Therapeutics 2 Tutoring: Asthma By Alaina Darby

Which of the following is most important and most common in asthma? Mast cells Eosinophils T lymphocytes neutrophils b

Which of the following is an indicator of asthma death? Mast cells Eosinophils T lymphocytes neutrophils d

Which of the following is most responsible for the early response (within minutes)? Mast cells Eosinophils T lymphocytes neutrophils a

Which of the following is highly involved in the late response (hours) and hyperresponsiveness with repeated exposure? Mast cells Eosinophils T lymphocytes neutrophils b

Amy is a 4 year old patient whose mother smokes Amy is a 4 year old patient whose mother smokes. How should she be treated? Low dose ICS Cromolyn Low dose ICS + Theophylline Low dose ICS + LABA d

Which of the following should you recommend to a 22 y/o woman with asthma who has GERD and whose asthma is worse close to menstruation? PPI Pneumococcal vaccine Oral contraceptives H2 blocker b

Which of the following is not a risk factor for increased asthma severity? Obesity Post-menstruation Gerd rhinitis b

Which of the following would be least likely to contribute to exercise induced asthma? Warm, humid climate Respiratory infection Severe asthma Large exercise load a

TK is a 24 y/o female with asthma TK is a 24 y/o female with asthma. Her maintenance treatment includes Advair and an albuterol inhaler for breakthrough symptoms. Which of the following would not be a counseling point to prevent her exercise induced asthma? Warmup before exercise Exercise indoors Albuterol 5-15 minutes before exercise Scarf over the mouth if exercising outside c

TD is a 3 y/O male who presents to your pharmacy with a wheeze, cough, and dyspnea, which his mother says get worse at night. sHe reports that His symptoms occur on a daily basis and wake him from sleep at least 1-2x a week. With What stage of asthma should he be diagnosed? Intermittent Mild Moderate Severe d

AJ is a 22 y/O male who presents to your pharmacy with a wheeze, cough, and dyspnea, which he says get worse at night and with exercise. He reports that it does cause interference with daily activities but not too much. His symptoms occur on a daily basis and wake him from sleep at least 1-2x a week. With What stage of asthma should he be diagnosed? Intermittent Mild Moderate Severe c

How should AJ be treated? SABA PRN Theophylline Low dose ics + LTRA Low dose ICS + LABA d

AJ’s personal best pefr is 376. currently his pefr is 223 AJ’s personal best pefr is 376. currently his pefr is 223. where is he currently? Green zone Yellow zone Red zone Friend zone b

BK is using his SABA once per week and is currently using a low dose ICS + LABA for therapy. Which of the following would be the preferred alteration of his therapy? Change to medium dose ICS Step down to low dose Ics Step up to medium dose icS + laba No change is needed d

Which of the following is not true of asthma management? Type of medication is dictated by asthma severity for initiating therapy amount of medication is dictated by asthma severity for initiating therapy Type of medication is dictated by asthma control for initiating therapy scheduling of medication is dictated by asthma control for adjusting therapy c

Which of the following follow up periods would not be appropriate for the indication? 2 weeks after initiation 8 months for well controlled patient 3 months for step down therapy 1 month after initiation b

Which of the following would be preferred for a 7 y/o patient who needs step 3 therapy? Low dose ics + laba Low dose ics Medium dose ics + laba Medium dose ics a

Which of the following is in qvar? Beclomethasone Budesonide Fluticasone Mometasone ciclesonide a

Which of the following is in alvesco? Beclomethasone Budesonide Fluticasone Mometasone ciclesonide e

Which of the following is in pulmicort? Beclomethasone Budesonide Fluticasone Mometasone ciclesonide b

Which of the following is in symbicort? Beclomethasone Budesonide Fluticasone Mometasone ciclesonide b

Which of the following is in advair? Beclomethasone Budesonide Fluticasone Mometasone ciclesonide c

Which of the following is in dulera? Beclomethasone Budesonide Fluticasone Mometasone ciclesonide d

How often should ICS’s be given? Daily Twice a day Three times a day As needed b

Which of the following is suitable for all patients? Saba for breakthrough symptoms Allergen avoidance for general control Ics for long term control b

Which of the following patients would it not be necessary to refer to a specialist? Exacerbation requiring hospitalization Considering omalizumab Using medium dose ics +laba Using theophylline d

Which of the following is not a suitable long-term regimen? Budesonide Formoterol Advair flovent b

Which of the following is a key counseling point for all inhalers? Breathe out first gently over several seconds Rinse and spit afterward Breath in fast and deep Inhale slowly over 4-5 seconds a

What is an important counseling point for the handihaler? Inhale slowly for 4-5 seconds Make sure hands are dry when handling Shake before inhaling Hold breath for 2-4 seconds after inhaling b

Which of the following patients would be the best fit to receive xolair? Frequent ed visits and hospitalizations with low baseline immunoglobulin-e Add on for Patient with allergies Using medium dose ics + laba patient using albuterol several times per day on Advair 500/50 and allergies Alternative to laba due to concern for asthma related death c

Which of the following has the most potential for mdi technique improvement via counseling? Shake well Exhaling slowly before use Removing cap Place between lips b

Which of the following IS THE MOST IMPORTANT FOR HOSPITAL discharge DUE TO asthma? SALMETEROL PRESCRIPTION ALBUTEROL PRESCRIPTION PULMICORT PRESCRIPTION REFERRAL TO PCP FOR PRESCRIPTION C

Which of the following people will likely have to take the largest dose of theophylline? 60 y/o patient who has liver failure due to chronic alcoholism 45 y/o patient with heart failure taking cimetidine for reflux 4 y/o patient taking phenobarbital for seizures 20 y/o patient who smokes and is taking oral contraceptives c

Do you remember AJ. is a 22 y/O male whose pef is ~60% Do you remember AJ? is a 22 y/O male whose pef is ~60%. How should AJ be treated at home? SABA Theophylline Lama ics a

He does not respond to the initial dose of saba. What should be done? Repeat saba every 20 minutes and reassess Call the doctor Take him to the hospital Give him oral corticosteroids a

After several doses of saba, his symptoms have improved slightly but he still has some wheezing and his pef is still only 75%. What would be the least appropriate? Repeat saba every 20 minutes and reassess Call the doctor Take him to the hospital Give him oral corticosteroids c

Which of the following long term medications blocks late phase reaction to allergen and most potent anti inflammatory medication available? Ics Labas Theophylline immunomodulators a

Which of the following may cause growth defects in children? Ics Labas Theophylline immunomodulators a

Tips and tricks for remembering ics doses: Children (<4) Only ever give them budesonide or fluticasone! Children (5-11) Low: usually 100-200 mcg Medium: usually 200-400 mcg High: usually >400 mcg adults (>12) Low: usually 100-300 mcg Medium: usually 300-500 mcg High: usually >500 mcg Adult doses are typically ~100 mcg higher than child doses