CHAPTER 17.

CHAPTER 17.Digoxin levels need to be monitored closely when the following medication is started: A.Loratadine B.Diphenhydramine C.Ipratropium D.Albuterol - answerD.Albuterol Patients with pheochromocytoma should avoid which of the following classes of drugs due to the possibility of developing hypertensive crisis? A. Expectorants B. Beta-2-agonists C. Antitussives D. Antihistamines - answerB. Beta-2-agonists Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all? A.Betamethasone, an inhaled corticosteroid B.Salmeterol, an inhaled long-acting beta-agonist C.Albuterol, a short-acting beta-agonist D.Montelukast, a leukotriene modifier - answerB.Salmeterol, an inhaled long-acting beta-agonist Long-acting beta-agonists (LTBAs) received a Black Box warning from the U.S. Food and Drug Administration due to the: A.Risk of life-threatening dermatological reactions B.Increased incidence of cardiac events when LTBAs are used C.Increased risk of asthma-related deaths when LTBAs are used D.Risk for life-threatening alterations in electrolytes - answerC.Increased risk of asthma-related deaths when LTBAs are used The bronchodilator of choice for patients taking propranolol is: A.Albuterol B.Pirbuterol C.Formoterol D.Ipratropium - answerD.Ipratropium James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin's diet for weight loss. The appropriate response would be: A. Congratulate him on making a positive change in his life B. Recommend he try stopping smoking instead of the Atkin's diet C. Schedule him for regular serum theophylline levels during his diet due to increased excretion of theophylline D.Decrease his theophylline dose because a high-protein diet may lead to elevated theophylline levels - answerC. Schedule him for regular serum theophylline levels during his diet due to increased excretion of theophylline Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would be to: A. Reassure him this is probably a viral infection and should be better soon B. Have him seen the same day for an assessment and theophylline level C. Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better D. Order a theophylline level at the lab for him - answerB. Have him seen the same day for an assessment and theophylline level Tiotropium bromide (Spiriva) is an inhaled anticholinergic: A. Used for the treatment of COPD B. Used in the treatment of asthma C. Combined with albuterol for treatment of asthma exacerbations D.Combined with fluticasone for the treatment of persistent asthma - answerA. Used for the treatment of COPD Christy has exercise and mild persistent asthma and is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (QVAR) is also prescribed. Teaching regarding her inhalers includes: A. Use one to two puffs of albuterol per day to prevent an attack with no more than eight puffs per day B. Beclomethasone needs to be used every day to treat her asthma C. Report any systemic side effects she is experiencing, such as weight gain D.Use the albuterol MDI immediately after her corticosteroid MDI to facilitate bronchodilation - answerB. Beclomethasone needs to be used every day to treat her asthma When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed: A.Montelukast twice a day is started when there is an asthma exacerbation B.Patients may experience weight gain on montelukast C.Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast D.Lethargy and hypersomnia may occur when taking montelukast - answerC.Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast Montelukast (Singulair) may be prescribed for: A.A 6 year old with exercise-induced asthma B.A 2 year old with moderate persistent asthma C.An 18 month old with seasonal allergic rhinitis D.None of the above; montelukast is not approved for use in children - answerB.A 2 year old with moderate persistent asthma The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include: A. Albuterol B. MMR vaccine C. Insulin D. None of the above - answerD. None of the above When educating patients who are starting on inhaled corticosteroids, the provider should include: A.They need to get any live vaccines before starting the medication. B.Inhaled corticosteroids need to be used daily during asthma exacerbations to be effective. C.Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush. D.They can triple the dose number of inhalations of medication during colds to prevent needing systemic steroids. - answerC.Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush. Patients with allergic rhinitis may benefit from a prescription of: A.Fluticasone (Flonase) B.Cetirizine (Zyrtec) C.OTC cromolyn nasal spray (Nasalcrom) D.Any of the above - answerD.Any of the above Howard is a 72-year-old male who occasionally takes diphenhydramine for his seasonal allergies. Monitoring for this patient taking diphenhydramine would include assessing for: A.Urinary retention B.Cardiac output C.Peripheral edema D.Skin for rash - answerA.Urinary retention Second generation antihistamines such as l