Advanced pharmacology Verified Exam Questions and Answers Latest
update 2026/2027
Question:
1. Intermittent Asthma
Answer:
Intermittent, < 2 times/wk, <2 times month @ night, asymptomatic between exacerbations, rescue
inhaler < 2d/wk
Question:
2. Mild persistent
Answer:
Sx >2x/wk but < once/day; 3-4x/month nocturnal; reduced FEV1 @ 80% predicted; rescue inhaler
2d/wk but not daily; minor limitation on activity
Question:
3. moderate persistent
Answer:
daily symptoms; > 1 weekly nocturnal episode, not nightly; reduced FEV1 60%-80%,reduction in
FEV1/FVC ratio; rescue inhaler daily; some limitation of activity
Question:
4. severe persistent Severe persistent
Answer:
Symptoms throughout the day and nightly Reduced FEV1 d60 predicted, reduction in FEV1/FVC
ratio Use rescue inhaler several times a day Very limited physical activity
Question:
5. Diagnosis
Answer:
Diagnosis is made by a history of recurrent episodes of coughing, wheezing, chest tightness, or
shortness of breath. This is confirmed by spirometry. Spirometry will demonstrate obstruction with
positive post bronchodilator reversibility. Some patients early on in the disease process will have a
normal spirometry, this is particularly true for patients who only suffer from intermittent symptoms.
Other tests including an exercise challenge test, IgE, Eos, allergy panel, or a methacholine challenge
test can be used to further confirm a diagnosis
,Question:
6. Desired outcomes
Answer:
Prevent chronic and troublesome symptoms Infrequent use (2 or fewer days/week) of SABA Normal
or near normal pulmonary function. Normal activity levels Prevent exacerbations and need for ED
visits/hospitalizations. Prevent progressive loss of lung function Provide optimal pharmacotherapy
with minimal or no adverse effects
Question:
7. Step 1 in asthma As needed low dose ICS- formoterol vs low dose ICS and SABA together
(preferred
Answer:
controller) Step 1 is considered intermittent
Question:
8. Step 2 Asthma
Answer:
Daily low dose ICS or PRN ICS vs Low dose ICS and SABA vs LTRA (leukotriene receptor
antagonists) or low dose ICS taken when SABA taken (controller)
Question:
9. Step 3 Asthma
Answer:
Low dose ICS-LABA vs medium dose ICS vs Low-dose ICS+LTRA (considered moderate persistent)
Question:
10. Step 4 Asthma
Answer:
Medium dose ICS-LABA vs high-dose ICS, add on tiotripium vs add on LTRA (severe persistent)
Question:
11. Step 5 Asthma
Answer:
High dose ICS-LABA and refer for phenotypic assessment +/- add on therapy OCS (consider side
effects) (Severe persistent)
, Question:
12. Reliever for asthma
Answer:
Low dose ICS vs SABA
Question:
13. Non-pharmacologic therapy in Asthma
Answer:
Patient education and teaching of self-management skills Home PEF meter Avoidance of known
triggers Supplemental oxygen if acute severe asthma to keep sats >90%
Question:
14. Beta2-Adrenergic Agonists
Answer:
Relax airway smooth muscle by directly stimulating B2-adrenergic receptors Dilate airways, increase
mucous clearance, and stabilize mast cell membranes Comes in short-acting and long-acting
Question:
15. Beta2-Adrenergic Agonists Adverse Effects
Answer:
Tremor, nervousness, tachycardia. Caution in patients with arrhythmias- use Levalbuterol
Question:
16. Beta2-Adrenergic Agonists
Contraindications
Answer:
MAOIs and/or TCAs
Question:
17. SABAs (short acting beta agonists)
Answer:
Albuterol (ProAir, Proventil, RespiClick, Ventolin, AccuNeb) Levalbuterol (Xopenex) Usual dose for
an MDI is 2 inhalations q 4-6 hrs prn recommended for exacerbations only--only PRN---and if more
than one cannister a month then poor asthma control
update 2026/2027
Question:
1. Intermittent Asthma
Answer:
Intermittent, < 2 times/wk, <2 times month @ night, asymptomatic between exacerbations, rescue
inhaler < 2d/wk
Question:
2. Mild persistent
Answer:
Sx >2x/wk but < once/day; 3-4x/month nocturnal; reduced FEV1 @ 80% predicted; rescue inhaler
2d/wk but not daily; minor limitation on activity
Question:
3. moderate persistent
Answer:
daily symptoms; > 1 weekly nocturnal episode, not nightly; reduced FEV1 60%-80%,reduction in
FEV1/FVC ratio; rescue inhaler daily; some limitation of activity
Question:
4. severe persistent Severe persistent
Answer:
Symptoms throughout the day and nightly Reduced FEV1 d60 predicted, reduction in FEV1/FVC
ratio Use rescue inhaler several times a day Very limited physical activity
Question:
5. Diagnosis
Answer:
Diagnosis is made by a history of recurrent episodes of coughing, wheezing, chest tightness, or
shortness of breath. This is confirmed by spirometry. Spirometry will demonstrate obstruction with
positive post bronchodilator reversibility. Some patients early on in the disease process will have a
normal spirometry, this is particularly true for patients who only suffer from intermittent symptoms.
Other tests including an exercise challenge test, IgE, Eos, allergy panel, or a methacholine challenge
test can be used to further confirm a diagnosis
,Question:
6. Desired outcomes
Answer:
Prevent chronic and troublesome symptoms Infrequent use (2 or fewer days/week) of SABA Normal
or near normal pulmonary function. Normal activity levels Prevent exacerbations and need for ED
visits/hospitalizations. Prevent progressive loss of lung function Provide optimal pharmacotherapy
with minimal or no adverse effects
Question:
7. Step 1 in asthma As needed low dose ICS- formoterol vs low dose ICS and SABA together
(preferred
Answer:
controller) Step 1 is considered intermittent
Question:
8. Step 2 Asthma
Answer:
Daily low dose ICS or PRN ICS vs Low dose ICS and SABA vs LTRA (leukotriene receptor
antagonists) or low dose ICS taken when SABA taken (controller)
Question:
9. Step 3 Asthma
Answer:
Low dose ICS-LABA vs medium dose ICS vs Low-dose ICS+LTRA (considered moderate persistent)
Question:
10. Step 4 Asthma
Answer:
Medium dose ICS-LABA vs high-dose ICS, add on tiotripium vs add on LTRA (severe persistent)
Question:
11. Step 5 Asthma
Answer:
High dose ICS-LABA and refer for phenotypic assessment +/- add on therapy OCS (consider side
effects) (Severe persistent)
, Question:
12. Reliever for asthma
Answer:
Low dose ICS vs SABA
Question:
13. Non-pharmacologic therapy in Asthma
Answer:
Patient education and teaching of self-management skills Home PEF meter Avoidance of known
triggers Supplemental oxygen if acute severe asthma to keep sats >90%
Question:
14. Beta2-Adrenergic Agonists
Answer:
Relax airway smooth muscle by directly stimulating B2-adrenergic receptors Dilate airways, increase
mucous clearance, and stabilize mast cell membranes Comes in short-acting and long-acting
Question:
15. Beta2-Adrenergic Agonists Adverse Effects
Answer:
Tremor, nervousness, tachycardia. Caution in patients with arrhythmias- use Levalbuterol
Question:
16. Beta2-Adrenergic Agonists
Contraindications
Answer:
MAOIs and/or TCAs
Question:
17. SABAs (short acting beta agonists)
Answer:
Albuterol (ProAir, Proventil, RespiClick, Ventolin, AccuNeb) Levalbuterol (Xopenex) Usual dose for
an MDI is 2 inhalations q 4-6 hrs prn recommended for exacerbations only--only PRN---and if more
than one cannister a month then poor asthma control
