Theophylline has been used to treat all of the following except:
B. pneumonia
The xanthine of choice to treat apnea of prematurity is:
C. caffeine citrate
Theophylline and caffeine are examples of:
D. methylxanthines
Theophylline is classified as a bronchodilator because it:
D. has a relaxing effect on bronchial smooth muscle
Xanthines have all the following physiological effects except:
A. cerebral vasodilation
Which drug stimulates skeletal muscle and the CNS most strongly?
B. caffeine
An incr in intracellular cyclic adenosine 3',5'-monophosphate (cAMP) causes:
C. bronchial smooth muscle relaxation
It is difficult to determine therapeutic doses of theophylline because:
C. individuals metabolize theophylline at different rates
The currently recommended blood serum theophylline level for the management of asthma is:
D. 5 to 15 micrograms/ml
The recommended therapeutic blood serum range of theophylline for use in the treatment of COPD is:
B. 10 to 12
Dosage of theophylline is best monitored by:
C. measurement of serum drug levels
Theophylline blood levels can be increased by all of the following except:
b. B blockers
A. B agonists
Common, less toxic side effects of theopylline therapy include which of the following?
I. h/a
II. gastric upset
III. anxiety
IV. nervousness
V. diuresis
C. I, II, III, IV, and V
A decr in blood theophylline levels could be caused by all of the following except:
A. renal failure
Disadvantages of theophylline therapy include which of the following:
I. narrow therapeutic margin
II. toxic effects
III. unpredictable blood levels
IV. need for individual dosing
V. numerous drug-drug and drug-condition interactions
all (five) of the above
Nonbronchodilating effects of theophylline include all the following except:
B. incr pulmonary vascular resistance
You are working the night shift when a 68-year-old COPD patient is admitted through the ER. He has been given combivent and inhaled corticosteroids. The intern on call asks your recommendation for additional medication to give the patient. You would recommend:
D. theophylline
A significant side effect of theophylline often seen in patients is:
A. nausea
The therapeutic range for theophylline is:
C. 10 to 20
There are many possible explanations of how theophylline works. All of the following are possible theories except:
c. produces catecholamines
C. blocks acetylcholine
Which of the following is not a function of mucus in the body?
C. improvement of gas exchange
Diseases with hypersecretion or poor clearance of secretions include which of the following?
I. cystic fibrosis
II. pneumonia
III. CHF
IV. primary ciliary dyskinesia
D. I, II, and IV only
Medications that incr mucociliary or cough efficiency are:
C. mucokinetics
The number of goblet cells per square mm of normal airway mucosa is:
B. 6000
What structure is responsible for providing the majority of mucus secretions?
B. submucosal glands
In peripheral airways the rate of mucociliary transport in the normal peripheral aiway is approx:
B. 1.5 mm/min
The cholinergic (sympathetic) response in terms of mucociliary clearance is:
I. incr ciliary beat
II. decr ciliary beat
III. incr mucus production
IV. decr mucus production
D. I and III only
Antibaccterial defense in the airway is provided by which of the following?
I. IgA
II. IgG
III. Phospholipids
IV. Serine proteases
A. I, II, and IV only
What mucus color indicates retainedf secretions and neutrophil activation?
D. green
The physical properties of mucus include which of the following?
I. adhesion
II. cohesion
III. elasticity
IV. viscosity
D. I, II, III, and IV
Which of the following agents is/are currently approved for administration as an aerosolized mucoactive agent?
I. dry powder mannitol
II. N-acetylcysteine (NAC)
III. dornase alfa
IV. ipratropium bromide
A. II and III only
All of the following are hazards associated with the use of acetylcysteine except:
B. tachycardia
Pulmozyme is the trade name for the mucoactive agent:
D. dornase alfa
The standard dose of dornase alfa for aerosolization is:
B. 2.5 mg in 2.5 m. of diluent
Agents that incr volume or hydration of airway secretions are called:
D. expectorants
The expectoranct that may stimulate the cholinergic pathway to incr mucus secretion is:
C. guaifenesin
You have a patient with COPD who is struggling to expel viscid mucus plugs. What would you recommend for this problem?
D. acetylcysteine
A resident orders 4 cc of 20% mucomyst aerosolized for an asthma patient. You are called by the unit secretary about te order. You would:
B. call the resident and obtain a verbal order to give a B2 agonist with the mucomyst
All the following nebulizers have been tested and approved for use with dornase alfa except:
C. Misty-Neb
Acetylcysteine is incompatible in solution with which of the following:
C. certain antibiotics
How does dornase alfa work?
C. breaks down DNA content in sputum
How does acetylcysteine (mucomyst) work?
A. substitutes sulhydryl radicals for disulfide bonds to mucus
