Pulmonary #1

Asthma Anesthesia Pharmacology Chapter 19: Co-Existing Conditions (Asthma) Practice Questions

May precipitate acute asthma:
1. exercise
2. aspirin
3. respiratory infection
4. A, B, C
Some asthmatic patients exhibit aspirin sensitivity (and sensitivity to other NSAIDS). Daily administration of aspirin causes desensitization not only to aspirin also to other NSAIDS. This phenomenon is:
1. the placebo effect
2. cross-tolerance
3. efficacy
4. potency
A thirty-eight year old asthmatic who has been using beta adrenergic agonists for several years began to experience arrhythmias, premature atrial contractions. In order to suppress the arrhythmias, high-dose metoprolol therapy was started. Suggest a likely consequence:
1. The cardioselective beta-blocker, metoprolol, alleviated the arrhythmia and did not affect the patient's asthma symptoms
2. Since metoprolol is a beta agonist, the patient's arrhythmias worsened, but symptoms of asthma improved.
3. The expiratory component of the patient's flow/volume curve was shortened.
4. Metoprolol increased airway obstruction, worsening the patient's asthma, but improved the cardiac rhythm disorder.
Anti-asthma agent that acts in part by activating pulmonary beta-receptors thus increasing cAMP
1. ipratropium
2. terbutaline
3. cromolyn
4. methoxamine
An asthmatic is prescribed an adrenergic agent. After administration, the drug makes the patient tachycardiac and nervous. This drug was probably:
1. albuterol
2. isoproterenol
3. terbutaline
4. A & C
V/Q (ventilation/perfusion) mismatching which occurs in severe asthma results in hypoxemia. Terbutaline inhalation inproves the V/Q ratio. Why?
1. Increased cardiac output increases pulmonary artery perfusion pressure in the lung
2. Pulmonary vasodilation improves V/Q mismatching
3. Bronchiolar relaxation improves ventilation.
4. Actually, it is the use of supplimental oxygen that is more important than terbutaline.
Correct drug:property combination
1. theophylline: hepatic oxidation and demethylation
2. albuterol: beta2 adrenergic blocker
3. ipratropium bromide: well-absorbed quaternary anticholinergic; associated with dry mouth
4. Beclomethasone: enhances release of chemical mediators of bronchospasm which diminishes effectiveness of beta-2 adrenergic agonists.
Corticosteroids and the treatment of asthma:
1. Corticosteroids relax smooth muscle
2. Corticosteroids inhibit the inflammatory response.
3. Corticosteroids reduce patient responsiveness to beta agonists
4. In acute asthma, corticosteroids increase airway obstruction; therefore corticosteroids should only be used for chronic treatment.
Phosphodiesterase-inhibitor used in asthma therapy:
1. ipratropium bromide
2. aminophylline
3. metaproterenol
4. cyclosporine
Prophylactic antiasthmatic drug probably acts by preventing release of bronchoconstrictive mediators from mast cells:
1. beclomethasone
2. cromolyn
3. metaproterenol
4. albuterol