PAPER 2026 FULL SOLUTION GRADED A+
◉ What are examples of xanthine derivatives? Answer:
Theophylline, aminophylline, caffeine
◉ What is xanthine derivatives used for? Answer: Treatment of
asthma
◉ What is the MOA of xanthine derivatives? Answer: Produces and
increase in cAMP
= bronchial smooth muscle and pulmonary RELAXATION
◉ What are side effects of xanthine derivatives? Answer: Insomnia,
excitability, increased heart rate, GI upset
◉ What is special to know about xanthine derivatives? Answer: They
affect all body systems and theophylline lab values are necessary
(especially in patients with nausea, vomiting, and HA)
,◉ What are examples of leukotriene modifiers (leukotriene receptor
antagonists)? Answer: montelukast (Singulair), zafirlukast
(Accolate)
◉ What is the MOA of leukotriene antagonists? Answer:
Leukotrienes BLOCK the leukotrienes that have an important role in
the inflammatory process (leukotrienes cause smooth muscle
contraction, neutrophil aggregation, and chemotaxis)
◉ What are adverse effects and patient education for leukotriene
antagonists? Answer: 1. Anxiety
2. Depression
3. Agression
4. Suicidal thoughts
◉ What is an example of a monoclonal antibody drug? Answer:
omalizumab (Zolair)
◉ What is the use of omalizumab (Zolair)? Answer: Used in
moderate to severe asthma (subQ injection)
◉ What is the MOA of omalizumab (Zolair) (monoclonal antibody)?
Answer: Limits the binding of IgE to receptors on the surface of mast
cells and basophils
,◉ What are examples of intranasal corticosteroids? Answer:
mometasone (Nasonex), fluticasone (Flonase)
◉ What is the use of intranasal corticosteroids? Answer: Drug of
choice in treatment of allergic rhinitis
Also used in asthma
◉ What is the MOA of intranasal corticosteroids? Answer: Anti-
inflammatory -- they interrupt inflammation by inhibiting the
synthesis of mediators
◉ When are intranasal corticosteroids contraindicated? Answer:
Acute asthma attacks because there is NO relief of acute
bronchospasm
◉ What are side effects of inhaled corticosteroids? Answer: Mostly
drying or burning of nasal mucosa
RARE systemic absorption
◉ What are examples of 1st generation antihistamines? Answer: 1.
chlorpheniramine
, 2. diphenhydramine (Benadryl)
3. hydroxyzine (Atarax)
4. promethazine (Phenergan)
◉ 1st generation antihistamines have a GREAT effect on what?
Answer: central nervous system
◉ What should antihistamines not be used with? Answer: ETOH
◉ What are adverse effects of 1st generation antihistamines?
Answer: HIGH anticholinergic effects:
1. sedation
2. tinnitus
3. coordination problems
4. fatigue, HA, irritability, nervousness, blurred vision, tremors
5. Dry mouth, GI slowing, urinary retention
◉ What are examples of 2nd generation antihistamines? Answer: 1.
certrizine (Zyrtec)
2. fexofenadine (Allegra)
3. loratadine (Claritin)