New Respiratory Pharmacology Quiz

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Questions: 41 | Attempts: 2,053 | Updated: Mar 21, 2023

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New Respiratory Pharmacology Quiz - Quiz

Respiratory pharmacology - including asthma and COPD. Based on Rang and Dale Pharmacology.

Questions and Answers

1.

From where and how is respiration controlled?
- A.
  
  Spontaneous rhythmic discharges from the respiratory centre of the medulla
- B.
  
  Spontaneous rhythmic discharges from the respiratory centre of the cerebellum
- C.
  
  Continual stimulation from the pons
- D.
  
  Continual stimulation from the medulla
- E.
  
  Spasmodic stimulation from the motor region
Correct Answer
A. Spontaneous rhythmic discharges from the respiratory centre of the medulla

Explanation
Respiration is controlled by spontaneous rhythmic discharges from the respiratory centre of the medulla. The medulla is a part of the brainstem that plays a crucial role in regulating involuntary functions such as breathing. It contains specialized neurons that generate rhythmic signals to initiate and control the muscles involved in respiration. These spontaneous discharges ensure a regular and coordinated pattern of breathing. The cerebellum is not directly involved in respiratory control, and although the pons plays a role in respiration, it does not provide continual stimulation. The motor region is responsible for voluntary movement and not respiration.

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2.

What is respiration modulated by?
- A.
  
  Pontine CNS centre
- B.
  
  Vagal afferents from the lungs
- C.
  
  Chemoreceptors on aortic and carotid bodies
- D.
  
  Medullary chemoreceptors
- E.
  
  Motor area
Correct Answer(s)
A. Pontine CNS centre
B. Vagal afferents from the lungs
C. Chemoreceptors on aortic and carotid bodies
D. Medullary chemoreceptors

Explanation
Respiration is modulated by multiple factors including the Pontine CNS centre, which plays a role in controlling the rate and depth of breathing. Vagal afferents from the lungs also contribute to the regulation of respiration by providing feedback to the brain about lung stretch and the need for ventilation. Chemoreceptors on the aortic and carotid bodies detect changes in oxygen and carbon dioxide levels in the blood, influencing the respiratory rate. Additionally, medullary chemoreceptors in the brainstem respond to changes in pH and carbon dioxide levels, further regulating respiration.

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3.

Which gases are monitored at which points?
- A.
  
  PCO2 at the medullary chemoreceptors
- B.
  
  PO2 at the aortic and carotid bodies
- C.
  
  PCO2 at the aortic body
- D.
  
  PCO2 at the aortic and carotid body
- E.
  
  PO2 at the carotid body
Correct Answer(s)
A. PCO2 at the medullary chemoreceptors
B. PO2 at the aortic and carotid bodies

Explanation
The correct answer states that PCO2 is monitored at the medullary chemoreceptors, and PO2 is monitored at the aortic and carotid bodies. This means that the levels of carbon dioxide (PCO2) in the blood are detected by the chemoreceptors located in the medulla of the brain, while the levels of oxygen (PO2) in the blood are detected by the chemoreceptors located in the aortic and carotid bodies. These chemoreceptors play a crucial role in regulating breathing and maintaining the body's homeostasis.

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4.

List all the neurotransmitters of the sympathetic nervous system which act on the lungs.

Correct Answer(s)
NA-releasing sympathetic nerves
Noradrenaline
Circulating adrenaline
circulating adrenaline

Explanation
The neurotransmitters of the sympathetic nervous system that act on the lungs include NA-releasing sympathetic nerves, Noradrenaline, Circulating adrenaline, and circulating adrenaline. These neurotransmitters are responsible for regulating various functions in the lungs, such as bronchodilation and increased respiration rate, in response to sympathetic activation.

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1
4 0
5.

List all the Parasympathetic neurotransmitters active on the lungs.

Correct Answer(s)
Acetylcholine

Explanation
Acetylcholine is the correct answer because it is the primary neurotransmitter involved in parasympathetic innervation of the lungs. When released by parasympathetic nerves, acetylcholine binds to muscarinic receptors in the smooth muscle of the airways, causing bronchoconstriction and increased mucus secretion. This helps to regulate airflow and maintain the balance between sympathetic and parasympathetic activity in the lungs.

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6.

Which inhibitory neurons provide innervation to the lungs?

Correct Answer(s)
Non-adrenergic, non-cholinergic (NANC) inhibitory neurons
NANC neurones
NANC
Non-adrenergic, non-cholinergic neurones

Explanation
Non-adrenergic, non-cholinergic (NANC) inhibitory neurons provide innervation to the lungs. These neurons release neurotransmitters other than adrenaline and acetylcholine to inhibit the activity of other neurons or muscle cells in the lungs. NANC neurones and Non-adrenergic, non-cholinergic neurones are alternative terms used to refer to these inhibitory neurons.

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2
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7.

Which technologies measure airway resistance in asthma and bronchitis?
- A.
  
  Spirometry FEV1
- B.
  
  Peak expiratory flow meter
- C.
  
  Spirometry VC
- D.
  
  Spirometry RC
- E.
  
  Bronchodilator spirometry
Correct Answer(s)
A. Spirometry FEV1
B. Peak expiratory flow meter

Explanation
Spirometry FEV1 and peak expiratory flow meter are both technologies used to measure airway resistance in asthma and bronchitis. Spirometry FEV1 measures the forced expiratory volume in one second, which is the amount of air a person can forcefully exhale in the first second of a forced breath. This measurement is often used to assess lung function and diagnose respiratory conditions. Peak expiratory flow meter measures the maximum flow rate of air during forced exhalation, providing information about the narrowing of the airways. Both of these technologies are commonly used to monitor and manage respiratory conditions such as asthma and bronchitis.

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1
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8.

What are M1 receptors?
- A.
  
  Muscarinic receptors which facilitate ACh transmission on nicotinic receptors, localised in the bronchial ganglia post-synaptic cells
- B.
  
  Inhibitory autoreceptors, which mediate negative feedback effects on ACh release by postganglionic cholinergic nerves
- C.
  
  Mediate contraction of brachial smooth muscle and secretion of glands
Correct Answer
A. Muscarinic receptors which facilitate ACh transmission on nicotinic receptors, localised in the bronchial ganglia post-synaptic cells

Explanation
M1 receptors are muscarinic receptors that are located in the bronchial ganglia post-synaptic cells. These receptors facilitate the transmission of acetylcholine (ACh) on nicotinic receptors. They play a role in mediating the contraction of bronchial smooth muscle and the secretion of glands.

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9.

What are M2 receptors?
- A.
  
  Muscarinic receptors which facilitate ACh transmission on nicotinic receptors, localised in the bronchial ganglia post-synaptic cells
- B.
  
  Inhibitory autoreceptors, which mediate negative feedback effects on ACh release by postganglionic cholinergic nerves
- C.
  
  Mediate contraction of brachial smooth muscle and secretion of glands
Correct Answer
B. Inhibitory autoreceptors, which mediate negative feedback effects on ACh release by postganglionic cholinergic nerves

Explanation
M2 receptors are inhibitory autoreceptors that regulate the release of acetylcholine (ACh) by postganglionic cholinergic nerves. They provide negative feedback to control the amount of ACh being released. These receptors help maintain a balance in the cholinergic system by inhibiting excessive ACh release.

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10.

What are M3 receptors?
- A.
  
  Muscarinic receptors which facilitate ACh transmission on nicotinic receptors, localised in the bronchial ganglia post-synaptic cells
- B.
  
  Inhibitory autoreceptors, which mediate negative feedback effects on ACh release by postganglionic cholinergic nerves
- C.
  
  Mediate contraction of brachial smooth muscle and secretion of glands
Correct Answer
C. Mediate contraction of brachial smooth muscle and secretion of glands

Explanation
M3 receptors are a type of muscarinic receptors that are involved in mediating the contraction of bronchial smooth muscle and the secretion of glands. These receptors play a role in regulating the function of the respiratory system by controlling the contraction of smooth muscle in the bronchi and bronchioles, which helps to regulate airflow. Additionally, M3 receptors also regulate the secretion of glands in the respiratory system, such as mucus-producing glands, which helps to maintain the proper lubrication and protection of the airways.

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11.

What are the general functions of the vagus nerve in the respiratory system?
- A.
  
  Causes bronchoconstriction
- B.
  
  Causes bronchodilation
- C.
  
  Causes increased secretion of glands
- D.
  
  Causes increased respiratory rate
- E.
  
  Causes decreased respiratory rate
Correct Answer(s)
A. Causes bronchoconstriction
C. Causes increased secretion of glands
E. Causes decreased respiratory rate

Explanation
The vagus nerve plays a role in regulating various functions of the respiratory system. It causes bronchoconstriction, which is the narrowing of the airways, and this helps to regulate the flow of air in and out of the lungs. It also causes increased secretion of glands, which helps to moisten and lubricate the airways. Additionally, the vagus nerve is involved in controlling the respiratory rate, and it can cause a decrease in the respiratory rate.

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12.

Where are B2 adrenoceptors located?
- A.
  
  In the alveoli
- B.
  
  In the airways
- C.
  
  On mast cells
- D.
  
  In the epithelium
- E.
  
  In smooth muscle
Correct Answer(s)
A. In the alveoli
B. In the airways
C. On mast cells
D. In the epithelium
E. In smooth muscle

Explanation
B2 adrenoceptors are located in various parts of the respiratory system. They can be found in the alveoli, which are the tiny air sacs in the lungs where gas exchange occurs. They are also present in the airways, which include the bronchi and bronchioles that allow air to flow in and out of the lungs. B2 adrenoceptors are also found on mast cells, which play a role in allergic reactions and inflammation. Additionally, they are located in the epithelium, which is the tissue that lines the respiratory tract. Finally, B2 adrenoceptors are present in smooth muscle, which is responsible for regulating the diameter of the airways.

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1
13.

Where are B1 adrenoceptors found?
- A.
  
  On the mast cells
- B.
  
  In the airways
- C.
  
  In the epithelium
- D.
  
  On the glands
- E.
  
  In the alveoli
Correct Answer
E. In the alveoli

Explanation
B1 adrenoceptors are found in the alveoli. Alveoli are tiny air sacs located at the end of the respiratory bronchioles in the lungs. These receptors are part of the sympathetic nervous system and are involved in regulating bronchial smooth muscle tone and airway resistance. Activation of B1 adrenoceptors in the alveoli can lead to bronchodilation and increased airflow, making it easier to breathe.

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14.

Which is the main inhibitory NANC mediator - the main neurotransmitter relaxant in the lungs?
- A.
  
  Noradrenaline
- B.
  
  Excitatory peptides
- C.
  
  Nitric Oxide (NO)
- D.
  
  Adrenaline
- E.
  
  Acetylcholine
Correct Answer
C. Nitric Oxide (NO)

Explanation
Nitric oxide (NO) is the main inhibitory non-adrenergic, non-cholinergic (NANC) mediator and the main neurotransmitter relaxant in the lungs. It plays a crucial role in regulating smooth muscle tone and blood flow in the respiratory system. NO acts by diffusing into smooth muscle cells and activating guanylate cyclase, leading to the production of cyclic guanosine monophosphate (cGMP), which causes relaxation of the smooth muscle. This relaxation allows for increased airway diameter and improved airflow in the lungs.

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15.

Which of these are stimulant NANC mediators, and where are they released from?
- A.
  
  Excitatory neuropeptides - eg. substance P and neurokinin A
- B.
  
  Nitric Oxide (NO)
- C.
  
  Adrenaline
- D.
  
  Released from Sensory C fibres
- E.
  
  Released from irritant receptors
Correct Answer(s)
A. Excitatory neuropeptides - eg. substance P and neurokinin A
D. Released from Sensory C fibres

Explanation
Excitatory neuropeptides such as substance P and neurokinin A are stimulant NANC mediators. They are released from sensory C fibers. These neuropeptides play a role in transmitting pain signals and promoting inflammation in response to various stimuli.

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16.

Which afferent receptors are involved in the central regulation of respiraton by the respiratory centre?
- A.
  
  Slowly adapting stretch receptors
- B.
  
  Adrenoceptors
- C.
  
  Unmyelinated senory C fibres
- D.
  
  Muscarinic receptors
- E.
  
  Rapidly adapting irritant receptors associated with myelinated vagal fibres
Correct Answer(s)
A. Slowly adapting stretch receptors
C. Unmyelinated senory C fibres
E. Rapidly adapting irritant receptors associated with myelinated vagal fibres

Explanation
The correct answer is slowly adapting stretch receptors, unmyelinated sensory C fibers, and rapidly adapting irritant receptors associated with myelinated vagal fibers. These afferent receptors play a role in the central regulation of respiration by the respiratory center. Slowly adapting stretch receptors detect changes in lung volume and provide feedback to the respiratory center to adjust breathing rate and depth. Unmyelinated sensory C fibers are involved in detecting pain and reflexive responses to lung inflammation or injury. Rapidly adapting irritant receptors, associated with myelinated vagal fibers, detect irritants in the airways and trigger protective reflexes such as coughing or bronchoconstriction.

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17.

Sympathetic nerves innervate what?
- A.
  
  Blood vessels (causing constriction)
- B.
  
  Glands (inhibiting secretion)
- C.
  
  Glands (increasing secretion)
- D.
  
  Blood vessels (causing dilation)
- E.
  
  Adrenal gland causing increased circulating adrenaline affecting smooth muscle in the lungs
Correct Answer(s)
A. Blood vessels (causing constriction)
B. Glands (inhibiting secretion)
E. Adrenal gland causing increased circulating adrenaline affecting smooth muscle in the lungs

Explanation
The sympathetic nerves innervate blood vessels, causing constriction, which leads to a decrease in blood flow. They also innervate glands, inhibiting secretion, which helps to conserve energy. Additionally, the sympathetic nerves stimulate the adrenal gland to release adrenaline, which affects smooth muscle in the lungs, causing relaxation and dilation of the airways. This response helps to increase airflow and improve breathing.

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18.

What causes contraction of bronchial smooth muscle?
- A.
  
  Circulating adrenaline
- B.
  
  Sympathetic nerve stimulation
- C.
  
  Circulating acetylcholine
- D.
  
  Parasympathetic nerve stimulation
Correct Answer
A. Circulating adrenaline

Explanation
Circulating adrenaline causes the contraction of bronchial smooth muscle. Adrenaline, also known as epinephrine, is a hormone released by the adrenal glands in response to stress or excitement. It acts on the beta-2 adrenergic receptors present in the bronchial smooth muscle, leading to relaxation and dilation of the airways. However, in some individuals, adrenaline can also cause bronchoconstriction, leading to difficulty in breathing.

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19.

What are the features of asthma?
- A.
  
  Decreased FEV1
- B.
  
  Decreased VC
- C.
  
  Cough
- D.
  
  Wheeze
- E.
  
  Difficulty breathing out
Correct Answer(s)
A. Decreased FEV1
C. Cough
D. Wheeze
E. Difficulty breathing out

Explanation
The features of asthma include decreased FEV1, cough, wheeze, and difficulty breathing out. Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms such as coughing, wheezing, and difficulty exhaling. Decreased FEV1 refers to a reduced forced expiratory volume in one second, which is a measure of how much air a person can forcibly exhale in one second. These features are commonly seen in individuals with asthma and are used to diagnose and manage the condition.

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20.

Which of these drugs is a bronchodilator?
- A.
  
  B2 adrenoceptor agonists
- B.
  
  Cysteinyl-leukotriene receptor antagonists
- C.
  
  Muscarinic receptor agonists
- D.
  
  Muscarinic receptor antagonists
- E.
  
  Xanthines
Correct Answer(s)
A. B2 adrenoceptor agonists
B. Cysteinyl-leukotriene receptor antagonists
D. Muscarinic receptor antagonists
E. Xanthines

Explanation
Bronchodilators are medications that relax and widen the airways in the lungs, making it easier to breathe. B2 adrenoceptor agonists, cysteinyl-leukotriene receptor antagonists, muscarinic receptor agonists, and xanthines are all types of bronchodilators. B2 adrenoceptor agonists work by stimulating the B2 adrenoceptors in the smooth muscles of the airways, causing them to relax. Cysteinyl-leukotriene receptor antagonists block the action of leukotrienes, which are substances that can cause inflammation and constriction of the airways. Muscarinic receptor agonists work by stimulating muscarinic receptors in the airways, leading to relaxation. Xanthines, such as theophylline, also relax the smooth muscles of the airways.

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21.

Where is the action of B2 adrenoceptor agonists?.
- A.
  
  B2 receptors of the smooth muscle
- B.
  
  B2 receptors of the alveoli
- C.
  
  B2 receptors of the vasculature
- D.
  
  Decreasing mediator release from mast cells
- E.
  
  Increasing mucous clearance in the cilia
Correct Answer(s)
A. B2 receptors of the smooth muscle
D. Decreasing mediator release from mast cells
E. Increasing mucous clearance in the cilia

Explanation
B2 adrenoceptor agonists act on the smooth muscle by binding to B2 receptors, causing relaxation of the smooth muscle. This leads to bronchodilation and helps in relieving symptoms of airway obstruction in conditions such as asthma and chronic obstructive pulmonary disease (COPD). B2 adrenoceptor agonists also decrease mediator release from mast cells, which helps in reducing inflammation and allergic reactions in the airways. Additionally, they increase mucous clearance in the cilia, which aids in removing mucus and improving airflow.

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22.

Which of these are short acting B2 adreoceptor agonists?
- A.
  
  Salbutamol
- B.
  
  Formoterol
- C.
  
  Terbutaline
- D.
  
  Salmeterol
- E.
  
  Bambuterol
Correct Answer(s)
A. Salbutamol
C. Terbutaline
E. Bambuterol

Explanation
Salbutamol, terbutaline, and bambuterol are short-acting B2 adrenoceptor agonists. These medications are commonly used to treat conditions such as asthma and chronic obstructive pulmonary disease (COPD). They work by relaxing the muscles in the airways, allowing for easier breathing. These short-acting medications provide quick relief of symptoms and are often used as rescue inhalers during acute episodes of breathing difficulties. Formoterol and salmeterol, on the other hand, are long-acting B2 adrenoceptor agonists and are typically used for maintenance therapy to prevent symptoms.

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23.

Which of these are long-acting B2 adrenoceptor agonists?
- A.
  
  Salmeterol
- B.
  
  Formoterol
- C.
  
  Fenoterol
- D.
  
  Pirbuterol
- E.
  
  Reprotelol
Correct Answer(s)
A. Salmeterol
B. Formoterol
C. Fenoterol
D. Pirbuterol
E. Reprotelol

Explanation
Salmeterol, formoterol, fenoterol, pirbuterol, and reprotelol are all long-acting B2 adrenoceptor agonists. These medications work by stimulating the B2 adrenoceptors in the lungs, causing the smooth muscles to relax, and thus opening up the airways. This makes them effective in treating conditions such as asthma and chronic obstructive pulmonary disease (COPD). Their long-acting nature means that they provide sustained relief and can be used as maintenance therapy to control symptoms over an extended period of time.

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24.

What are the effects of xanthine drugs?
- A.
  
  Anti-asthmatic bronchodilation
- B.
  
  Increased alertness, tremor and nervousness
- C.
  
  Affect sleep and increase respiratory rate
- D.
  
  Increase heart rate and vasodilatation
- E.
  
  Weak diuretic effect
Correct Answer(s)
A. Anti-asthmatic bronchodilation
B. Increased alertness, tremor and nervousness
C. Affect sleep and increase respiratory rate
D. Increase heart rate and vasodilatation
E. Weak diuretic effect

Explanation
Xanthine drugs have multiple effects on the body. They can cause anti-asthmatic bronchodilation, which helps to relax and open up the airways, making it easier to breathe. These drugs also increase alertness, but they can also lead to side effects such as tremor and nervousness. Xanthine drugs can affect sleep patterns and increase the respiratory rate. Additionally, they can increase heart rate and cause vasodilatation, which widens the blood vessels. Lastly, xanthine drugs have a weak diuretic effect, meaning they can increase urine production.

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25.

How do xanthines work, and what are their side effects?
- A.
  
  Unclear. Believed part is due to the inhibition of phosphdiesterase isoenzymes, which increase cAMP.
- B.
  
  Unclear. Believed to be due to an action at the Beta adrenoceptors
- C.
  
  Decreases the level of circulating adrenaline.
- D.
  
  Side effects: nausea, vomiting, anorexia, nervousness, tremour, dysrhythmia in high concentrations, seizures at slightly above normal range.
- E.
  
  Side effects: excessive somnolence, fatigue and lethargy, lack of concentration, pigmentation of the skin and bradycardia.
Correct Answer(s)
A. Unclear. Believed part is due to the inhibition of pHospHdiesterase isoenzymes, which increase cAMP.
D. Side effects: nausea, vomiting, anorexia, nervousness, tremour, dysrhythmia in high concentrations, seizures at slightly above normal range.

Explanation
Xanthines are believed to work by inhibiting phosphodiesterase isoenzymes, which leads to an increase in cAMP. This mechanism of action is not fully understood. The side effects of xanthines include nausea, vomiting, anorexia, nervousness, tremor, dysrhythmia at high concentrations, and seizures at slightly above normal range. These side effects can occur due to the effects of xanthines on the central nervous system and cardiovascular system.

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26.

Muscarinic receptor agonist are:
- A.
  
  Ipratropium
- B.
  
  Oxitropium
- C.
  
  Salbutamol
- D.
  
  Theophylline
- E.
  
  Zafirlukast
Correct Answer(s)
A. Ipratropium
B. Oxitropium

Explanation
Ipratropium and oxitropium are muscarinic receptor agonists.

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2
27.

How do muscarinic receptor antagonists work?
- A.
  
  Relax bronchial constriction caused by parasympathetic stimulation
- B.
  
  Increases bronchial constriction caused by sympathetic stimulation
- C.
  
  Inhibits augmentation of mucous secretion
- D.
  
  Increases augmentation of mucous secretion
- E.
  
  Increases the mucocillary clearance of bronchial secretions
Correct Answer(s)
A. Relax bronchial constriction caused by parasympathetic stimulation
C. Inhibits augmentation of mucous secretion
E. Increases the mucocillary clearance of bronchial secretions

Explanation
Muscarinic receptor antagonists work by relaxing bronchial constriction caused by parasympathetic stimulation. They also inhibit the augmentation of mucous secretion and increase the mucociliary clearance of bronchial secretions.

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28.

What is the main benefit of muscarinic receptor antagonists, and in what capacity are they used?
- A.
  
  Main benefit: few unwanted side effects and is generally safe and well tolerated.
- B.
  
  Main benefit: quick effects, causing rapid bronchodilatation and relief of symptoms
- C.
  
  Used as an adjunct to B2-adrenoceptor antagonists and steroids
- D.
  
  Used as a primary treatment for severe asthma
- E.
  
  Used as a second-line therapy with B2 adrenoceptor antagonists
Correct Answer(s)
A. Main benefit: few unwanted side effects and is generally safe and well tolerated.
C. Used as an adjunct to B2-adrenoceptor antagonists and steroids

Explanation
Muscarinic receptor antagonists have the main benefit of few unwanted side effects and being generally safe and well tolerated. They are used as an adjunct to B2-adrenoceptor antagonists and steroids, meaning they are used in combination with these medications to enhance their effectiveness in treating certain conditions.

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29.

Which medications are cysteinyl-leukotriene receptor antagonists?
- A.
  
  Montelucast
- B.
  
  Zafirlukast
- C.
  
  Salbutamol
- D.
  
  Theophylline
- E.
  
  Enprophylline
Correct Answer(s)
A. Montelucast
B. Zafirlukast

Explanation
Montelukast and zafirlukast are cysteinyl-leukotriene receptor antagonists. These medications work by blocking the action of leukotrienes, which are chemicals that cause inflammation and constriction of the airways in conditions such as asthma. By inhibiting the action of leukotrienes, these medications help to reduce inflammation and relax the airway muscles, making it easier to breathe. Salbutamol, theophylline, and enprophylline are not cysteinyl-leukotriene receptor antagonists, and they work through different mechanisms to relieve symptoms of asthma or other respiratory conditions.

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30.

What is the method of delivery and method of action of cysteinyl-leukotriene receptor antagonists?
- A.
  
  Orally
- B.
  
  Inhalation
- C.
  
  IV
- D.
  
  Act on the cysteinyl-leukotriene receptors, causing bronchodilatation, and preventing aspirin-sensitive and exercise-induced asthma and reducing sputum eosinophilia
- E.
  
  Act on the cysteinyl-leukotriene receptors, causing bronchodilatation, and decreasing allergenic reactivity by acting on the irritant receptors
Correct Answer(s)
A. Orally
D. Act on the cysteinyl-leukotriene receptors, causing bronchodilatation, and preventing aspirin-sensitive and exercise-induced asthma and reducing sputum eosinopHilia

Explanation
Cysteinyl-leukotriene receptor antagonists are administered orally. They act on the cysteinyl-leukotriene receptors, causing bronchodilation. They also have the ability to prevent aspirin-sensitive and exercise-induced asthma, as well as reduce sputum eosinophilia.

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31.

What is the prescribing order for bronchodilators?
- A.
  
  B2-adrenoceptor agonists - theophylline - muscarinic receptor agonists - cysteinyl-leukotriene receptor antagonists
- B.
  
  Cysteinyl-leukotriene receptor antagonists - B2 adrenoceptor agonists - theophylline - muscarinic receptor agonists
- C.
  
  B2-adrenoceptor agonists - theophylline / muscarinic receptor agonists - cysteinyl-leukotriene receptor antagonists
- D.
  
  Theophylline - muscarinic receptor agonists - B2 adrenoceptor agonists - cysteinyl-leukotriene receptor antagonists
Correct Answer
C. B2-adrenoceptor agonists - theopHylline / muscarinic receptor agonists - cysteinyl-leukotriene receptor antagonists

Explanation
The correct answer is B2-adrenoceptor agonists - theophylline / muscarinic receptor agonists - cysteinyl-leukotriene receptor antagonists. This ordering is based on the stepwise approach to treating bronchoconstriction. B2-adrenoceptor agonists are typically the first-line bronchodilators used to relieve acute symptoms. Theophylline and muscarinic receptor agonists can be added if symptoms persist or worsen. Cysteinyl-leukotriene receptor antagonists are used as add-on therapy for patients with persistent asthma symptoms.

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32.

What is the action of glucocorticoids in asthma?
- A.
  
  Decrease the formation of cytokines, in particular the Th2 cytokines and decrease eosinophilic recruitment and activation
- B.
  
  Decrease IgE production and IgE receptor expression and inhibit vasodilatation by suppressing PGE2 and PGI2 though induction of COX-2
- C.
  
  Decrease spasmogens LTC4 and LTD4, decrease chemotactins LTB4 and platelet activating factor and therefore decreasing recruitment and activation of inflam cells
- D.
  
  Can upregulate B2 adrenoceptors and decrease mediator release from eosinophils
- E.
  
  Long term Rx reduces the early phase response to allergens and prevents exercise-induced asthma
Correct Answer(s)
A. Decrease the formation of cytokines, in particular the Th2 cytokines and decrease eosinopHilic recruitment and activation
B. Decrease IgE production and IgE receptor expression and inhibit vasodilatation by suppressing PGE2 and PGI2 though induction of COX-2
C. Decrease spasmogens LTC4 and LTD4, decrease chemotactins LTB4 and platelet activating factor and therefore decreasing recruitment and activation of inflam cells
D. Can upregulate B2 adrenoceptors and decrease mediator release from eosinopHils
E. Long term Rx reduces the early pHase response to allergens and prevents exercise-induced asthma

Explanation
Glucocorticoids have multiple actions in asthma. They decrease the formation of cytokines, particularly the Th2 cytokines, which are involved in the inflammatory response. They also decrease eosinophilic recruitment and activation, which helps reduce the inflammation in the airways. Additionally, glucocorticoids decrease IgE production and IgE receptor expression, which are involved in allergic reactions. They inhibit vasodilatation by suppressing PGE2 and PGI2 through the induction of COX-2. Glucocorticoids also decrease the production of spasmogens like LTC4 and LTD4, as well as chemotactins like LTB4 and platelet activating factor, which helps decrease the recruitment and activation of inflammatory cells. They can upregulate B2 adrenoceptors, leading to decreased mediator release from eosinophils. Long-term use of glucocorticoids can also reduce the early phase response to allergens and prevent exercise-induced asthma.

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33.

Which of these are glucocorticoids?
- A.
  
  Beclometasone dipropionate
- B.
  
  Budesonide
- C.
  
  Fluticaone propionate
- D.
  
  Salbutamol
- E.
  
  Theophylline
Correct Answer(s)
A. Beclometasone dipropionate
B. Budesonide
C. Fluticaone propionate

Explanation
Beclometasone dipropionate, budesonide, and fluticaone propionate are glucocorticoids. Glucocorticoids are a type of steroid hormones that are involved in various physiological processes, including regulating inflammation and immune responses. These drugs are commonly used in the treatment of inflammatory conditions, such as asthma and allergies, due to their anti-inflammatory properties. On the other hand, salbutamol and theophylline are not glucocorticoids. Salbutamol is a bronchodilator used to relieve symptoms of asthma, while theophylline is a bronchodilator and a mild bronchodilator used in the treatment of respiratory conditions.

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34.

How are glucocorticoids prescribed?
- A.
  
  Metered-dose inhaler, with boosts of oral glucorticoids if severe or rapidly deteriorating
- B.
  
  Orally, with boosts of inhaled glucorticoids if severe or rapidly deteriorating
- C.
  
  Metered-dose inhaler
- D.
  
  Orally
- E.
  
  IV infusion
Correct Answer
A. Metered-dose inhaler, with boosts of oral glucorticoids if severe or rapidly deteriorating

Explanation
Glucocorticoids are prescribed through a metered-dose inhaler. If the condition is severe or rapidly deteriorating, boosts of oral glucocorticoids are also given. This combination of inhaler and oral medication helps to manage and control the symptoms effectively.

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35.

What are the side effects of glucocorticoids?
- A.
  
  Oropharyngeal candidiasis
- B.
  
  Dysphonia
- C.
  
  Adrenal suppression with regular large doses
- D.
  
  Cushing syndrome in oral Rx
- E.
  
  Cardiac arrhythmias
Correct Answer(s)
A. OropHaryngeal candidiasis
B. DyspHonia
C. Adrenal suppression with regular large doses
D. Cushing syndrome in oral Rx

Explanation
Glucocorticoids are known to have several side effects. Oropharyngeal candidiasis is a fungal infection that can occur in the mouth and throat. Dysphonia refers to hoarseness or difficulty in speaking. Adrenal suppression can occur with regular large doses of glucocorticoids, leading to decreased production of natural corticosteroids by the adrenal glands. Cushing syndrome, characterized by weight gain, high blood pressure, and other symptoms, can occur with long-term oral use of glucocorticoids. Cardiac arrhythmias are abnormal heart rhythms that can also be a side effect of glucocorticoid use.

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36.

Where are cromoglicate and nedocromil sodium useful?
- A.
  
  Given prophylactically
- B.
  
  Allergen-induced, exercise induced and irritant induced asthma
- C.
  
  In those patients who respond (is not possible to predict who will, but more commonly children)
- D.
  
  cold-air induced, drug induced asthma
- E.
  
  Useful in all asthmatics, in acute bronchospasm
Correct Answer(s)
A. Given propHylactically
B. Allergen-induced, exercise induced and irritant induced asthma
C. In those patients who respond (is not possible to predict who will, but more commonly children)

Explanation
Cromoglicate and nedocromil sodium are useful in the prophylactic treatment of asthma. They are particularly effective in cases of allergen-induced, exercise-induced, and irritant-induced asthma. While it is not possible to predict who will respond to these medications, they are more commonly used in children. Additionally, they are not effective in treating acute bronchospasm but rather in preventing asthma symptoms from occurring.

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37.

How is cromoglicate etc theorised to work?
- A.
  
  It depresses the exaggerated neuronal reflexes - ie. it suppresses the response of senxory C fibres to capsaicin irritant and may inhibit the release of preformed T cell cytokines
- B.
  
  It binds to B2 adrenoceptor molecules and causes sustained agonist action
- C.
  
  It suppresses the release of inflammatory cytokines from mast cells
- D.
  
  It decreases circulating adrenaline
- E.
  
  It blocks parasympathetic innervation
Correct Answer
A. It depresses the exaggerated neuronal reflexes - ie. it suppresses the response of senxory C fibres to capsaicin irritant and may inhibit the release of preformed T cell cytokines

Explanation
Cromoglicate is theorized to work by depressing the exaggerated neuronal reflexes. This means that it suppresses the response of sensory C fibers to capsaicin irritant and may also inhibit the release of preformed T cell cytokines. This mechanism of action helps to reduce inflammation and alleviate symptoms associated with conditions such as asthma and allergic rhinitis.

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38.

What is chronic obstructive pulmonary disease (COPD)?
- A.
  
  A syndrome of chronic bronchitis and emphysema
- B.
  
  Chronic bronchitis: inflammation of the bronchi and bronchioles due to cigarette smoke or air pollution.
- C.
  
  A syndrome of cough, then productive cough, then wheezing and breathlessness due to airflow limitation
- D.
  
  Emphysema: distension and damage of lung tissue beyond the respiratory bronchioles (bronchiectasis)
- E.
  
  Sudden-onset cough, relieved by bronchodilators
Correct Answer(s)
A. A syndrome of chronic bronchitis and empHysema
B. Chronic bronchitis: inflammation of the bronchi and bronchioles due to cigarette smoke or air pollution.
C. A syndrome of cough, then productive cough, then wheezing and breathlessness due to airflow limitation
D. EmpHysema: distension and damage of lung tissue beyond the respiratory bronchioles (bronchiectasis)

Explanation
The correct answer is a syndrome of chronic bronchitis and emphysema. Chronic bronchitis is characterized by inflammation of the bronchi and bronchioles, often caused by cigarette smoke or air pollution. This leads to symptoms such as coughing, wheezing, and breathlessness. Emphysema, on the other hand, involves the distension and damage of lung tissue beyond the respiratory bronchioles, leading to further breathing difficulties. Together, chronic bronchitis and emphysema make up the condition known as chronic obstructive pulmonary disease (COPD).

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39.

Which of these is treatment for COPD?
- A.
  
  Ipratropium bromide
- B.
  
  Salbutamol
- C.
  
  Oral prednisolone
- D.
  
  Beclometasone dipropionate, budesonide and fluticasone propionate
- E.
  
  Theophylline
Correct Answer(s)
A. Ipratropium bromide
B. Salbutamol
C. Oral prednisolone
D. Beclometasone dipropionate, budesonide and fluticasone propionate

Explanation
Ipratropium bromide, salbutamol, oral prednisolone, beclometasone dipropionate, budesonide, and fluticasone propionate are all treatments for COPD. Ipratropium bromide and salbutamol are bronchodilators that help to relax the muscles in the airways, making it easier to breathe. Oral prednisolone is a corticosteroid that reduces inflammation in the airways. Beclometasone dipropionate, budesonide, and fluticasone propionate are inhaled corticosteroids that also help to reduce inflammation in the airways. These medications are commonly prescribed to manage symptoms and improve lung function in patients with COPD. Theophylline, which is not listed as a correct answer, is also a medication used to treat COPD by relaxing the muscles in the airways and improving breathing.

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40.

How do antitussive drugs work?
- A.
  
  An ill-defined effect on the brainstem, suppressing the 'cough centre'
- B.
  
  Inhibit release of excitatory neuropeptides through action on mew receptors on sensory nerves in the bronchi
- C.
  
  Decreasing nerve conduction from the 'cough centre' to the motor centre of the brain
- D.
  
  Decreasing the ability of nerves in the respiratory system to respond to stimuli
- E.
  
  Paralysing the abdominal muscles and accessory muscles of respiration
Correct Answer(s)
A. An ill-defined effect on the brainstem, suppressing the 'cough centre'
B. Inhibit release of excitatory neuropeptides through action on mew receptors on sensory nerves in the bronchi

Explanation
Antitussive drugs work by having an ill-defined effect on the brainstem, specifically suppressing the 'cough centre'. They also inhibit the release of excitatory neuropeptides through action on mew receptors on sensory nerves in the bronchi. These actions help decrease nerve conduction from the 'cough centre' to the motor centre of the brain, ultimately reducing the ability of nerves in the respiratory system to respond to stimuli and alleviating coughing.

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41.

Which of these are in use as antitussives?
- A.
  
  Codeine
- B.
  
  Dextromethorphan
- C.
  
  Pholcodeine
- D.
  
  Morphine
- E.
  
  Salbutamol
Correct Answer(s)
A. Codeine
B. DextromethorpHan
C. pHolcodeine

Explanation
Codeine, dextromethorphan, and pholcodeine are all used as antitussives. Antitussives are medications that suppress or relieve coughing. Codeine is an opioid that works by decreasing the sensitivity of the cough reflex. Dextromethorphan is a non-opioid that works by suppressing the cough reflex in the brain. Pholcodeine is also an opioid that acts as a cough suppressant. Therefore, all three of these medications are commonly used to treat coughs.

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Current Version
Mar 21, 2023

Quiz Edited by
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Jun 21, 2009

Quiz Created by
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New Respiratory Pharmacology Quiz

From where and how is respiration controlled?

What is respiration modulated by?

Which gases are monitored at which points?

List all the neurotransmitters of the sympathetic nervous system which act on the lungs.

List all the Parasympathetic neurotransmitters active on the lungs.

Which inhibitory neurons provide innervation to the lungs?

Which technologies measure airway resistance in asthma and bronchitis?

What are M1 receptors?

What are M2 receptors?

What are M3 receptors?

What are the general functions of the vagus nerve in the respiratory system?

Where are B2 adrenoceptors located?

Where are B1 adrenoceptors found?

Which is the main inhibitory NANC mediator - the main neurotransmitter relaxant in the lungs?

Which of these are stimulant NANC mediators, and where are they released from?

Which afferent receptors are involved in the central regulation of respiraton by the respiratory centre?

Sympathetic nerves innervate what?

What causes contraction of bronchial smooth muscle?

What are the features of asthma?

Which of these drugs is a bronchodilator?

Where is the action of B2 adrenoceptor agonists?.

Which of these are short acting B2 adreoceptor agonists?

Which of these are long-acting B2 adrenoceptor agonists?

What are the effects of xanthine drugs?

How do xanthines work, and what are their side effects?

Muscarinic receptor agonist are:

How do muscarinic receptor antagonists work?

What is the main benefit of muscarinic receptor antagonists, and in what capacity are they used?

Which medications are cysteinyl-leukotriene receptor antagonists?

What is the method of delivery and method of action of cysteinyl-leukotriene receptor antagonists?

What is the prescribing order for bronchodilators?

What is the action of glucocorticoids in asthma?

Which of these are glucocorticoids?

How are glucocorticoids prescribed?

What are the side effects of glucocorticoids?

Where are cromoglicate and nedocromil sodium useful?

How is cromoglicate etc theorised to work?

What is chronic obstructive pulmonary disease (COPD)?

Which of these is treatment for COPD?

How do antitussive drugs work?

Which of these are in use as antitussives?