NURS 615: ADVANCED
PHARMACOTHERAPEUTICS Maryville
university exam 4 with correct solutions
2025/2026 questions and answers highly
graded A+
What is the drug classification of Tiotropium? - CORRECT ANSWERS-->It is a long-
acting, 24H anticholinergic-bronchodilator.
>It is a muscurinic receptor antagonist, often referred to as an antimuscurinic or
anticholinergic agent.
What is the mechanism of action of Tiotropium (SPIRIVA) - CORRECT ANSWERS--It
does not display selectivity for specific muscarinic receptors, when topically applied it
acts mainly on M3 muscarinic receptors[8] located on smooth muscle cells and
submucosal glands. This leads to a reduction in smooth muscle contraction and mucus
secretion and thus produces a bronchodilatory effect.
What are the adverse effects with montelukast (Singular) - CORRECT ANSWERS--
Anxiety, aggression, depression, suicidal thoughts,
What patient teaching should accompany the prescription of montelukast (Singulair)? -
CORRECT ANSWERS--Teach pt regarding adverse effect about aggression ,
depression suicidal thoughts that could occur
What patient teaching should be provided when prescribing inhaled corticosteroids? -
CORRECT ANSWERS--They should be taken 2x a day every day for the use of
prevention of asthma.
Rinse mouth after use to prevent oral thrush.
What ethnic background should not be prescribed long-acting beta agonists? -
CORRECT ANSWERS--African Americans, increased incidence of death in this
population
What medication would you prescribe for bronchospasm for a patient taking
propranolol? - CORRECT ANSWERS--Ipratropium
What is the mechanism of action of albuterol? - CORRECT ANSWERS--Activation of
beta adrenergic receptors lead to relaxation of the muscle of the lung and opening and
dilation of the airway
, Beta adrenergic receptor are coupled with stimulatory g-protein of the the d-anelyl
cyclase> This enzyme produces the second messennger cyclic AMP (in the lungs it
cAMP decreases calcium concentration w/in cells and and activates protein kinase A.
Both of these inactivates myosin activase kinase and myosin like phosphatase
They open large conductants of hyperpolarize airway smooth muscle cells
What is the mechanism of action of inhaled corticosteroids? - CORRECT ANSWERS--
Extremely potent vasoconstrictive and anti-inflammatory activity.
When is it appropriate to use a short acting beta agonist? - CORRECT ANSWERS--the
drug of choice for acute treatment of asthma symptoms and exacerbations.
Relief of acute asthma attack.
LABA not used for acute rather used for long term treatment and prevention of asthma -
CORRECT ANSWERS--True
What is the mechanism of action of inhaled muscarinic receptor antagonists? -
CORRECT ANSWERS--Atropine (the prototype of muscarinic receptor antagonists)
prevents the effects of ACh by competitively blocking its binding to muscarinic receptors
in the CNS, peripheral ganglia, and at neuroeffector sites on smooth muscle, cardiac
muscle, and secretory glands.
What are side effects of atropine in patients with airway disease. - CORRECT
ANSWERS--Atropine inhibits secretions of the nose, mouth, pharynx, and bronchi and
thus causes dryness of the mucous membranes of the respiratory tract. This action is
especially marked if secretion is excessive and is the basis for the use of atropine and
scopolamine in preanesthetic medication. It causes depression of mucous secretion and
the inhibition of mucociliary clearance.
What are the adverse effects associated with inhaled corticosteroids? - CORRECT
ANSWERS--Cough, Thrush, dysphonia, cough and bronchospasm, thin skin, bone loss,
smell of burning plastic, HA, visual changes
What special populations should not be prescribed pseudoephedrine? - CORRECT
ANSWERS--Not to be used in children under four years of age, elderly, and patients
with HTN.
What drug should be prescribed for a patient with nasal congestion with hypertension? -
CORRECT ANSWERS--Coricidin HBP, chlorpheneramine
What are the adverse effects of antihistamines? - CORRECT ANSWERS--Dry mouth,
changes in vision, increased heart rate Urinary retention, constipation, increased HR,
pupil dilation, hallucination delirium Motor impairment (ataxia) flushed skin, cyclopesia,
sedation diff. conc. Visual disturbances
PHARMACOTHERAPEUTICS Maryville
university exam 4 with correct solutions
2025/2026 questions and answers highly
graded A+
What is the drug classification of Tiotropium? - CORRECT ANSWERS-->It is a long-
acting, 24H anticholinergic-bronchodilator.
>It is a muscurinic receptor antagonist, often referred to as an antimuscurinic or
anticholinergic agent.
What is the mechanism of action of Tiotropium (SPIRIVA) - CORRECT ANSWERS--It
does not display selectivity for specific muscarinic receptors, when topically applied it
acts mainly on M3 muscarinic receptors[8] located on smooth muscle cells and
submucosal glands. This leads to a reduction in smooth muscle contraction and mucus
secretion and thus produces a bronchodilatory effect.
What are the adverse effects with montelukast (Singular) - CORRECT ANSWERS--
Anxiety, aggression, depression, suicidal thoughts,
What patient teaching should accompany the prescription of montelukast (Singulair)? -
CORRECT ANSWERS--Teach pt regarding adverse effect about aggression ,
depression suicidal thoughts that could occur
What patient teaching should be provided when prescribing inhaled corticosteroids? -
CORRECT ANSWERS--They should be taken 2x a day every day for the use of
prevention of asthma.
Rinse mouth after use to prevent oral thrush.
What ethnic background should not be prescribed long-acting beta agonists? -
CORRECT ANSWERS--African Americans, increased incidence of death in this
population
What medication would you prescribe for bronchospasm for a patient taking
propranolol? - CORRECT ANSWERS--Ipratropium
What is the mechanism of action of albuterol? - CORRECT ANSWERS--Activation of
beta adrenergic receptors lead to relaxation of the muscle of the lung and opening and
dilation of the airway
, Beta adrenergic receptor are coupled with stimulatory g-protein of the the d-anelyl
cyclase> This enzyme produces the second messennger cyclic AMP (in the lungs it
cAMP decreases calcium concentration w/in cells and and activates protein kinase A.
Both of these inactivates myosin activase kinase and myosin like phosphatase
They open large conductants of hyperpolarize airway smooth muscle cells
What is the mechanism of action of inhaled corticosteroids? - CORRECT ANSWERS--
Extremely potent vasoconstrictive and anti-inflammatory activity.
When is it appropriate to use a short acting beta agonist? - CORRECT ANSWERS--the
drug of choice for acute treatment of asthma symptoms and exacerbations.
Relief of acute asthma attack.
LABA not used for acute rather used for long term treatment and prevention of asthma -
CORRECT ANSWERS--True
What is the mechanism of action of inhaled muscarinic receptor antagonists? -
CORRECT ANSWERS--Atropine (the prototype of muscarinic receptor antagonists)
prevents the effects of ACh by competitively blocking its binding to muscarinic receptors
in the CNS, peripheral ganglia, and at neuroeffector sites on smooth muscle, cardiac
muscle, and secretory glands.
What are side effects of atropine in patients with airway disease. - CORRECT
ANSWERS--Atropine inhibits secretions of the nose, mouth, pharynx, and bronchi and
thus causes dryness of the mucous membranes of the respiratory tract. This action is
especially marked if secretion is excessive and is the basis for the use of atropine and
scopolamine in preanesthetic medication. It causes depression of mucous secretion and
the inhibition of mucociliary clearance.
What are the adverse effects associated with inhaled corticosteroids? - CORRECT
ANSWERS--Cough, Thrush, dysphonia, cough and bronchospasm, thin skin, bone loss,
smell of burning plastic, HA, visual changes
What special populations should not be prescribed pseudoephedrine? - CORRECT
ANSWERS--Not to be used in children under four years of age, elderly, and patients
with HTN.
What drug should be prescribed for a patient with nasal congestion with hypertension? -
CORRECT ANSWERS--Coricidin HBP, chlorpheneramine
What are the adverse effects of antihistamines? - CORRECT ANSWERS--Dry mouth,
changes in vision, increased heart rate Urinary retention, constipation, increased HR,
pupil dilation, hallucination delirium Motor impairment (ataxia) flushed skin, cyclopesia,
sedation diff. conc. Visual disturbances
