NR565 WEEK 4 MIDTERM ADVANCED
PHARMACOLOGY REVIEW SCRIPT 2026
FULL ANSWERS GRADED A+
⩥ Inhaled glucocorticoids contraindication.
Answer: patients with persistently positive sputum cultures for Candida
albicans.
⩥ Oral Glucocorticoids.
Answer: may be required for patients with moderate to severe persistent
asthma or for management of acute exacerbations of asthma or COPD
when symptoms cannot be controlled with safer medications (inhaled
glucocorticoids, inhaled β2 agonists).
⩥ Oral Glucocorticoid AE.
Answer: prolonged therapy, even in moderate doses, can be hazardous.
Potential adverse effects include adrenal suppression, osteoporosis,
hyperglycemia, peptic ulcer disease, and, in young patients, growth
suppression.
⩥ Glucocorticoids Prototype Drugs.
Answer: Beclomethasone, Budesonide, Fluticasone (inhaled)
Prednisone, Methylprednisolone (oral)
,⩥ Leukotriene Receptor Antagonists (LTRA) MOA.
Answer: block the action of leukotrienes in the lungs and bronchial
tubes, which reduces bronchoconstriction. used for the prevention and
chronic treatment of asthma and the prevention of exercise-induced
bronchospasm in both adults and children.
⩥ Montelukast (Singulair):.
Answer: most commonly used leukotriene modulator. The drug has three
approved indications: (1) prophylaxis and maintenance therapy of
asthma in patients at least 1 year old; (2) prevention of exercise-induced
bronchospasm (EIB) in patients at least 15 years old; and (3) relief of
allergic rhinitis
⩥ 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.
PHARMACOLOGY REVIEW SCRIPT 2026
FULL ANSWERS GRADED A+
⩥ Inhaled glucocorticoids contraindication.
Answer: patients with persistently positive sputum cultures for Candida
albicans.
⩥ Oral Glucocorticoids.
Answer: may be required for patients with moderate to severe persistent
asthma or for management of acute exacerbations of asthma or COPD
when symptoms cannot be controlled with safer medications (inhaled
glucocorticoids, inhaled β2 agonists).
⩥ Oral Glucocorticoid AE.
Answer: prolonged therapy, even in moderate doses, can be hazardous.
Potential adverse effects include adrenal suppression, osteoporosis,
hyperglycemia, peptic ulcer disease, and, in young patients, growth
suppression.
⩥ Glucocorticoids Prototype Drugs.
Answer: Beclomethasone, Budesonide, Fluticasone (inhaled)
Prednisone, Methylprednisolone (oral)
,⩥ Leukotriene Receptor Antagonists (LTRA) MOA.
Answer: block the action of leukotrienes in the lungs and bronchial
tubes, which reduces bronchoconstriction. used for the prevention and
chronic treatment of asthma and the prevention of exercise-induced
bronchospasm in both adults and children.
⩥ Montelukast (Singulair):.
Answer: most commonly used leukotriene modulator. The drug has three
approved indications: (1) prophylaxis and maintenance therapy of
asthma in patients at least 1 year old; (2) prevention of exercise-induced
bronchospasm (EIB) in patients at least 15 years old; and (3) relief of
allergic rhinitis
⩥ 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.
