Respiratory Pharmacology

41 Questions

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Respiratory Pharmacology Quizzes & Trivia

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

  • 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

  • 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

  • 4. 
    List all the neurotransmitters of the sympathetic nervous system which act on the lungs.
  • 5. 
    List all the Parasympathetic neurotransmitters active on the lungs.
  • 6. 
    Which inhibitory neurons provide innervation to the lungs?
  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 18. 
    What causes contraction of bronchial smooth muscle?
    • A. 

      Circulating adrenaline

    • B. 

      Sympathetic nerve stimulation

    • C. 

      Circulating acetylcholine

    • D. 

      Parasympathetic nerve stimulation

  • 19. 
    What are the features of asthma?
    • A. 

      Decreased FEV1

    • B. 

      Decreased VC

    • C. 

      Cough

    • D. 

      Wheeze

    • E. 

      Difficulty breathing out

  • 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

  • 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

  • 22. 
    Which of these are short acting B2 adreoceptor agonists?
    • A. 

      Salbutamol

    • B. 

      Formoterol

    • C. 

      Terbutaline

    • D. 

      Salmeterol

    • E. 

      Bambuterol

  • 23. 
    Which of these are long-acting B2 adrenoceptor agonists?
    • A. 

      Salmeterol

    • B. 

      Formoterol

    • C. 

      Fenoterol

    • D. 

      Pirbuterol

    • E. 

      Reprotelol

  • 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

  • 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.

  • 26. 
    Muscarinic receptor agonist are:
    • A. 

      Ipratropium

    • B. 

      Oxitropium

    • C. 

      Salbutamol

    • D. 

      Theophylline

    • E. 

      Zafirlukast

  • 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

  • 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

  • 29. 
    Which medications are cysteinyl-leukotriene receptor antagonists?
    • A. 

      Montelucast

    • B. 

      Zafirlukast

    • C. 

      Salbutamol

    • D. 

      Theophylline

    • E. 

      Enprophylline

  • 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

  • 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

  • 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

  • 33. 
    Which of these are glucocorticoids?
    • A. 

      Beclometasone dipropionate

    • B. 

      Budesonide

    • C. 

      Fluticaone propionate

    • D. 

      Salbutamol

    • E. 

      Theophylline

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 41. 
    Which of these are in use as antitussives?
    • A. 

      Codeine

    • B. 

      Dextromethorphan

    • C. 

      Pholcodeine

    • D. 

      Morphine

    • E. 

      Salbutamol