Chapter 07: Anticholinergic (Parasympatholytic) Bronchodilators

Chapter 07: Anticholinergic (Parasympatholytic) Bronchodilators

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. An anticholinergic that can be administered via aerosolization is

a.	ipratropium bromide.
b.	albuterol sulfate.
c.	glycopyrrolate.
d.	atropine.

 

 

ANS:  A

Ipratropium is approved specifically for maintenance treatment of airflow obstruction in chronic obstructive pulmonary disease (COPD). Albuterol is not an anticholinergic; it is an adrenergic. Glycopyrrolate is not approved for inhalation. Atropine is not recommended for inhalation because of its widespread distribution in the body and the availability of the approved drug ipratropium bromide.

 

REF:   p. 123

 

2. The combination of albuterol and ipratropium bromide can be delivered by which of the following methods?
3. Tablet
4. Nebulizer
5. Injection
6. MDI
7. Soft-mist inhaler

 

a.	2 only
b.	1, 3, and 4 only
c.	1, 2, and 4 only
d.	2, 4, and 5 only

 

 

ANS:  D

Combivent is available in three formulations for bronchodilator use: as a hydrofluoroalkane-propelled MDI (HFA MDI) with 17 µg/puff, as a nebulizer solution of 0.02% concentration in a 2.5-ml vial, giving a 500-µg dose per treatment, and as a soft-mist propellant-free Respimat inhaler.

 

REF:   p. 123

 

3. Incruse Ellipta^® is approved for

a.	exacerbation of chronic obstructive pulmonary disease (COPD).
b.	thinning of dried secretions.
c.	acute bronchoconstriction.
d.	maintenance treatment of airflow obstruction in COPD.

 

 

ANS:  D

Umeclidinium (Incruse Ellipta) is a long-acting anticholinergic approved by the FDA for once-daily maintenance treatment of airflow obstruction in patients with COPD.

 

REF:   p. 123

 

4. Combivent^® is a combination drug including which two medications?

a.	Albuterol and salmeterol
b.	Salmeterol and ipratropium bromide
c.	Albuterol and ipratropium bromide
d.	Pirbuterol and ipratropium bromide

 

 

ANS:  C

Ipratropium and albuterol (Combivent^®) is a combination metered dose inhaler (MDI) product, with the usual doses of each agent (18 µg/puff of ipratropium, 90 µg/puff of albuterol).

 

REF:   p. 123

 

5. Cholinergic stimulation produces which of the following effects?
6. Bronchoconstriction
7. Increased mucus secretion
8. Miosis
9. Decreased heart rate
10. Salivation

 

a.	4 only
b.	1, 3, and 5 only
c.	2, 3, and 4 only
d.	1, 2, 3, 4, and 5

 

 

ANS:  D

Cholinergic stimulation of muscarinic receptors on airway smooth muscle and submucosal glands causes contraction and release of mucus. Miosis, bradycardia, and salivation are also potential effects of cholinergic stimulation.

 

REF:   p. 127