NR 565 Advanced Pharmacology Final Exam – Week 6 Study Guide: (Latest
2025/2026 Update) Pulmonary, Smoking Cessation, Tuberculosis | Q&A | Grade
A | 100% Correct (Verified Answers)
Subject: Advanced Pharmacology (NR 565) – Week 6: Asthma/COPD, Methylxanthines, Beta-Agonists,
Inhaled Corticosteroids, Smoking Cessation, Tuberculosis
Source: Final Exam Week 6 Blueprint – Step Therapy, Drug Classifications, Patient Education,
MDR/XDR-TB, Nicotine Replacement, Bupropion, Varenicline
Format: Q&A Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: Which patients are at higher risk for methylxanthine (theophylline) toxicity?
Correct Answer: Older adults, those with liver dysfunction, untreated seizure disorder, or peptic ulcer
disease
1. Theophylline is metabolized in the liver – liver disease decreases clearance → increased
toxicity risk.
2. Theophylline can lower seizure threshold – contraindicated in untreated seizure disorders.
3. Can exacerbate peptic ulcer disease due to gastric acid stimulation.
2: What are the symptom criteria for intermittent asthma?
Correct Answer: Symptoms 2 days/week or less; nighttime awakenings 2 times/month or less (≤2 for
ages 5+); SABA use 2 days/week or less; no activity limitation.
1. Intermittent asthma = Step 1 therapy (SABA PRN).
2. No daily medication needed.
3. Low risk for exacerbations (0-1 per year).
3: What are the criteria for mild persistent asthma?
Correct Answer: Symptoms >2 days/week but less than daily; nighttime awakenings 3-4 times/month
(ages 5+); SABA use >2 days/week but < daily and no more than 1 time/day; minimal activity
limitation.
1. Mild persistent = Step 2 therapy (low-dose ICS + SABA PRN).
2. Risk: ≥2 exacerbations/6 months or wheezing lasting >1 day ≥4 times/year.
3. Daily controller medication needed.
4: What are the criteria for moderate persistent asthma?
Correct Answer: Symptoms daily; nighttime awakenings >once/week but less than nightly (ages 5+);
SABA use daily; some activity limitation.
1. Moderate persistent = Step 3 or 4 therapy.
2. Ages 0-4: Step 3 (medium-dose ICS).
3. Ages 5-11: Step 3 or 4; Ages 12+: Step 4 or 5.
, 5: What are the criteria for severe persistent asthma?
Correct Answer: Symptoms several times daily; nighttime awakenings often nightly (ages 5+); SABA
use several times/day; severe activity limitation.
1. Severe persistent = Step 4 or 5 therapy.
2. May require high-dose ICS + LABA + oral corticosteroids.
3. Consider omalizumab for allergy-related asthma.
6: What are examples of Short-Acting Beta Agonists (SABA)?
Correct Answer: Albuterol (Proventil, ProAir, Ventolin), levalbuterol (Xopenex)
1. SABAs are rescue inhalers for acute asthma attacks – NOT for long-term use.
2. Activate beta-2 receptors in bronchial smooth muscle → bronchodilation.
3. Also used for exercise-induced bronchospasm prophylaxis (15-20 minutes before exercise).
7: What are the benefits and mechanisms of SABA?
Correct Answer: Promotes bronchodilation, relieves bronchospasm; limited role in suppressing
histamine release and increasing ciliary motility. Acute asthma attacks only.
1. All asthma patients should have a SABA rescue inhaler.
2. Patients with difficulty with hand-breath coordination should use a spacer with one-way valve.
3. Encourage daily peak expiratory flow monitoring and symptom diary.
8: Why is it important to know how frequently a patient uses their SABA?
Correct Answer: To assess the severity of asthma symptoms and determine if adjunct treatments are
needed for more severe cases. Increased use indicates poor control.
1. SABA use >2 days/week for symptom relief (not EIB prevention) indicates inadequate control.
2. Frequent SABA use is associated with increased risk of exacerbations and mortality.
3. Step up therapy if SABA use is increasing.
9: What are examples of Long-Acting Beta Agonists (LABA)?
Correct Answer: Formoterol (Foradil), Salmeterol (Serevent) – use caution in African Americans
1. LABAs should be taken on a fixed schedule (NOT PRN) and always in combination with
inhaled glucocorticoid.
2. LABA monotherapy in asthma is contraindicated (black box warning for asthma-related death).
3. LABAs are preferred over SABAs for stable COPD (better long-term control).
10: What is the LABA black box warning?
Correct Answer: All LABAs carry a risk of asthma-related deaths. LABA monotherapy is
contraindicated; must be prescribed with inhaled corticosteroid (ICS).
1. Fixed-dose combination inhalers (Advair, Symbicort, Dulera) are approved.
2. Black box does NOT apply to COPD use.
3. LABAs are not for acute symptom relief.
2025/2026 Update) Pulmonary, Smoking Cessation, Tuberculosis | Q&A | Grade
A | 100% Correct (Verified Answers)
Subject: Advanced Pharmacology (NR 565) – Week 6: Asthma/COPD, Methylxanthines, Beta-Agonists,
Inhaled Corticosteroids, Smoking Cessation, Tuberculosis
Source: Final Exam Week 6 Blueprint – Step Therapy, Drug Classifications, Patient Education,
MDR/XDR-TB, Nicotine Replacement, Bupropion, Varenicline
Format: Q&A Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: Which patients are at higher risk for methylxanthine (theophylline) toxicity?
Correct Answer: Older adults, those with liver dysfunction, untreated seizure disorder, or peptic ulcer
disease
1. Theophylline is metabolized in the liver – liver disease decreases clearance → increased
toxicity risk.
2. Theophylline can lower seizure threshold – contraindicated in untreated seizure disorders.
3. Can exacerbate peptic ulcer disease due to gastric acid stimulation.
2: What are the symptom criteria for intermittent asthma?
Correct Answer: Symptoms 2 days/week or less; nighttime awakenings 2 times/month or less (≤2 for
ages 5+); SABA use 2 days/week or less; no activity limitation.
1. Intermittent asthma = Step 1 therapy (SABA PRN).
2. No daily medication needed.
3. Low risk for exacerbations (0-1 per year).
3: What are the criteria for mild persistent asthma?
Correct Answer: Symptoms >2 days/week but less than daily; nighttime awakenings 3-4 times/month
(ages 5+); SABA use >2 days/week but < daily and no more than 1 time/day; minimal activity
limitation.
1. Mild persistent = Step 2 therapy (low-dose ICS + SABA PRN).
2. Risk: ≥2 exacerbations/6 months or wheezing lasting >1 day ≥4 times/year.
3. Daily controller medication needed.
4: What are the criteria for moderate persistent asthma?
Correct Answer: Symptoms daily; nighttime awakenings >once/week but less than nightly (ages 5+);
SABA use daily; some activity limitation.
1. Moderate persistent = Step 3 or 4 therapy.
2. Ages 0-4: Step 3 (medium-dose ICS).
3. Ages 5-11: Step 3 or 4; Ages 12+: Step 4 or 5.
, 5: What are the criteria for severe persistent asthma?
Correct Answer: Symptoms several times daily; nighttime awakenings often nightly (ages 5+); SABA
use several times/day; severe activity limitation.
1. Severe persistent = Step 4 or 5 therapy.
2. May require high-dose ICS + LABA + oral corticosteroids.
3. Consider omalizumab for allergy-related asthma.
6: What are examples of Short-Acting Beta Agonists (SABA)?
Correct Answer: Albuterol (Proventil, ProAir, Ventolin), levalbuterol (Xopenex)
1. SABAs are rescue inhalers for acute asthma attacks – NOT for long-term use.
2. Activate beta-2 receptors in bronchial smooth muscle → bronchodilation.
3. Also used for exercise-induced bronchospasm prophylaxis (15-20 minutes before exercise).
7: What are the benefits and mechanisms of SABA?
Correct Answer: Promotes bronchodilation, relieves bronchospasm; limited role in suppressing
histamine release and increasing ciliary motility. Acute asthma attacks only.
1. All asthma patients should have a SABA rescue inhaler.
2. Patients with difficulty with hand-breath coordination should use a spacer with one-way valve.
3. Encourage daily peak expiratory flow monitoring and symptom diary.
8: Why is it important to know how frequently a patient uses their SABA?
Correct Answer: To assess the severity of asthma symptoms and determine if adjunct treatments are
needed for more severe cases. Increased use indicates poor control.
1. SABA use >2 days/week for symptom relief (not EIB prevention) indicates inadequate control.
2. Frequent SABA use is associated with increased risk of exacerbations and mortality.
3. Step up therapy if SABA use is increasing.
9: What are examples of Long-Acting Beta Agonists (LABA)?
Correct Answer: Formoterol (Foradil), Salmeterol (Serevent) – use caution in African Americans
1. LABAs should be taken on a fixed schedule (NOT PRN) and always in combination with
inhaled glucocorticoid.
2. LABA monotherapy in asthma is contraindicated (black box warning for asthma-related death).
3. LABAs are preferred over SABAs for stable COPD (better long-term control).
10: What is the LABA black box warning?
Correct Answer: All LABAs carry a risk of asthma-related deaths. LABA monotherapy is
contraindicated; must be prescribed with inhaled corticosteroid (ICS).
1. Fixed-dose combination inhalers (Advair, Symbicort, Dulera) are approved.
2. Black box does NOT apply to COPD use.
3. LABAs are not for acute symptom relief.
