mepolizumab

b)

Omalizumab

c)

Reslizumab

d)

Dupilumab

34.

Which of the following needs to be considered when dispensing Omalizumab (Xolair® )? Select all that apply

a)

Reduced asthma exacerbations 33-75%

b)

requires refrigeration

c)

based on weight and pretreatment IgE levels

d)

ADRs: Injection site reactions, malignancies, Anaphylaxis

35.

Which of the following are Interleukin Receptor Antagonists? Select all that apply

a)

Mepolizumab

b)

Reslizumab

c)

Benralizumab

d)

Dupilumab

e)

Omalizumab

36.

Which of the following Interleukin Receptor Antagonists can cause Hypersensitivity reactions as an ADR?

a)

Mepolizumab

b)

Reslizumab

c)

Dupilumab

d)

Benralizumab

37.

Which of the following Interleukin Receptor Antagonists we must treat helminth parasites before using, may need to discontinue if patient does not respond to therapy for acquired parasite infections? Select all that apply

a)

Reslizumab

b)

Benralizumab

c)

Omalizumab

d)

Mepolizumab

38.

Which of the following Interleukin Receptor Antagonists reactivates the herpes zoster infection?

a)

Benralizumab

b)

Mepolizumab

c)

Reslizumab

d)

Omalizumab

39.

Which of the following could be a counseling point for Mepolizumab?

a)

patient may consider monkey pox vaccine before use

b)

patient may consider herpes zoster vaccine before use

c)

patient may consider chicken vaccine before use

d)

patient may consider flu vaccine before use

40.

Which of the following are TRUE regarding Roflumilast (Daliresp)? Select all that apply

a)

Dose: Start at 250 mcg PO daily then ↑ 500 mcg PO daily (after 4 weeks as tolerated)

b)

Phosphodiesterase-4 Inhibitor

c)

relaxes smooth muscle, decreases activity of inflammatory cells and mediators

d)

ADEs: Weight loss, decreased appetite

e)

Always use with a long-acting bronchodilator

41.

Which of the following are considered Meter Dose Inhalers (MDIs) that use a propellent? Select all that apply

a)

Diskus

b)

HFA

c)

Respimat

d)

Ellipta

e)

Respiclick

42.

Which of the following are considered Dry Powder Inhalers (DPIs) in which a spacer CANNOT BE USED? Select all that apply

a)

Flexhaler

b)

Respiclick

c)

Diskus

d)

Ellipta

e)

Handihaler

43.

Which of the following are TRUE about Patient Counseling for Inhalers?

a)

Use bronchodilator first if using multiple inhalers

b)

Cleaning the device and Priming

c)

Rinse mouth & spit with ICS

d)

Do not swallow capsules with Spiriva (Tiotropium)

e)

Swallow capsules with Spiriva (Tiotropium) for better effect

44.

Which of the following vaccines a patient with Asthma/COPD should get?

a)

Tdap at least one dose as an adult

b)

Influenza annually

c)

Pneumococcal vaccines

d)

COVID-19

e)

Zoster

45.

Which of the following could be used in exercise-induced bronchospasm? Select all that apply

a)

ICS

b)

SABA

c)

LABA

d)

Leukotriene modifiers