GNRS 5670 EXAM 2 ACTUAL SCRIPT 2026
COMPLETE QUESTIONS AND CORRECT
ANSWERS GRADED A+
◉ bronchitis (COPD) pathway to airflow limitation.
Answer: - continuous irritation from smoke/pollution >
inflammation > bronchial edema/hyper secretion of mucus > airway
obstruction
◉ emphysema (COPD) pathway to airflow limitation.
Answer: - continuous irritation from smoke/pollution >
inflammation > increased protease activity > destruction of alveolar
walls > airway obstruction
◉ considerations for metered dose inhalers (MDIs).
Answer: - most commonly prescribed
- must coordinate between activation and inhalation
- notorious for incorrect use: patient education necessary
- more drug reaches lungs with use of spacer (21% vs 9%)
◉ considerations for dry powder inhaler (DPIs).
,Answer: - activated by inhalation (no coordination/spacer
necessary)
- improved medication delivery to lungs
◉ considerations for nebulizers.
Answer: - fine mist droplets
- no coordination necessary
- powered equipment (not portable, needs battery or plug)
◉ considerations for respimats.
Answer: - better than other drug inhalation delivery devices
- activated by inhalation (no coordination)
- fine mist droplets (better delivery to lower respiratory tract)
- portable
◉ Uses for pulmonary glucocorticoids.
Answer: asthma and COPD
◉ routes for pulmonary glucocorticoids.
Answer: - oral
- parenteral
- inhalation
,◉ mechanism of pulmonary glucocorticoids.
Answer: - anti-inflammatory
- immunosuppressant
◉ pulmonary glucocorticoid prototypes (and their routes).
Answer: - fluticasone/budesonide (inhalation)
- prednisone/prednisolone (oral)
- methylprednisolone (IV)
◉ indications for pulmonary glucocorticoids.
Answer: *prophylaxis for obstructive airway diseases*
- inhaled
- on a fixed schedule
- controller medication
*temporary use for severe obstructive disease when unable to
deliver drug via inhalation*
- oral or parenteral
- ex: no airway movement during status asthmaticus finch
◉ side effects for pulmonary glucocorticoids.
, Answer: - thrush (oral candidiasis): rinse mouth after usage of
inhaled agents to prevent this
- hyperglycemia
- peptic ulcer disease
theoretical side effects
- immunosuppression
- skeletal muscle growth suppression in children
- bone loss
- adrenal suppression
◉ why are side effects of inhaled glucocorticoids rare (other than
thrush)?.
Answer: These side effects are predictable for glucocorticoid use.
However, the inhaled dose for asthma patients is typically too low to
elicit any of these effects. They may be seen during long term oral
use, which is also uncommon for asthma patients.
◉ short acting beta agonists (SABA) prototype and route.
Answer: - albuterol
- oral or inhaled
◉ long acting beta agonists (LABA) prototype.
COMPLETE QUESTIONS AND CORRECT
ANSWERS GRADED A+
◉ bronchitis (COPD) pathway to airflow limitation.
Answer: - continuous irritation from smoke/pollution >
inflammation > bronchial edema/hyper secretion of mucus > airway
obstruction
◉ emphysema (COPD) pathway to airflow limitation.
Answer: - continuous irritation from smoke/pollution >
inflammation > increased protease activity > destruction of alveolar
walls > airway obstruction
◉ considerations for metered dose inhalers (MDIs).
Answer: - most commonly prescribed
- must coordinate between activation and inhalation
- notorious for incorrect use: patient education necessary
- more drug reaches lungs with use of spacer (21% vs 9%)
◉ considerations for dry powder inhaler (DPIs).
,Answer: - activated by inhalation (no coordination/spacer
necessary)
- improved medication delivery to lungs
◉ considerations for nebulizers.
Answer: - fine mist droplets
- no coordination necessary
- powered equipment (not portable, needs battery or plug)
◉ considerations for respimats.
Answer: - better than other drug inhalation delivery devices
- activated by inhalation (no coordination)
- fine mist droplets (better delivery to lower respiratory tract)
- portable
◉ Uses for pulmonary glucocorticoids.
Answer: asthma and COPD
◉ routes for pulmonary glucocorticoids.
Answer: - oral
- parenteral
- inhalation
,◉ mechanism of pulmonary glucocorticoids.
Answer: - anti-inflammatory
- immunosuppressant
◉ pulmonary glucocorticoid prototypes (and their routes).
Answer: - fluticasone/budesonide (inhalation)
- prednisone/prednisolone (oral)
- methylprednisolone (IV)
◉ indications for pulmonary glucocorticoids.
Answer: *prophylaxis for obstructive airway diseases*
- inhaled
- on a fixed schedule
- controller medication
*temporary use for severe obstructive disease when unable to
deliver drug via inhalation*
- oral or parenteral
- ex: no airway movement during status asthmaticus finch
◉ side effects for pulmonary glucocorticoids.
, Answer: - thrush (oral candidiasis): rinse mouth after usage of
inhaled agents to prevent this
- hyperglycemia
- peptic ulcer disease
theoretical side effects
- immunosuppression
- skeletal muscle growth suppression in children
- bone loss
- adrenal suppression
◉ why are side effects of inhaled glucocorticoids rare (other than
thrush)?.
Answer: These side effects are predictable for glucocorticoid use.
However, the inhaled dose for asthma patients is typically too low to
elicit any of these effects. They may be seen during long term oral
use, which is also uncommon for asthma patients.
◉ short acting beta agonists (SABA) prototype and route.
Answer: - albuterol
- oral or inhaled
◉ long acting beta agonists (LABA) prototype.
