NR565 FINAL PHARMACOLOGY EXAM SCRIPT
2026 TESTED QUESTIONS AND SOLUTIONS
100% CORRECT
◉ Black Box Warning for Montelukast (Singulair). Answer: Drug is
known to cause serious neuropsychiatric effects such as agitation,
aggression, insomnia, depression, anxiety, and suicidal ideation.
◉ Mast Cell Stabilizers Prototype Drug. Answer: Cromolyn
(Inhalation)
◉ Mast Cell Stabilizers MOA. Answer: is used for prophylaxis—not
quick relief—in patients with mild to moderate asthma; prescribed
for exercise-induced asthma. They STABILIZE MAST CELLS TO
REDUCE HISTAMINE RELEASE; , an inflammatory mediator.
◉ Cromolyn patient teaching. Answer: should be administered 10 to
15 minutes before anticipated exertion but no longer than 1 hour
before exercise.
◉ Advantages of Inhaled Route of Anti-Asthma Drugs. Answer: (1)
therapeutic effects are enhanced by delivering drugs directly to their
site of action, (2) systemic effects are minimized, and (3) relief of
acute attacks is rapid.
,◉ Methylxanthines MOA. Answer: Bronchodilation to decrease the
intensity and frequency of moderate to severe asthma attacks and to
control chronic obstructive pulmonary disease exacerbations
◉ Methylxanthines Prototype Drug. Answer: Theophylline
◉ Theophylline Toxicity Risk. Answer: can cause severe cardiac
dysrhythmias and convulsions
◉ Methylxanthines Contraindication. Answer: These drugs are
contraindicated for patients with untreated seizure disorders or
peptic ulcer disease
◉ Theophylline contraindication w/ Caffeine. Answer: can intensify
the adverse effects of the drug on the heart and CNS; Can decrease
drug metabolism.
◉ Theophylline contraindication w/ Smoking Tobacco or Marijuana.
Answer: can increase clearance to 50% in adults and 80% in older
adults; Can cause an ineffective dosing.
◉ Drugs that Reduce Theophylline Levels (CYP3A Inducers).
Answer: Phenobarbital, phenytoin, rifampin; May need to increase
, drug level if given in conjunction; Increase metabolism rate of target
drug;
◉ Drugs that Increase Theophylline Levels (CYP3A Inhibitors).
Answer: Cimetidine, fluoroquinolone antibiotics; May need to
reduce drug level if given in conjunction; These drugs will increase
AE associated w/ target drug due to prolonged activity and
decreased metabolism of target drug.
◉ Theophylline Lifespan Concerns. Answer: Elderly patients: Use
with extreme caution in elderly patients as these patients are at an
increased risk of serious toxicity.
Pediatric patients: Dose selection requires caution, and regular
monitoring of concentrations is necessary (especially if the child is
younger than 1 year of age) as the rate of clearance varies
significantly in these patients.
Pregnancy: Use cautiously only if risk outweighs benefit
◉ Roflumilast (Daliresp). Answer: phosphodiesterase-4 inhibitor
(PDE) approved for the treatment of COPD (and not asthma)
◉ Roflumilast MOA. Answer: selective action that inactivates cyclic
adenosine monophosphate (cAMP) which results in decreased
2026 TESTED QUESTIONS AND SOLUTIONS
100% CORRECT
◉ Black Box Warning for Montelukast (Singulair). Answer: Drug is
known to cause serious neuropsychiatric effects such as agitation,
aggression, insomnia, depression, anxiety, and suicidal ideation.
◉ Mast Cell Stabilizers Prototype Drug. Answer: Cromolyn
(Inhalation)
◉ Mast Cell Stabilizers MOA. Answer: is used for prophylaxis—not
quick relief—in patients with mild to moderate asthma; prescribed
for exercise-induced asthma. They STABILIZE MAST CELLS TO
REDUCE HISTAMINE RELEASE; , an inflammatory mediator.
◉ Cromolyn patient teaching. Answer: should be administered 10 to
15 minutes before anticipated exertion but no longer than 1 hour
before exercise.
◉ Advantages of Inhaled Route of Anti-Asthma Drugs. Answer: (1)
therapeutic effects are enhanced by delivering drugs directly to their
site of action, (2) systemic effects are minimized, and (3) relief of
acute attacks is rapid.
,◉ Methylxanthines MOA. Answer: Bronchodilation to decrease the
intensity and frequency of moderate to severe asthma attacks and to
control chronic obstructive pulmonary disease exacerbations
◉ Methylxanthines Prototype Drug. Answer: Theophylline
◉ Theophylline Toxicity Risk. Answer: can cause severe cardiac
dysrhythmias and convulsions
◉ Methylxanthines Contraindication. Answer: These drugs are
contraindicated for patients with untreated seizure disorders or
peptic ulcer disease
◉ Theophylline contraindication w/ Caffeine. Answer: can intensify
the adverse effects of the drug on the heart and CNS; Can decrease
drug metabolism.
◉ Theophylline contraindication w/ Smoking Tobacco or Marijuana.
Answer: can increase clearance to 50% in adults and 80% in older
adults; Can cause an ineffective dosing.
◉ Drugs that Reduce Theophylline Levels (CYP3A Inducers).
Answer: Phenobarbital, phenytoin, rifampin; May need to increase
, drug level if given in conjunction; Increase metabolism rate of target
drug;
◉ Drugs that Increase Theophylline Levels (CYP3A Inhibitors).
Answer: Cimetidine, fluoroquinolone antibiotics; May need to
reduce drug level if given in conjunction; These drugs will increase
AE associated w/ target drug due to prolonged activity and
decreased metabolism of target drug.
◉ Theophylline Lifespan Concerns. Answer: Elderly patients: Use
with extreme caution in elderly patients as these patients are at an
increased risk of serious toxicity.
Pediatric patients: Dose selection requires caution, and regular
monitoring of concentrations is necessary (especially if the child is
younger than 1 year of age) as the rate of clearance varies
significantly in these patients.
Pregnancy: Use cautiously only if risk outweighs benefit
◉ Roflumilast (Daliresp). Answer: phosphodiesterase-4 inhibitor
(PDE) approved for the treatment of COPD (and not asthma)
◉ Roflumilast MOA. Answer: selective action that inactivates cyclic
adenosine monophosphate (cAMP) which results in decreased
