GGG's Asthma and autocoids review questions
Questions with Detailed Verified Answers
Which of the following anti-asthma drug can cause esophageal candidiasis?
a.Zafirlukast
b.Ipratropium
c.Nedocromil
d.Salmeterol
e.Beclomethasone Ans: Beclomethasone is a glucocorticoid that is used in the inhaled
form to reduce the inflammation associated with the pathophysiology that underlies
asthma. A side effect of using this type of immunosuppressant drug is opportunistic
infections such as thrush or oral/esophageal candidiases.
Ipratropium bromide is beneficial in asthma, because it
a.Inhibits adrenergic effects on bronchi
b.Stimulates vagal effects on bronchi
c.Inhibits the effects of acetylcholine in the bronchi
d.Inhibits cytokine production
e.Inhibits mast cell degranulation Ans: Ipratropium and the longer acting tiotropium
are quaternary amine (doesn't pass readily through lipid bilayers) that block muscarinic
receptors. In this case the M3 receptors on the lungs are antagonized preventing
acetylcholine from activating these receptors. This blocks vagal induced
bronchoconstriction and mucous secretion. Note. These drugs are reserved for acute
asthmatic attacks in combination with beta 2 drugs and glucocorticoids. They are the
primary drugs to treat COPD.
,The most widely used, safe and effective drugs used to decrease bronchoconstriction
during an asthmatic attack is which of the following?
a.Methylxanthine
b. Beta-2-selective sympathomimetics
c.Corticosteroids
d. Leukotriene-pathway inhibitors
e.Potassium-sparing agents Ans: Beta-2-selective sympathomimetics (e.g. albuterol).
Methylxanthine, like theophylline, are phosphodiesterase inhibitors with many systemic
side effects. Corticosteroids and leukotriene pathway inhibitors are used to reduce
inflammation.
Which statement regarding cromolyn is CORRECT?
a.Relaxes the bronchial smooth muscle directly
b.Prevents bronchoconstriction caused by exercise
c.Inhibits muscarinic action on smooth muscle
d. Is used for the treatment for acute asthmatic attacks
e.Stimulates the degranulation of mast cells Ans: Prevents bronchoconstriction caused
by exercise. Cromolyn and nedocromil alter chloride conductance in mast cells
reducing degranulation (Histamine release). Based on this mechanism of action it is
used ONLY prophylactically. It can be used for allergic rhinitis and as a before
treatment for things like exercise induced asthma.
The mechanism of action of zileuton is similar to that of
a. Beclomethasone
© Get it right 2025 Getaway - Stuvia US All rights reserved
, b.Ipratropium bromide
c. Terbutaline
d. Cromolyn
e. Zafirlukast Ans: Zileuton inhibits the enzyme, 5' lipoxygenase, responsible for the
production of leukotrienes associated with inflammation and bronchoconstriction.
The other drug that affects leukotriene function is zafirlukast (leukotriene receptor
antagonist--notice the ast ending which looks like an abbreviation for antagonist).
Because of its narrow therapeutic window, the plasma concentration of one of the
following drugs should be determined in patients. Which drug is it?
a Theophylline
b Nedocromil
c Albuterol
d Zafirlukast
e Budesonide Ans: Theophylline: Theophylline is a phosphodiesterase inhibitor.
Phosphodiesterases are a family of enzyme is responsible for breaking down cyclic
nucleotides like cGMP and cAMP into the open monophosphate forms. Theophylline is
a relatively non-specific phosphodiesterase inhibitor so it will increase cAMP in the
lung to produce smooth muscle relaxation. It will also increase cAMP in the heart that
can result in tachycardia and in the vasculature that will result in vasodilation. These
later two effects can lead to arrhythmias or severe hypotension. Therefore, it is
important to measure plasma levels of theophylline because of its narrow therapeutic
window.
© Get it right 2025 Getaway - Stuvia US All rights reserved
Questions with Detailed Verified Answers
Which of the following anti-asthma drug can cause esophageal candidiasis?
a.Zafirlukast
b.Ipratropium
c.Nedocromil
d.Salmeterol
e.Beclomethasone Ans: Beclomethasone is a glucocorticoid that is used in the inhaled
form to reduce the inflammation associated with the pathophysiology that underlies
asthma. A side effect of using this type of immunosuppressant drug is opportunistic
infections such as thrush or oral/esophageal candidiases.
Ipratropium bromide is beneficial in asthma, because it
a.Inhibits adrenergic effects on bronchi
b.Stimulates vagal effects on bronchi
c.Inhibits the effects of acetylcholine in the bronchi
d.Inhibits cytokine production
e.Inhibits mast cell degranulation Ans: Ipratropium and the longer acting tiotropium
are quaternary amine (doesn't pass readily through lipid bilayers) that block muscarinic
receptors. In this case the M3 receptors on the lungs are antagonized preventing
acetylcholine from activating these receptors. This blocks vagal induced
bronchoconstriction and mucous secretion. Note. These drugs are reserved for acute
asthmatic attacks in combination with beta 2 drugs and glucocorticoids. They are the
primary drugs to treat COPD.
,The most widely used, safe and effective drugs used to decrease bronchoconstriction
during an asthmatic attack is which of the following?
a.Methylxanthine
b. Beta-2-selective sympathomimetics
c.Corticosteroids
d. Leukotriene-pathway inhibitors
e.Potassium-sparing agents Ans: Beta-2-selective sympathomimetics (e.g. albuterol).
Methylxanthine, like theophylline, are phosphodiesterase inhibitors with many systemic
side effects. Corticosteroids and leukotriene pathway inhibitors are used to reduce
inflammation.
Which statement regarding cromolyn is CORRECT?
a.Relaxes the bronchial smooth muscle directly
b.Prevents bronchoconstriction caused by exercise
c.Inhibits muscarinic action on smooth muscle
d. Is used for the treatment for acute asthmatic attacks
e.Stimulates the degranulation of mast cells Ans: Prevents bronchoconstriction caused
by exercise. Cromolyn and nedocromil alter chloride conductance in mast cells
reducing degranulation (Histamine release). Based on this mechanism of action it is
used ONLY prophylactically. It can be used for allergic rhinitis and as a before
treatment for things like exercise induced asthma.
The mechanism of action of zileuton is similar to that of
a. Beclomethasone
© Get it right 2025 Getaway - Stuvia US All rights reserved
, b.Ipratropium bromide
c. Terbutaline
d. Cromolyn
e. Zafirlukast Ans: Zileuton inhibits the enzyme, 5' lipoxygenase, responsible for the
production of leukotrienes associated with inflammation and bronchoconstriction.
The other drug that affects leukotriene function is zafirlukast (leukotriene receptor
antagonist--notice the ast ending which looks like an abbreviation for antagonist).
Because of its narrow therapeutic window, the plasma concentration of one of the
following drugs should be determined in patients. Which drug is it?
a Theophylline
b Nedocromil
c Albuterol
d Zafirlukast
e Budesonide Ans: Theophylline: Theophylline is a phosphodiesterase inhibitor.
Phosphodiesterases are a family of enzyme is responsible for breaking down cyclic
nucleotides like cGMP and cAMP into the open monophosphate forms. Theophylline is
a relatively non-specific phosphodiesterase inhibitor so it will increase cAMP in the
lung to produce smooth muscle relaxation. It will also increase cAMP in the heart that
can result in tachycardia and in the vasculature that will result in vasodilation. These
later two effects can lead to arrhythmias or severe hypotension. Therefore, it is
important to measure plasma levels of theophylline because of its narrow therapeutic
window.
© Get it right 2025 Getaway - Stuvia US All rights reserved