NR 565 VERIFIED EXAM QUESTIONS AND ANSWERS
Roflumilast MOA
selective action that inactivates cyclic adenosine monophosphate (cAMP) which results
in decreased cytokine release and subsequent lower levels of pulmonary infiltration by
neutrophils and other white blood cells
Roflumilast (Daliresp) Indication
not a first-line drug treatment and is reserved for severe cases of COPD with a primary
component of chronic bronchitis.
Bronchodilators: Anticholinergic Drugs Prototype Drugs
Ipratropium (inhaled, short acting; SAMA)
Tiotropium (inhaled, long acting; LAMA)
ipratropium/Tiotropium are anticholinergics, it is also considered a muscarinic receptor
antagonist as it relates specifically to the lungs. Blocks acetylcholine receptors and
prevents broonchospasm/bronchoconstriction.
Anticholinergic Drugs MOA
blocks acetylcholine, preventing bronchial constriction and narrowing of the airways,
which indirectly facilitates bronchodilation.
improve lung function by blocking muscarinic receptors in the bronchi, reducing
bronchoconstriction.
Anticholinergic Drugs Contraindication
patients with acute narrow-angle glaucoma or an enlarged prostate.
Nicotine-Free Products Smoking Cessation Products
Bupropion SR (Zyban); Varenicline (Chantix)
Bupropion SR (Zyban) MOA
an atypical antidepressant; blocks uptake of norepinephrine and dopamine.
Bupropion SR (Zyban) AE
,Dry mouth
Insomnia
Weight loss
Bupropion SR (Zyban) Contraindication
MAOIs
Wellbutrin
Use with caution in patients with history of seizure, anorexia nervosa, cocaine use, and
alcohol withdrawal.
Wellbutrin
Trade name of Bupropion when sold for depression; Same Drug
Bupropion SR (Zyban) Black Box Warning
Can cause serious neuropsychiatric effects, including mood changes, erratic behavior,
and suicidality. Should be used with caution in patients with a history of psychiatric
disease.
Bupropion SR (Zyban) Duration
Decrease use after 7-12 weeks
Varenicline (Chantix) MOA
partial agonist at nicotinic receptors, and most effective aid to smoking cessation
Varenicline (Chantix) AE
Nausea;
Can increase the risk for cardiovascular events (e.g., angina pectoris, peripheral
edema, hypertension, nonfatal myocardial infarction) in patients with stable
cardiovascular disease.
Varenicline (Chantix) Contraindication
Use by truck drivers, bus drivers, airplane pilots, and air traffic controllers is banned due
to unpredictable physical and psychiatric adverse effects. Monitor patients with known
cardiovascular disease closely.
Varenicline (Chantix) Duration
Decrease use after 12 weeks
Nicotine patch (NicoDerm CQ) Benefits
Nonprescription; provides a steady level of nicotine; easy to use; unobtrusive
, Nicotine patch (NicoDerm CQ) Duration
8-10 weeks
Nicotine patch (NicoDerm CQ) Patient Education
applied once a day to clean, dry, nonhairy skin of the upper body or upper arm. Site
should be changed daily and not reused for at least 1 week. patches are left in place for
24 hours and then immediately replaced with a fresh one
Nicotine gum (Nicorette, others) Benefits
Nonprescription; user controls dose;
Nicotine gum (Nicorette, others) Patient Education
chew the gum slowly and intermittently for approximately 30 minutes; should not eat or
drink while chewing or for 15 minutes before chewing
Nicotine gum (Nicorette, others) Duration
Use beyond 6 months is not recommended
Nicotine lozenge (Nicorette Lozenge, Thrive ) Benefits
Nonprescription; user controls dose; easier to use than nicotine gum
Nicotine lozenge (Nicorette Lozenge, Thrive ) Duration
Dosing should decrease over a period of 12 weeks
Dosing should stop after 12 weeks
Nicotine lozenge (Nicorette Lozenge, Thrive ) Patient Education
not eat or drink for 15 minutes before dosing and while in the mouth; should not chew or
swallow the lozenge
Nicotine nasal spray (Nicotrol NS) Benefit
User controls dose; fastest nicotine delivery and highest nicotine levels of all nicotine-
based products
Nicotine nasal spray (Nicotrol NS) Duration
After 3 months, taper use to complete cessation over additional 2-3 months
Nicotine inhaler (Nicotrol Inhaler, Nicorette Inhaler ) Benefit
User controls dose; mimics hand-to-mouth motion of smoking
Nicotine inhaler (Nicotrol Inhaler, Nicorette Inhaler ) Duration
Decrease use after 4-6 weeks
Isoniazid (INH)
Roflumilast MOA
selective action that inactivates cyclic adenosine monophosphate (cAMP) which results
in decreased cytokine release and subsequent lower levels of pulmonary infiltration by
neutrophils and other white blood cells
Roflumilast (Daliresp) Indication
not a first-line drug treatment and is reserved for severe cases of COPD with a primary
component of chronic bronchitis.
Bronchodilators: Anticholinergic Drugs Prototype Drugs
Ipratropium (inhaled, short acting; SAMA)
Tiotropium (inhaled, long acting; LAMA)
ipratropium/Tiotropium are anticholinergics, it is also considered a muscarinic receptor
antagonist as it relates specifically to the lungs. Blocks acetylcholine receptors and
prevents broonchospasm/bronchoconstriction.
Anticholinergic Drugs MOA
blocks acetylcholine, preventing bronchial constriction and narrowing of the airways,
which indirectly facilitates bronchodilation.
improve lung function by blocking muscarinic receptors in the bronchi, reducing
bronchoconstriction.
Anticholinergic Drugs Contraindication
patients with acute narrow-angle glaucoma or an enlarged prostate.
Nicotine-Free Products Smoking Cessation Products
Bupropion SR (Zyban); Varenicline (Chantix)
Bupropion SR (Zyban) MOA
an atypical antidepressant; blocks uptake of norepinephrine and dopamine.
Bupropion SR (Zyban) AE
,Dry mouth
Insomnia
Weight loss
Bupropion SR (Zyban) Contraindication
MAOIs
Wellbutrin
Use with caution in patients with history of seizure, anorexia nervosa, cocaine use, and
alcohol withdrawal.
Wellbutrin
Trade name of Bupropion when sold for depression; Same Drug
Bupropion SR (Zyban) Black Box Warning
Can cause serious neuropsychiatric effects, including mood changes, erratic behavior,
and suicidality. Should be used with caution in patients with a history of psychiatric
disease.
Bupropion SR (Zyban) Duration
Decrease use after 7-12 weeks
Varenicline (Chantix) MOA
partial agonist at nicotinic receptors, and most effective aid to smoking cessation
Varenicline (Chantix) AE
Nausea;
Can increase the risk for cardiovascular events (e.g., angina pectoris, peripheral
edema, hypertension, nonfatal myocardial infarction) in patients with stable
cardiovascular disease.
Varenicline (Chantix) Contraindication
Use by truck drivers, bus drivers, airplane pilots, and air traffic controllers is banned due
to unpredictable physical and psychiatric adverse effects. Monitor patients with known
cardiovascular disease closely.
Varenicline (Chantix) Duration
Decrease use after 12 weeks
Nicotine patch (NicoDerm CQ) Benefits
Nonprescription; provides a steady level of nicotine; easy to use; unobtrusive
, Nicotine patch (NicoDerm CQ) Duration
8-10 weeks
Nicotine patch (NicoDerm CQ) Patient Education
applied once a day to clean, dry, nonhairy skin of the upper body or upper arm. Site
should be changed daily and not reused for at least 1 week. patches are left in place for
24 hours and then immediately replaced with a fresh one
Nicotine gum (Nicorette, others) Benefits
Nonprescription; user controls dose;
Nicotine gum (Nicorette, others) Patient Education
chew the gum slowly and intermittently for approximately 30 minutes; should not eat or
drink while chewing or for 15 minutes before chewing
Nicotine gum (Nicorette, others) Duration
Use beyond 6 months is not recommended
Nicotine lozenge (Nicorette Lozenge, Thrive ) Benefits
Nonprescription; user controls dose; easier to use than nicotine gum
Nicotine lozenge (Nicorette Lozenge, Thrive ) Duration
Dosing should decrease over a period of 12 weeks
Dosing should stop after 12 weeks
Nicotine lozenge (Nicorette Lozenge, Thrive ) Patient Education
not eat or drink for 15 minutes before dosing and while in the mouth; should not chew or
swallow the lozenge
Nicotine nasal spray (Nicotrol NS) Benefit
User controls dose; fastest nicotine delivery and highest nicotine levels of all nicotine-
based products
Nicotine nasal spray (Nicotrol NS) Duration
After 3 months, taper use to complete cessation over additional 2-3 months
Nicotine inhaler (Nicotrol Inhaler, Nicorette Inhaler ) Benefit
User controls dose; mimics hand-to-mouth motion of smoking
Nicotine inhaler (Nicotrol Inhaler, Nicorette Inhaler ) Duration
Decrease use after 4-6 weeks
Isoniazid (INH)
