Nagelhout Pharm 2 test 3 ACTUAL
Questions and CORRECT Answers
What are the 4 different classifications of Asthma? - CORRECT ANSWER - Mild
intermittent
Mild persistent
Moderate persistent
Severe persistent
Step 1 Mild intermittent - CORRECT ANSWER - 1. Signs and symptoms twice per week.
2. Generally symptomatic with normal peak flows between exacerbation.
3. Brief exacerbations, intensity may vary.
4. Nighttime symptoms occur twice per month FEV1 or PEFR >80% predicted value.
Treatment of Mild Intermittent Asthma - CORRECT ANSWER - Short-acting bronchodilator
as needed: Inhaled Beta 2 agonists are first line selection.
Step 2 Mild Persistent Asthma - CORRECT ANSWER - 1. Signs and symptoms >twice per
week but <once per day.
2. Exacerbations may affect activity.
3. Nighttime symptoms occur >twice per month.
4. FEV1 or PEFR to 8-% of predicted value.
Treatment of Mild Persistent Asthma - CORRECT ANSWER - Long term anti inflammatory
medication: Inhaled corticosteroid, cromolyn or nedocromil particularly in children, sustained
release theophylline is an alternative and zafirlulast or zieuton may be considered for patients
>12 years old.
Step 3 Moderate Persistent Asthma. - CORRECT ANSWER - 1. Daily Symptoms
2. Daily use of short-acting beta agonist.
,3. Exacerbations that affect activity occur >twice per week and may last for days.
4. Nighttime symptoms occur >once per week.
5. FEV1 and PEFR 60% of 80% of predicted value?
Treatment of Moderate Persistent Asthma - CORRECT ANSWER - Long term control
medications: medium-dose inhaledcorticosteroids or low to medium dose inhaled corticosteroids
plus long-acting bronchodilator (inhaled or oral beta agonist, sustatined release theophylline),
especially for nocturnal symptoms.
Step 4 Severe Persistent Asthma - CORRECT ANSWER - 1. Continuous signs and
symptoms, frequently exacerbated.
2. Frequent nighttime symptoms
3. Limited physical activity.
4. FEV1 or PEFR 60% of predicted value.
Treatment of Severe Persistent Asthma - CORRECT ANSWER - High-dose inhaled
corticosteroids, long-acting bronchodilators, as indicated in step 3. Systemic corticosteroids (e.g.
prednisone).
A patient with frequent asthma exacerbation's that limit physical activity and a PEFR that is 60%
of their predicted value would be classified as ? - CORRECT ANSWER - Severe persistent
asthma
A patient with occasional asthma systoms (less than twice a week) and a PEFR that is 80% of
their predicted value would be classified as ? - CORRECT ANSWER - Mild Intermittent
asthma
A patient with sign & symptoms of asthma more than twice a week and nightly symptoms more
than twice a month, and a PEFR that is => 80% of their predicted value would be classified as ? -
CORRECT ANSWER - Mild persistent asthma
, A person with daily symptoms, exacerbation's that can last for days, nighttime symptoms that
occur at least twice per week, and a PEFR 60 to 80% of predicted value would be classifed as ? -
CORRECT ANSWER - Moderate persistent asthma
In which patients should H2 antagonists and Beta-blockers be avoided? - CORRECT
ANSWER - Asthmatics. (H2 blockers block the negative feedback mechanism and can result
in bronchospasm)
What is the preferred treatment for prophylaxis of chronic asthma? - CORRECT ANSWER -
Inhaled steroids
Which of the drugs used perioperatively would have to be avoided or used with caution in
asthmatic patients? - CORRECT ANSWER - Beta blockers obviously
Which group of drugs are most effective in managing chronic asthma? - CORRECT
ANSWER - Inhalation corticosteroids
What is the treatment for acute bronchoconstriction? - CORRECT ANSWER - Beta-2
agonists (Short acting Bronch dilators)
Which drugs cause histamine release? - CORRECT ANSWER - Phenanthrenes (Opioids),
Atracurium, Sux
Which would be the induction drug of choice in a patient that requires emergency surgery but
has active asthmatic symptoms? - CORRECT ANSWER - Ketamine
Most common types of IgE mediated allergic reactions - CORRECT ANSWER - 1.
Neuromuscular blocking agent
2. Latex
3. Antibiotics
Questions and CORRECT Answers
What are the 4 different classifications of Asthma? - CORRECT ANSWER - Mild
intermittent
Mild persistent
Moderate persistent
Severe persistent
Step 1 Mild intermittent - CORRECT ANSWER - 1. Signs and symptoms twice per week.
2. Generally symptomatic with normal peak flows between exacerbation.
3. Brief exacerbations, intensity may vary.
4. Nighttime symptoms occur twice per month FEV1 or PEFR >80% predicted value.
Treatment of Mild Intermittent Asthma - CORRECT ANSWER - Short-acting bronchodilator
as needed: Inhaled Beta 2 agonists are first line selection.
Step 2 Mild Persistent Asthma - CORRECT ANSWER - 1. Signs and symptoms >twice per
week but <once per day.
2. Exacerbations may affect activity.
3. Nighttime symptoms occur >twice per month.
4. FEV1 or PEFR to 8-% of predicted value.
Treatment of Mild Persistent Asthma - CORRECT ANSWER - Long term anti inflammatory
medication: Inhaled corticosteroid, cromolyn or nedocromil particularly in children, sustained
release theophylline is an alternative and zafirlulast or zieuton may be considered for patients
>12 years old.
Step 3 Moderate Persistent Asthma. - CORRECT ANSWER - 1. Daily Symptoms
2. Daily use of short-acting beta agonist.
,3. Exacerbations that affect activity occur >twice per week and may last for days.
4. Nighttime symptoms occur >once per week.
5. FEV1 and PEFR 60% of 80% of predicted value?
Treatment of Moderate Persistent Asthma - CORRECT ANSWER - Long term control
medications: medium-dose inhaledcorticosteroids or low to medium dose inhaled corticosteroids
plus long-acting bronchodilator (inhaled or oral beta agonist, sustatined release theophylline),
especially for nocturnal symptoms.
Step 4 Severe Persistent Asthma - CORRECT ANSWER - 1. Continuous signs and
symptoms, frequently exacerbated.
2. Frequent nighttime symptoms
3. Limited physical activity.
4. FEV1 or PEFR 60% of predicted value.
Treatment of Severe Persistent Asthma - CORRECT ANSWER - High-dose inhaled
corticosteroids, long-acting bronchodilators, as indicated in step 3. Systemic corticosteroids (e.g.
prednisone).
A patient with frequent asthma exacerbation's that limit physical activity and a PEFR that is 60%
of their predicted value would be classified as ? - CORRECT ANSWER - Severe persistent
asthma
A patient with occasional asthma systoms (less than twice a week) and a PEFR that is 80% of
their predicted value would be classified as ? - CORRECT ANSWER - Mild Intermittent
asthma
A patient with sign & symptoms of asthma more than twice a week and nightly symptoms more
than twice a month, and a PEFR that is => 80% of their predicted value would be classified as ? -
CORRECT ANSWER - Mild persistent asthma
, A person with daily symptoms, exacerbation's that can last for days, nighttime symptoms that
occur at least twice per week, and a PEFR 60 to 80% of predicted value would be classifed as ? -
CORRECT ANSWER - Moderate persistent asthma
In which patients should H2 antagonists and Beta-blockers be avoided? - CORRECT
ANSWER - Asthmatics. (H2 blockers block the negative feedback mechanism and can result
in bronchospasm)
What is the preferred treatment for prophylaxis of chronic asthma? - CORRECT ANSWER -
Inhaled steroids
Which of the drugs used perioperatively would have to be avoided or used with caution in
asthmatic patients? - CORRECT ANSWER - Beta blockers obviously
Which group of drugs are most effective in managing chronic asthma? - CORRECT
ANSWER - Inhalation corticosteroids
What is the treatment for acute bronchoconstriction? - CORRECT ANSWER - Beta-2
agonists (Short acting Bronch dilators)
Which drugs cause histamine release? - CORRECT ANSWER - Phenanthrenes (Opioids),
Atracurium, Sux
Which would be the induction drug of choice in a patient that requires emergency surgery but
has active asthmatic symptoms? - CORRECT ANSWER - Ketamine
Most common types of IgE mediated allergic reactions - CORRECT ANSWER - 1.
Neuromuscular blocking agent
2. Latex
3. Antibiotics
